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Am J Geriatr Psychiatry. 2019 Feb;27(2):162-166. doi: 10.1016/j.jagp.2018.11.011. Epub 2018 Dec 5.

Characteristics of Hospice Referrals From an Inpatient Geriatric Psychiatry Unit.

Author information

1
Division of Geriatric Psychiatry (JMW, EKG, BPF), McLean Hospital, Belmont, MA; Department of Psychiatry (JMW, BPF), Harvard Medical School, Boston. Electronic address: jwilkins1@partners.org.
2
Division of Geriatric Psychiatry (JMW, EKG, BPF), McLean Hospital, Belmont, MA.
3
Division of Geriatric Psychiatry (JMW, EKG, BPF), McLean Hospital, Belmont, MA; Department of Psychiatry (JMW, BPF), Harvard Medical School, Boston.

Abstract

OBJECTIVE:

Geriatric psychiatrists who treat neuropsychiatric symptoms of dementia are in the unique position of offering palliation to people with terminal illness in whom neuropsychiatric symptoms may be indicators of the illness's end stage (e.g., feeding problems). Little is known, however, about the characteristics of hospice referrals from inpatient geriatric psychiatry units.

METHODS:

This was a retrospective chart review of patients with dementia admitted to an inpatient geriatric psychiatry unit and referred to hospice on discharge.

RESULTS:

Patients were referred to hospice because of feeding problems, with oral intake insufficient to sustain life. Most patients (78%) died within 31 days of discharge, and all patients (100%) died within 6 months of discharge.

CONCLUSION:

The results from this study support a symptom-based approach to hospice referral for people with dementia, as opposed to prognostic estimation, where certain symptom clusters may indicate a more rapidly progressing course.

KEYWORDS:

Hospice; dementia; inpatient hospitalization; neuropsychiatric symptoms

PMID:
30583918
DOI:
10.1016/j.jagp.2018.11.011

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