Unmet Palliative Care Needs Among Patients with Dementia at the End of Life and Frequent Use of the Emergency Department: One-Year Retrospective Study in a Central Hospital.

Abstract

<b><i>Background:</i></b> The use of emergency departments (ED) by patients with dementia at the end-of-life (EOL) presents various challenges. <b><i>Objective:</i></b> To evaluate the prevalence of unmet palliative care (PC) needs among patients with dementia who use the ED at their EOL. <b><i>Methods:</i></b> A single-center, retrospective study analyzing ED visits in the last 12 months of life among patients with dementia who died in 2021 (359 patients, 1042 ED visits) in Portugal. Unmet PC needs were assessed using the Palliative Care and Rapid Emergency Screening tool (P-CaRES). <b><i>Results:</i></b> Unmet PC needs were highly prevalent (78.2%). Dyspnea (30.9%) was the prevailing reason for ED visits; 29.5% of patients were considered frequent ED users. The association between P-CaRES status and frequent ED use was nonsignificant (<i>p</i> = 0.47). <b><i>Discussion:</i></b> The high prevalence of unmet PC needs and frequent ED use highlights the need for better responding to these needs.