University of Oulu

Konttila, T., Finne-Soveri, U. H., Leskinen, R., Niemelä, K., & Antikainen, R. (2020). Progress in advance care planning among nursing home residents dying with advanced dementia—Does it make any difference in end-of-life care? Archives of Gerontology and Geriatrics, 86, 103955.

Progress in advance care planning among nursing home residents dying with advanced dementia : does it make any difference in end-of-life care?

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Author: Konttila, Tarja1,2; Finne-Soveri, Ulla Harriet3; Leskinen, Riitta2,4,5;
Organizations: 1Kuusamo Public Health Care, Kuusamo, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3National Institute for Health and Welfare, Helsinki, Finland
4Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
5Oulu City Hospital, Oulu, Finland
6Coronaria Hoiva Oy, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 5 MB)
Persistent link:
Language: English
Published: Elsevier, 2020
Publish Date: 2020-09-12


Background: Increased awareness of the clinical course of nursing home residents with advanced dementia and advance care planning (ACP) has become the cornerstone of good palliative care.

Objective: The aim of our study is to describe changes in ACP in the form of physician treatment orders (PTOs), symptom prevalence and possible burdensome interventions among nursing home (NH) residents who died between 2004–2009 and 2010–2013

Methods: Retrospective study.

Results: The number of PTOs regarding forgoing antibiotics or parenteral antibiotics, forgoing artificial nutrition or hydration or forgoing hospitalisation doubled between 2004–2009 and 2010–2013 (38.1% vs. 64.9%, p < 0.001; 40.0% vs. 81.7%, p < 0.001; 28.1% vs. 69.5%, p < 0.001, respectively). PTOs were also done significantly earlier in 2010–2013 than in 2004–2009. The prevalence of distressing symptoms and possible burdensome interventions remained unchanged, although the prevalence of consistency with the PTOs was high.

Conclusion: Despite the increased number of PTOs, this had little effect on symptom prevalence and possible burdensome interventions experienced by NH residents in the last days of life.

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Series: Archives of gerontology and geriatrics
ISSN: 0167-4943
ISSN-E: 1872-6976
ISSN-L: 0167-4943
Volume: 86
Article number: 103955
DOI: 10.1016/j.archger.2019.103955
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Copyright information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http:/