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Understanding Factors that Influence Why People with Dementia Make Transitions from the Community to Acute Hospital Care Settings in the Last Months of Life

Project U-Care

This retrospective cohort study uses routine data to understand why people with dementia move between healthcare settings (termed a ‘transition’) in the months preceding their deaths.

Aims

To determine the relative individual, illness-related, and environmental factors associated with burdensome transitions for people with dementia in their last year of life, to inform effective public health policies to improve care towards the end of life for this growing population. 

Methods

We will use data that has already been collected as part of hospital and administrative systems to explore the factors associated with burdensome transitions for people with dementia in the last months of life. These factors will be classified according to whether they are related to the individual themselves (e.g. age, ethnicity), to the illness (e.g. mental function, physical function), or to the environment (e.g. local services available). We will use statistical techniques to understand the relative importance of these factors and build a model of how they interact. The results will be used to inform health policies, in order to reduce burdensome transitions for people with dementia close to the end of life. 

Publications

Policy brief: A right to be heard: Better palliative and end-of-life care for people affected by dementia

Sleeman KE, Perera G, Stewart R, Higginson IJ. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. Alzheimers Dement. 2018 Jan;14(1):20-27 https://pubmed.ncbi.nlm.nih.gov/28838779/

Leniz J, Higginson IJ, Stewart R, Sleeman KE. Understanding which people with dementia are at risk of inappropriate care and avoidable transitions to hospital near the end-of-life: a retrospective cohort study. Age Ageing. 2019 Sep 1;48(5):672-679. https://pubmed.ncbi.nlm.nih.gov/31135024/

Publications

Policy brief: A right to be heard: Better palliative and end-of-life care for people affected by dementia

Sleeman KE, Perera G, Stewart R, Higginson IJ. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. Alzheimers Dement. 2018 Jan;14(1):20-27 https://pubmed.ncbi.nlm.nih.gov/28838779/

Leniz J, Higginson IJ, Stewart R, Sleeman KE. Understanding which people with dementia are at risk of inappropriate care and avoidable transitions to hospital near the end-of-life: a retrospective cohort study. Age Ageing. 2019 Sep 1;48(5):672-679. https://pubmed.ncbi.nlm.nih.gov/31135024/

Project status: Ongoing

Principal Investigator

  • Image of Katherine Sleeman

    Katherine Sleeman

    Laing Galazka Chair in Palliative Care, Honorary Consultant in Palliative Medicine

Investigators

  • Image of Irene Higginson

    Irene Higginson

    Executive Dean, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care

  • R Stewart (colour)

    Robert Stewart

    Professor of Psychiatric Epidemiology & Clinical Informatics

  • Deok Hee Yi

    Health Economist

Funding

Funding Body: National Institute for Health Research

Amount: £794,133.00

Period: March 2016 - August 2021

Keywords

PALLIATIVE CAREEND OF LIFE CAREDEMENTIAROUTINE DATATRANSITIONS