RESUMO
AIM: Although the facilities for end-of-life care in the special elderly (SE) nursing home are increasing, there are no standard guidelines for end-of-life care interventions. Furthermore, in the SE nursing home, there are not enough data concerning those who have had end-of-life care and/or emergency hospital palliative therapy. Therefore, we compared the clinical outcome of end-of-life care patients and emergency palliative therapy patients. PARTICIPANTS: Five end-of-life care patients (99+/-10 years old) in the SE nursing home, and 48 emergency palliative therapy patients (89+/-15 years old) in the hospitals. RESULTS: All end-of-life care patients are still living after 300+/-70 days by standard nursing care (mainly fluid diets with small doses of vasodilators and antibiotics) with bed side music. Their average CRP values in terminal end-of-life care patients decreased from 10+/-12 mg/dl to 1.2+/-0.5 (p<0.05), serum albumin levels increased from 2.7+/-1.6 g/dl to 3.5+/-2.6 and body mass index increased from 16+/-1.6 to 18.3+/-0.75 (p<0.05). Among 48 emergency hospitalized palliative patients, 32 patients were discharged to our facility after 120+/-26 days of hospitalization, whereas 16 patients died in hospital after 100+/-36 days of hospitalization (aspiration pneumonia: 11 patients, heart failure: 3 patients and G-I causes: 2 patients). CONCLUSION: End-of-life care in the SE nursing home prolonged their life expectancy despite centenarian status. Hospital mortality rates of palliative emergency therapy were higher than usual end-of-life care. These data suggest that end-of-life care interventions, including bed side music, could provide physical satisfaction.
