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The last days of life of nursing home patients with and without dementia assessed with the Palliative care Outcome Scale

Departments of Nursing Home Medicine and Public and Occupational Health and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam

Luc Deliens

Department of Public and Occupational Health and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam; Department of Medical Sociology and Health Sciences, End-of-life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium

Jenny T van der Steen

Departments of Nursing Home Medicine and Public and Occupational Health and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam

Marcel E Ooms

Miel W Ribbe

Department of Nursing Home Medicine and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam

Gerrit vander Wal

Department of Public and Occupational Health and Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands

The aim of this study was to assess the Palliative care Outcome Scale (POS) for terminally ill nursing home (NH) patients in the Netherlands.

Methods: A prospective observational study of patients with a life-expectancy of six weeks or less in 16 Dutch NHs. NH staff rated the patient characteristics and measured palliative care with the POS, including items on physical, psychosocial, informational, spiritual and practical aspects.

Results: POS nonscores (not applicable; unknown) were mainly found in the psychosocial and spiritual domains, particularly in patients with dementia. Mean scores for non-demented patients and patients with dementia were favourable for the majority of the POS items.

Conclusion: According to the NH staff, fairly good quality care was provided, but the psychosocial and spiritual aspects of care need to be addressed more in the last days of the dying NH patient's life. The results indicate that the POS is an appropriate instrument to assess not only cancer patients, but also non-cancer and (moderately) severely demented patients.

Key Words: quality of care • nursing home • palliative care outcome scale (POS) • demented patients • last days of life

Palliative Medicine, Vol. 19, No. 4, 334-342 (2005)
DOI: 10.1191/0269216305pm1018oa


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