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Table 3 Factors potentially related to reported comfort during the final illness

From: Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study

 

n “comfortable”

/ total each group (%)

Unadjusted OR (95% C.I.)

Socio-Demographics

Age

145/180

 

 < 90 years old

62/78 (79)

1

 ≥ 90 years old

83/102 (81)

1.1 (0.5–2.4)

Sex

145/180

 

 Male

46/57 (81)

1

 Female

99/123 (80)

1.0 (0.4–2.2)

Marital statusa

143/178

 

 Married

31/38 (82)

1

 Widowed

98/123 (80)

0.9 (0.3–2.2)

 Single

14/17 (82)

1.1 (0.2–4.7)

School leaving agea

144/179

 

 ≤ 14 years old

90/115 (78)

1

 ≥ 15 years old

54/64 (84)

1.5 (0.7–3.4)

Social classab

143/178

 

 Non-manual

61/79 (77)

1

 Manual

82/99 (83)

1.4 (0.7–3.0)

Place of residence at last interviewc

145/180

 

 Home

104/134 (78)

1

 Long-term care

41/46 (89)

2.4 (0.9–6.5)

Location of End of Life Care

Place of care during final illnessc

145/180

 

 Hospital

55/75 (73)

1

 Home

24/33 (73)

1.0 (0.4–2.4)

 Long-term care

66/72 (92)

4.0 (1.5–10.7)

Place of deathc

145/180

 

 Hospital

59/85 (69)

1

 Home

17/19 (89)

3.7 (0.8–17.4)

 Long-term care

69/76 (91)

4.3 (1.8–10.7)

Places of care and death - transitions at the end of lifead

137/169

 

 Care in final illness: hospital

 Place of death: hospital

53/71 (75)

1

 Final illness: home

 Place of death: hospital

6/13 (46)

0.3 (0.1–1.0)

 Final illness: home

 Place of death: home

14/16 (88)

2.4 (0.5–11.5)

 Final illness: long-term care

 Place of death: long-term care

64/69 (93)

4.3 (1.5–12.5)

Place of death same as usual address

145/180

 

 No

76/105 (72)

1

 Yes

69/75 (92)

4.4 (1.7–11.2)

Health & Disability

Dementia status

145/180

 

 No dementia-cognitively intact

25/33 (76)

1

 Cognitively impaired +/− minimal/mild dem

61/81 (75)

1.0 (0.4–2.5)

 Moderate/severe dementia

59/66 (89)

2.7 (0.9–8.2)

Duration of final illnessa

145/180

 

 Less than a week

39/44 (89)

1

 7 days up to a month

62/80 (78)

0.4 (0.2–1.3)

 1 month or more

44/56 (79)

0.5 (0.2–1.5)

No. of hospital admissions/year since last interviewa

138/173

 

 None

79/98 (81)

1

 One or more

59/75 (79)

0.9 (0.4–1.9)

Functional disabilities in ADLs

145/180

 

 No basic or instrumental ADL disability

8/10 (80)

1

 Instrumental ADL disability only

14/ 20 (70)

0.6 (0.1–3.6)

 Basic + instrumental ADL disability

123/150 (82)

1.1 (0.2–5.7)

Receiving service support (excluding long-term care)a

100/130

 

 More than once a week

33/51 (65)

1

 Once a week

32/38 (84)

2.9 (1.0–8.3)

 None

35/41 (85)

3.2 (1.1–9.0)

Informants & Interviews

Informant’s sex

145/180

 

 Male

50/57 (88)

1

 Female

95/123 (77)

0.5 (0.2–1.2)

Informant’s relationship to participanta

143/178

 

 Husband or wife

15/18 (83)

1

 Son or daughter

78/97 (80)

0.8 (0.2–3.1)

 Other relative

8/12 (67)

0.4 (0.1–2.2)

 Friend

6/8 (75)

0.6 (0.1–4.5)

 Warden or matron

13/15 (87)

1.3 (0.2–9.0)

 Other

23/28 (82)

0.9 (0.2–4.4)

How often informant saw participant

145/180

 

 Lived with participant

24/29 (83)

1

 Daily

35/45 (78)

0.7 (0.2–2.4)

 More than once a week

45/55 (82)

0.9 (0.3–3.1)

 Once a week

18/22 (82)

0.9 (0.2–4.0)

 Less than once a week

23/29 (79)

0.8 (0.2–3.0)

Interval from last survey interview to death

145/180

 

 < median

73/90 (81)

1

 ≥ median

72/90 (80)

0.9 (0.4–1.9)

Interval from death to informant interview

145/180

 

 < median

70/90 (78)

1

 ≥ median

75/90 (83)

1.4 (0.7–3.0)

  1. Footnotes
  2. OR = Odds Ratio (shown to 1 decimal point)
  3. bold OR = significant (p < 0.05); italic bold OR = borderline significant (p = 0.5)
  4. 95% C.I. = 95% Confidence Interval (shown to 1 decimal point)
  5. ADL(s) = Activity (or Activities) of Daily Living
  6. aVariables in which categories total < 180 had missing data
  7. bSocial class categorised following contemporary UK Office of National Statistics grading of occupation reported at baseline interview: Non-manual = I, II or IIIa, Manual = IIIb, IV or V
  8. cHome: community-dwelling in a house, flat, ‘granny flat’ (part of a relative’s home) or sheltered accommodation
  9. Long-term care: in an older people’s residential home, nursing home or long-stay ward
  10. dTo explore the effects of transitions in place of care at the very end of life, the variable Places of care at the end of life was derived from data on where each individual was cared for during their final illness and where they died. Frequencies in other categories were too small (between 1 and 4 people) to calculate any estimates for other combinations of place of care
  11. End-of-life care in long-term care, avoiding transition between care settings at the end of life and not needing support from formal services were associated with dying comfortably, as reported by informants