How do our older adults die? The perception of family members about suffering in the last year of life

• Main Author: Assumpção,Daniela de
• Publication Date: 2023
• Other Authors: Francisco,Priscila Maria Stolses Bergamo, Seoanes,Gabriela Asenjo, Chierighini,Roberto, Silva,Larissa de Pontes, Neri,Anita Liberalesso
• Format: Article
• Language: eng
• Source: Geriatrics, Gerontology and Aging (Online)
• Download full: https://ggaging.com/details/1789
• topic: older adults; physical suffering; frailty; end of life; end-of-life care; health services.

<p><b>OBJECTIVES:</b> To characterize the signs and symptoms of suffering, the circumstances of death, and health service use in the 12 months prior to death in a cohort of community-dwelling older adults according to relatives&rsquo; perception, as well as to verify the relationships between baseline frailty and signs/symptoms of suffering in the last year of life.<br> <b>METHODS:</b> This retrospective cohort study used data from the Frailty in Older Brazilians (<i>FIBRA</i>) Study. Home interviews were carried out with the relatives of deceased older adults. Descriptive statistical analyses were performed, including adjusted prevalence ratios through Poisson regression.<br> <b>RESULTS:</b> A total of 192 family members participated (64.58% women). The mean age of the deceased was 80.59 years (59.90% women; 27.08% with no formal education). In the year before death, 51.34% had fatigue, 43.68% had pain, 42.63% had anorexia, 41.27% had dyspnea, and 41.21% suffered a fall. Most died either at home (52.10%) or in the hospital (41.66%). The most frequent causes of death were circulatory and respiratory system diseases and neoplasms; 29.63% died suddenly, 51.05% were admitted to an intensive care unit, 52.60% were hospitalized, 58.76% used pain medication, and 27.13% received home care. Relative to non-frailty, baseline frailty was associated with dependence (prevalence ratio = 2.52) and pain medication use (prevalence ratio = 1.52) in the last year of life.<br> <b>CONCLUSIONS:</b> Signs and symptoms of suffering in the last year of life were high among community-dwelling older adults, highlighting the need to support them and their families through provide palliative care.</p>