Near Life's End, Older Patients Benefit from Aid with Daily Activities

(PhysOrg.com) -- Yale researchers have found that services to assist with daily living activities such as bathing, dressing and walking, are needed for all older persons at the end of life, regardless of the conditions leading to their deaths. The team also found that these services are needed most for older persons dying from advanced dementia.

Published in the current issue of the New England Journal of Medicine, the study tracked the course of disability in activities of daily living among older persons and their families. The results are part of the ongoing Precipitating Events Project (PEP) at Yale, which seeks to better understand how older persons manage day-to-day activities and remain independent at home. The PEP study includes 754 participants age 70 and older from the Greater New Haven area.

The researchers followed the participants with monthly telephone interviews for over 10 years to determine the occurrence of disability. They evaluated the ability to complete essential activities of daily living in the last year of the lives of 383 participants who had died.

Lead author of the study, Thomas M. Gill, M.D., the Humana Foundation Professor of Geriatric Medicine at Yale School of Medicine, and his team sought to identify distinct patterns of disability in the last year of life and to determine whether and how these patterns differ according to the condition leading to death.

“We found that the need for services to aid in activities of daily living is at least as great for older persons dying from organ failure and frailty as for those dying from more traditional terminal conditions such as cancer,” said Gill. “We also found that the burden of disability in the last year of life was greatest among participants who died from advanced dementia.”