The Twilight Study

• Research type

  Research Study

• Full title

  The Twilight Study: A qualitative study to explore the journey taken by people aged over 85 in their last years of life

• IRAS ID

  150335

• Contact name

  Lucy Pocock

• Contact email

  lucy.pocock@bris.ac.uk

• Sponsor organisation

  University of Bristol

• Research summary

  This study will explore the life events, over a year, of people over 85 who may be approaching the end of life.

  The number of deaths in those 85 and over is increasing; the majority of these deaths occur in hospital. Those aged 84 and over are more likely to be admitted to hospital as an emergency than any other age group; 37.8% of hospital deaths in the over 85s will be following an emergency admission. The majority of elderly people would like the opportunity to discuss end of life care, though this is only realised for a minority. The oldest old, who are progressively frail, with multi-morbidity, do not fit within the traditional palliative care model. If we are to provide appropriate end of life care for this growing group, we need to better understand and accommodate their needs.

  We aim to explore:
  1.The issues facing elderly people and their carers in the last years of life
  2.The key events that shape the course of this period and how their interactions with healthcare affect this.
  3.If elderly people and their carers want to discuss end of life issues.
  4.Whether this group are offered the opportunity to discuss these issues.

  Five eligible participants will be identified in appropriate wards in the Bristol Royal Infirmary. Eligibility criteria include:
  • Age over 85
  • Advanced progressive condition(s) (excluding advanced dementia)
  • Likely to be in the last year of life
  • Capacity to consent

  Each participant will be invited to participate in ethnographic visits, every 4-8 weeks over 6-12 months, including interviews with them and their carer (if applicable) and observational field notes. An interview with a key healthcare professional will be carried out towards the end of the study period. The medical records for each participant will also be interrogated.

• REC name

  South West - Central Bristol Research Ethics Committee

• REC reference

  14/SW/1023

• Date of REC Opinion

  15 Sep 2014

• REC opinion

  Further Information Favourable Opinion