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End of Life Care in Pflegeeinrichtungen

  • Alexander M. Fassmer ORCID logo EMAIL logo , Guido Schmiemann and Falk Hoffmann
Published/Copyright: February 25, 2023

Zusammenfassung

Pflegeheimbewohner werden in ihrer letzten Lebensphase häufig ins Krankenhaus verlegt – eine oftmals vermeidbare Belastung für Betroffene und Angehörige. Dieser Artikel widmet sich den aktuellen Daten aus Deutschland und diskutiert als wichtigste Verbesserungen eine bessere Palliativversorgung und den Ausbau der vorausschauenden Versorgungsplanung. Zusätzlich wird die Situation mit den Niederlanden verglichen, wo die Ausmaße dieses Versorgungsproblem weitaus geringer sind.

Abstract

Nursing home residents are frequently transferred to hospital in their end-of-life phase - an often avoidable burden for those affected and their relatives. This article focuses on the current data from Germany and discusses better palliative care and the expansion of advance care planning as the most important improvements. In addition, the situation is compared with the Netherlands, where the extent of this care problem is considerably lower.

  1. Autorenerklärung

  2. Autorenbeteiligung: Alle Autoren tragen Verantwortung für den gesamten Inhalt dieses Artikels und haben der Einreichung des Manuskripts zugestimmt. Finanzierung: Das Projekt wurde gefördert durch den Innovationsfonds des Gemeinsamen Bundesausschusses (FKZ: 01VSF16043). Interessenkonflikt: Die Autoren erklären, dass kein wirtschaftlicher oder persönlicher Interessenkonflikt vorliegt. Ethisches Statement: Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Die Studien wurden von der Ethikkommissionen der Ärztekammer Bremen (RA/RE-613, 16. Februar 2018), der medizinischen Ethikkommission der Carl von Ossietzky Universität Oldenburg (2018–080 und 2018–147) sowie der Datenschutzbeauftragten der Universität Bremen (6. März 2018) zugelassen.

  3. Author Declaration

  4. Author contributions: All authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Funding: The project was funded by the Innovation Fund coordinated by the Innovation Committee of the Federal Joint Committee in Germany (grant number: 01VSF16043). Conflict of interest: Authors state no conflict of interest. Ethical statement: For the studies listed, the ethical guidelines given in each case apply. The studies were approved by the ethics committee of the Medical Association of Bremen (RA/RE-613, February 16, 2018), medical ethics committee of the Carl von Ossietzky University of Oldenburg in Germany (2018–080 and 2018–147) and the Data Protection Officer of the University of Bremen (March 6, 2018).

Literatur

1. Statistisches Bundesamt. Pflegestatistik 2019. Pflege im Rahmen der Pflegeversicherung. Deutschlandergebnisse. Wiesbaden, 2020.Search in Google Scholar

2. Pivodic L, Smets T, Van den Noortgate N, Onwuteaka-Philipsen BD, Engels Y, Szczerbińska K, et al. Quality of dying and quality of end-of-life care of nursing home residents in six countries: an epidemiological study. Palliat Med 2018;32:1584–95.10.1177/0269216318800610Search in Google Scholar PubMed PubMed Central

3. Hoffmann F, Allers K. Hospitalization of nursing home residents in the last phase of life: an analysis of health insurance data. Z Gerontol Geriatr 2021;54:247–54.10.1007/s00391-020-01716-3Search in Google Scholar PubMed PubMed Central

4. Hoffmann F, Allers K. Ten-year trends in end-of-life hospitalizations of nursing home residents in Germany, 2006–2015. Maturitas 2020;134:47–53.10.1016/j.maturitas.2020.02.006Search in Google Scholar PubMed

5. Allers K, Hoffmann F, Schnakenberg R. Hospitalizations of nursing home residents at the end of life: a systematic review. Palliat Med 2019;33:1282–98.10.1177/0269216319866648Search in Google Scholar PubMed PubMed Central

6. Allers K, Fassmer AM, Spreckelsen O, Hoffmann F. End-of-life care of nursing home residents: a survey among general practitioners in northwestern Germany. Geriatr Gerontol Int 2020;20:25–30.10.1111/ggi.13809Search in Google Scholar PubMed

7. Strautmann A, Allers K, Fassmer AM, Hoffmann F. Nursing home staff’s perspective on end-of-life care of German nursing home residents: a cross-sectional survey. BMC Palliat Care 2020;19:2.10.1186/s12904-019-0512-8Search in Google Scholar PubMed PubMed Central

8. Lemoyne SE, Herbots HH, De Blick D, Remmen R, Monsieurs KG, Van Bogaert P. Appropriateness of transferring nursing home residents to emergency departments: a systematic review. BMC Geriatr 2019;19:17.10.1186/s12877-019-1028-zSearch in Google Scholar PubMed PubMed Central

9. Appelmann I, Hoffmann-Menzel H. Spezialisierte ambulante Palliativversorgung (SAPV). Schmerz 2022;36:371–80.10.1007/s00482-022-00662-wSearch in Google Scholar PubMed

10. Fassmer AM, Pulst A, Schmiemann G, Hoffmann F. Sex-specific differences in hospital transfers of nursing home residents: results from the HOspitalizations and eMERgency Department Visits of Nursing Home Residents (HOMERN) Project. Int J Environ Res Public Health 2020;17:3915.10.3390/ijerph17113915Search in Google Scholar PubMed PubMed Central

11. Deutsche Gesellschaft zur Palliativmedizin. Deutsche Gesellschaft zur Palliativmedizin: Definitionen zur Hospiz-und Palliativversorgung Vorbemerkung, 2016.Search in Google Scholar

12. Reyniers T, Houttekier D, Cohen J, Pasman HR, Deliens L. What justifies a hospital admission at the end of life? A focus group study on perspectives of family physicians and nurses. Palliat Med 2014;28:941–8.10.1177/0269216314522317Search in Google Scholar PubMed

13. Teno JM, Gozalo P, Mitchell SL, Bynum JP, Dosa D, Mor V. Terminal hospitalizations of nursing home residents: Does facility increasing the rate of do not resuscitate orders reduce them? J Pain Symptom Manage 2011;41:1040–7.10.1016/j.jpainsymman.2010.07.014Search in Google Scholar PubMed PubMed Central

14. Deutscher Hospiz- und PalliativVerband e.V. ADVANCE CARE PLANNING (ACP) in stationären Pflegeeinrichtungen. Eine Einführung auf Grundlage des Hospiz- und Palliativgesetzes (HPG), 2016. https://www.dhpv.de/tl_files/public/Service/Broschueren/Handreichung_ACP.pdf. Accessed: 3 Feb 2021.Search in Google Scholar

15. Martin RS, Hayes B, Gregorevic K, Lim WK. The effects of advance care planning interventions on nursing home residents: a systematic review. J Am Med Dir Assoc 2016;17:284–93.10.1016/j.jamda.2015.12.017Search in Google Scholar PubMed

16. Walther W, Müller-Mundt G, Wiese B, Schneider N, Stiel S. Providing palliative care for residents in LTC facilities: an analysis of routine data of LTC facilities in Lower Saxony, Germany. BMC Palliat Care 2022;21:111.10.1186/s12904-022-00998-1Search in Google Scholar PubMed PubMed Central

17. Honinx E, Piers RD, Onwuteaka-Philipsen BD, Payne S, Szczerbińska K, Gambassi G, et al. Hospitalisation in the last month of life and in-hospital death of nursing home residents: a cross-sectional analysis of six European countries. BMJ Open 2021;11:e047086.10.1136/bmjopen-2020-047086Search in Google Scholar PubMed PubMed Central

18. Schols JM, Frijters DH, Kempen RG, Hamers JP. Quality monitoring of long-term care in The Netherlands. Regul Long-Term Care Qual An Int Comp 2014:211–39.10.1017/CBO9781107323711.012Search in Google Scholar

19. Schröder A-K, Fassmer AM, Allers K, Hoffmann F. Needs and availability of medical specialists’ and allied health professionals’ visits in German nursing homes: a cross-sectional study of nursing home staff. BMC Health Serv Res 2020;20:332.10.1186/s12913-020-05169-7Search in Google Scholar PubMed PubMed Central

20. Hoek JF, Ribbe MW, Hertogh CM, Van Der Vleuten CP. The role of the specialist physician in nursing homes: the Netherlands’ experience. Int J Geriatr Psychiatry 2003;18:244–9.10.1002/gps.816Search in Google Scholar PubMed

Online erschienen: 2023-02-25
Erschienen im Druck: 2023-02-23

©2023 Walter de Gruyter GmbH, Berlin/Boston

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