Predicting hospice appropriateness for nursing home residents with dementia in Korea: A systematic review approach

Abstract

Background: Korea is one of the fastest aging societies; the number of elderly who die due to Alzheimer dementia has increaseddramatically. The benefits of hospice care were recognized in effective pain management, advance-care planning, decreasedhospitalization, decreased aggressive treatment, and increased job satisfaction. To estimate life expectancy of residents withdementia precisely is difficult, exacerbating the ability to provide palliative care for residents with dementia. However, theunderuse of hospice care in nursing homes (NHs) is a major problem in Korea. Few researchers have identified the needs ofpeople dying with dementia in NHs in Korea. The purpose of this paper was to review and discuss hospice-eligibility assessmenttools.

Methods: Four tools were available for discussion at the point of investigation: the Functional Assessment Staging Scale,Alzheimer’s Hospice Placement Evaluation Scale, Advanced Dementia Prognostic Tool from the U.S. Hospice Medicare guidelines,and Global Deterioration Scale.

Results: Major problems are underuse of hospice care and lack of guidelines to assess hospice in patients with dementia inKorea.

Conclusion: Successfully categorizing elders with dementia as hospice enrollees in Korea will improve the quality of end-of-lifecare for increasing numbers of elders with dementia and their family members.