How do the elderly die in very fast ageing territories? The case of the French overseas departments

Sophie Pennec, Institut National d'Études Démographiques (INED)
adrien evin, Nantes university
Vincent Guion, Centre hospitalier de Brioude
Mélanie Lepori, University of Strasbourg
Melvin Hervy, Centre hospitalier de Nantes
silvia Pontone, Centre hospitalier Robert Debre - AP/HP

Objectives: The aim of the study was to describe the circumstances of death in nonagenarians, and to compare them with the rest of the population in these territories, particularly with regard to the characteristics of the patients and the clinicians caring for them. Methods: A retrospective study of a random sample of adult patients who died March 2020 and February 2021 was conducted in overseas France. Physicians who certified the deaths were asked to describe end-of-life care and medical decisions in a questionnaire. Results: A total of 1815 deaths were analysed with a total of 1407 questionnaires collecting data on informed deaths. The nonagenarians were mostly women with cognitive disorders and died at home Physicians were mostly general practitioners with many years of practice. Nonagenarians received less palliative care than the rest of the population. There is a lower use of deep and continuous sedation maintained until death and less intensification of treatments to relieve symptoms. Conclusions: The population of nonagenarians is quite specific in terms of causes of death and comorbidities. It seems essential to improve end-of-life care for these patients, particularly in terms of access to palliative care and management of discomfort symptoms.

Keywords: Health and Morbidity, Mortality and Longevity, Population Policies

See extended abstract.