Patterns of care in the last two years of life (Pehmeäkantinen kirja)

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In old age people have more disabilities and diseases than at younger age which increases the need for and use of different care services. With approaching death people use more care services than at the earlier stages of life. Besides the age and closeness of death, the use of care among old people is associated with gender, morbidity and service supply. When people use different services they might move from one care facility to another, or have several readmissions from home. What is not known, however, is what the patterns of care are, including the frequency of care transitions across the care settings, and the places of death. The aim of this study was to discover the frequency and type of care transitions in the last two years of life, the places of death, how dementia affects the number of care transitions, and how age, gender, municipality of residence, and different care sites contribute to the number of care transitions in the last two years of life.

The data were collected from The Care Register for Health Care, The Care Register for Social Welfare, and The Causes of Death Register. Data included all those who died at the age of 70 or older in the years 1998, 2002-2008, and a 40% random sample of those who died during the years 1999-2001. Care transitions could be followed for 730 days preceding death for each individual. The care services included in analyses were health center inpatient wards, residential care including nursing homes and sheltered housing with 24-hour assistance, general hospitals, and university hospitals.

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