{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:10:50Z","timestamp":1789002650800,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While transfer of aged care facility (ACF) residents to an acute hospital is sometimes necessary, for those at end of life this can cause fragmented care and disruption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the characteristics of ACF residents transferred to hospital in the last 24 h of life and factors that might influence this decision, including access to medical review, advance care planning (ACP) and pre\u2010emptive symptom management prescribing, an area not previously researched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational audit of ACF residents transferred to a metropolitan hospital between 2012 and 2017 who died within 24 h of transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 149 patients met the criteria. The median age was 87 years, and 63 (42%) were male. Eighty\u2010three (56%) were transferred \u2018out\u2010of\u2010hours\u2019, the majority (71%) having no medical review in the 24 h prior, and 43 (29%) died within 4 h of arrival. The most common reasons for transfer were dyspnoea (46%) and altered conscious state (32%), and the most common cause of death was pneumonia (37%). Some form of ACP documentation was available in 48%. Of the 86 (58%) patients who required injectable opioid for symptom management in hospital, only 7 (8%) had this pre\u2010emptively prescribed on their ACF medication chart.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Appropriate decision\u2010making around hospital transfers and end\u2010of\u2010life care for ACF residents may be influenced by access to professionals able to diagnose dying and access to appropriate symptom management medications. ACP is important, but often requires the aforementioned to be enacted. Further research is needed to better inform how we can identify and meet the end\u2010of\u2010life care needs of this cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15084","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T12:45:25Z","timestamp":1601901925000},"page":"27-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Care to the end: a retrospective observational study of aged care facility residents transferred to hospital in the last day of life"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-5372","authenticated-orcid":false,"given":"Hannah","family":"Brownstein","sequence":"first","affiliation":[{"name":"Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Hayes","sequence":"additional","affiliation":[{"name":"Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrita","family":"Simadri","sequence":"additional","affiliation":[{"name":"Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Tacey","sequence":"additional","affiliation":[{"name":"Northern Health  Melbourne Victoria Australia"},{"name":"Melbourne University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwina","family":"Holbeach","sequence":"additional","affiliation":[{"name":"Northern Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2007.0224"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gln034"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2013.03.009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.03.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314535962"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.05.012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1345"},{"key":"e_1_2_6_9_1","unstructured":"Australian Bureau of Statistics (ABS). 2016 Census QuickStats: Whittlesea. Canberra: ABS; 2016 [cited 2020 Jul 21]. Available from URL:https:\/\/quickstatscensusdataabsgovau\/census_services\/getproduct\/census\/2016\/quickstat\/LGA27070?opendocument"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3954"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","unstructured":"LynnJ AdamsonD. Living well at the end of life: adapting health care to serious chronic illness in old age. Santa Monica CA; RAND Corporation;2003[cited 2020 Jul 23]. Available from URL:https:\/\/www.rand.org\/pubs\/white_papers\/WP137.html","DOI":"10.7249\/WP137"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.12.017"},{"key":"e_1_2_6_13_1","unstructured":"BuckK DeteringK SellarsM SinclairC WhilteB KellyHet al. Prevalence of advance care planning documentation in Australian health and residential aged care services. Melbourne: Advance Care Planning Australia;2019. Available from URL:https:\/\/www.advancecareplanning.org.au\/docs\/default-source\/acpa-resource-library\/acpa-publications\/report-national-acd-prevalence-study-2019.pdf"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2016-001225"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13886"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13572"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw267"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.07.032"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12162"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2011-000178"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.15084","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.15084","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.15084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T03:44:10Z","timestamp":1693712650000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.15084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/imj.15084"],"URL":"https:\/\/doi.org\/10.1111\/imj.15084","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"assertion":[{"value":"2020-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}