Differences in care received by patients with and without dementia who died during acute hospital admission: a retrospective case note study

Abstract

SIR—Dementia is a malignant and ultimately fatal condition, yet may not be viewed as such [1]. One-third of patients aged between 75 and 84 years with Mini Mental State Examination (MMSE) [2] scores of 19–23 will die within a year [3]. The acute admission of a person with dementia to the general hospital setting increases mortality even further and over half of patients with moderately severe dementia (MMSE cutoff 17/18) admitted with hip fracture or pneumonia will die within 6 months [4]. The incidence of dementia from all causes increases with age, the number of older people is increasing and therefore more patients with dementia will be admitted to, and die on, acute hospital wards. Little is known about the experience of dying dementia patients in the acute hospital setting, although a recent Royal Commission report suggested that they receive sub-optimal care [5] and their religious and spiritual needs are neglected [6].