Formal service utilization by the frail elderly at home during the last 6 months of life

Abstract

The purpose of this study was to examine how the use of medical/social services by elderly persons changes over time as they approach death. This research was conducted at a public visiting nursing office in Tokyo. Nursing records of all elderly persons, those who died at home or died within 1 week of hospital admission between April 1993 and June 1997 were reviewed. The percent of patients using each type of medical or social service was calculated for three time periods before death: more than 6 months, 1–6 months and within 1 month. This retrospective examination clearly demonstrates a shift in specific service usage by elderly persons during the months prior to death. As terminal illness becomes more advanced, the use of medical services increases more remarkably than the use of social services. The increase in nurse visits is far greater than that of home aid visits. Visiting nurses should demonstrate their skills of care appropriate to the changeable conditions of the elderly and their families in the terminal stage.