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A brand new examine by researchers from Duke-NUS Medical College has revealed that the majority community-dwelling older adults with superior dementia in Singapore expertise at the least one probably burdensome intervention of their final 12 months of life. The findings spotlight an pressing want for brand new methods to assist households and scale back pointless interventions on the finish of life.
Though the variety of people dwelling with dementia within the Asia-Pacific area is projected to rise to 71 million by 2050, present understanding of the final 12 months of life with dementia is usually knowledgeable by research performed in western contexts.
Printed within the Journal of Gerontology: Medical Sciences, the examine, inspecting people with dementia’s care expertise of their final 12 months of life in Singapore, discovered that 92% of older adults with superior dementia skilled burdensome interventions equivalent to feeding tubes or restraints—approaches that consultants say could not enhance consolation or survival.
From surveys, the researchers discovered that the beneath key points affected the standard of end-of-life care skilled by older adults with dementia dwelling at dwelling:
A. Overreliance on burdensome medical interventions: Almost all older adults skilled taxing interventions of their last 12 months of life, together with antibiotics (49%), IV fluids (22%), and feeding tubes, restraints or each (74%). The proportion of tube-fed older adults was considerably increased than in western contexts, and tube feeding usually triggers the usage of bodily restraints to forestall tube elimination. Medical pointers suggest cautious hand feeding as a substitute of tube feeding.
B. Excessive hospitalization price: Virtually half (48%) of older adults have been hospitalized for at the least an evening of their last 12 months, and 35% died in hospital—proportions notably increased than in western research the place long-term care services equivalent to nursing houses are the first place of dying. Such elevated hospitalization can expose sufferers to taxing and dear care experiences with restricted scientific profit.
C. Heavy burden on casual caregivers: Relations bore the brunt of care, with 42% offering at the least 60% of complete care for his or her family members with dementia, and 30% quitting their jobs to take action. Caregivers offered a mean of 42 hours of care per week—greater than a full-time job—equal to an annual wage of S$32,125.
D. Inadequate caregiving assist: A majority of caregivers (62%) reported receiving insufficient info when making care or remedy choices, and solely 15% have been instructed how for much longer their family members may reside. The findings spotlight essential gaps in caregiver communication and end-of-life preparedness.
The info was culled from a longitudinal cohort, titled Panel examine Investigating Standing of Cognitively impaired Aged in Singapore (PISCES), wherein the researchers surveyed household caregivers of people with superior dementia each 4 months, between 2018 and 2023.
Caregivers additionally usually agreed (98%) that consolation was a main care objective, nonetheless, near a 3rd (31%) of caregivers—principally youngsters of the older adults—thought-about prolonging life a precedence.
Dr. Ellie Bostwick Andres, first creator of the paper and a senior analysis fellow from the Lien Heart for Palliative Care at Duke-NUS, mentioned, “Our study highlights a mismatch between caregivers’ stated values and the reality of older adults’ experience in their last year of life. Frequent hospitalizations and the widespread use of interventions generally deemed ‘low-value’ among older adults living at home highlights the need to adopt a palliative approach at home to alleviate symptoms and minimize burden on older adults and their caregivers.”
Dr. Andres additionally mentioned that as reliance on household caregivers will increase in an growing older society like Singapore, extra must be performed to assist and equip household caregivers to offer compassionate care for his or her family members at dwelling.
Senior creator, Affiliate Professor Chetna Malhotra and Analysis Director on the Duke-NUS’ Lien Heart for Palliative Care, added, “In Asia, cultural values shape approaches towards caring for end-of-life individuals with dementia living at home. For instance, children with strong filial values may be more inclined to try to help their parents live longer instead of opting for a palliative approach. This means that strategies to promote palliative care need to be driven by caregiver education and tailored to the region.”
Insights from the workforce’s examine are actually getting used to curate instruments that assist caregivers—together with CareBuddy, a cellular software that promotes wholesome and sleek growing older, and resolution aids that assist them make knowledgeable care choices for his or her family members.
Professor Patrick Tan, Duke-NUS’ Dean-designate and Senior Vice-Dean for Analysis, mentioned, “These findings reveal the human reality of dementia care in Asia—one defined by love, sacrifice, and difficult choices. As more older adults spend their final days at home, it’s critical that we build systems of care that show compassion not only to patients, but also to their caregivers who sustain them.”
Extra info:
Ellie B Andres et al, The ultimate 12 months for community-dwelling older adults with dementia in an Asian setting: admissions, interventions, and caregiver burden, The Journals of Gerontology, Collection A: Organic Sciences and Medical Sciences (2025). DOI: 10.1093/gerona/glaf227
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Research exhibits over 90% of older adults with dementia endure burdensome interventions of their last 12 months (2025, November 17)
retrieved 17 November 2025
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