Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Survival Differences Amongst Nursing Home Residents with Life-Limiting Illness Under Home Hospice Follow Up (119831)

Yun Cao 1 , Bao Yu Pang 2 , Grace O Silva 3 , Ling Ling Soh 3 , Wei Ting Chen 4 , WP Lester Leong 3 , YO Ian Leong 3 , Wee Shiong Lim 1 5 , Joshua S Lee 3 5
  1. Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
  2. Ministry of Health Holdings, Singapore
  3. Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore
  4. Population Health Campus, National Healthcare Group, Singapore
  5. Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore

Aims

Many nursing home residents have life-limiting illness.1,2 We aimed to determine the difference in survival between nursing home residents who were enrolled into a home hospice programme with incurable cancer, end-stage organ failure and advanced dementia/frailty, as well as the difference in healthcare utilisation between them at the last 6 months of life.

 

Methods

We conducted a retrospective cohort study of 475 nursing home residents enrolled between March 2022 to February 2024 and followed up until February 2025. Survival was analysed using Kaplan-Meier Curves and Cox regression analysis. Difference in healthcare utilization was analysed using analysis of variance.

 

Results

There were 321 decedents. The median survival of residents with advanced dementia/frailty (479 days, CI:385–572 days, P=0.002) was longer compared to residents with incurable cancer (245 days, CI:165–325 days, P=0.002) and end stage organ failure (229 days, CI:70-388 days, P=0.002). Residents with incurable cancer (HR 1.52, CI:1.04-2.21, P=0.03) and end-stage organ failure (HR 1.51, CI:1.07-2.23, P=0.02) were more likely to demise during the follow up period. Residents with advanced dementia/frailty had fewer in person reviews (2.41, P<0.001), compared to those with incurable cancer (4.67, P<0.001) and end-stage organ failure (3.43, P<0.001). There was no difference in number of hospitalizations and emergency department visits.


Conclusion

Nursing home residents with advanced dementia/frailty lived longer compared to residents with incurable cancer and end-stage organ failure. Providers of palliative care would need to adjust service planning and allocate resources adequately in response to the longer follow up period required for this group of residents.

  1. 1. Ersek, M. & Carpenter, J. G. Geriatric Palliative Care in Long-Term Care Settings with a Focus on Nursing Homes. J Palliat Med 16, 1180–1187 (2013)
  2. 2. Mitchell, S. L., Teno, J. M., Miller, S. C. & Mor, V. A National Study of the Location of Death for Older Persons with Dementia. J Am Geriatr Soc 53, 299–305 (2005).