Evid Based Nurs doi:10.1136/eb-2013-101629
  • Care of the older person
  • Cohort study

Around a quarter of all older people have disability during the last 2 years of life, with prevalence higher among women and those aged over 80 years

  1. Calvin H Hirsch
  1. Division of General Medicine, University of California, Davis Medical Center, Sacramento, California, USA
  1. Correspondence to: Dr Calvin H Hirsch, Division of General Medicine, University of California, Davis Medical Center, PSSB 2400, Sacramento, CA 95817, USA; chhirsch{at}

Commentary on:

Implications for practice and research

  • A better understanding of the preventability of perimortal disability is needed.

  • Clinicians must regularly assess caregiver burden and be knowledgeable about resources for family caregivers.


The rapidly growing number of disabled elderly is expected to tax health delivery systems, whose focus has been the management of disease rather than the prevention and management of disability. The burden of caring for the disabled rests largely with family caregivers, who commonly experience physical and emotional strain. The network of community services designed to assist caregivers is fragmented, variable and costly. The …

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