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Advance Care Planning in Dementia

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https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#1
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911320/ethnic-variations-in-prognosis-of-patients-with-dementia-a-prospective-nationwide-registry-linkage-study-in-the-netherlands
#2
Charles Agyemang, Irene E van de Vorst, Huiberdina L Koek, Michiel L Bots, Azizi Sexas, Marie Norredam, Umar Ikram, Karien Stronks, Ilonca Vaartjes
BACKGROUND: Data on dementia prognosis among ethnic minority groups are limited in Europe. OBJECTIVE: We assessed differences in short-term (1-year) and long-term (3-year) mortality and readmission risk after a first hospitalization or first ever referral to a day clinic for dementia between ethnic minority groups and the ethnic Dutch population in the NetherlandsMethods: Nationwide prospective cohorts of first hospitalized dementia patients (N = 55,827) from January 1, 2000 to December 31, 2010 were constructed...
November 29, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27895004/predictors-of-vascular-cognitive-impairment-poststroke-in-a-middle-eastern-bahrain-cohort-a-proposed-case-control-comparison
#3
Claire Donnellan, Mona Al Banna, Noor Redha, Adel Al Jishi, Isa Al Sharoqi, Safa Taha, Moiz Bakhiet, Fatema Abdulla, Patrick Walsh
BACKGROUND: Poststroke dementia and cognitive impairment are associated with poor long-term outcomes after stroke. The contribution of genetic factors such as the presence of apolipoprotein (ApoE) ɛ4 allele and its association with cognitive impairment poststroke remains inconclusive, particularly in Middle Eastern regions. OBJECTIVE: The aim of this study is to examine all correlates and potential predictors of cognitive impairment including self-awareness and regulation deficits in stroke patients and compare these functions with healthy older adults from a Middle Eastern population...
November 28, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#4
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27859597/quality-of-care-for-people-with-dementia-and-professional-caregivers-perspectives-regarding-palliative-care-in-japanese-community-care-settings
#5
Miharu Nakanishi, Kayo Hirooka, Yuko Morimoto, Atsushi Nishida
OBJECTIVE: Palliative care for dementia includes psychosocial interventions as first-line treatment for challenging behaviour. However, the national dementia plan in Japan contradicts recommendations for palliative care for dementia. This study aimed to examine the association between care quality for patients with dementia and professional caregivers' perspectives regarding palliative care for dementia in Japanese community care settings. METHODS: In total, 2116 professional caregivers from 329 agencies (217 in-home long-term care support providers; 29 small-scale, multiple home-care providers; and 83 group homes) in Tokyo prefecture, Japan, completed cross-sectional, paper-based questionnaires about 3603 people diagnosed with dementia, in May 2016...
November 17, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27849637/pneumonia-intake-problems-and-survival-among-nursing-home-residents-with-variable-stages-of-dementia-in-the-netherlands-results-from-a-prospective-observational-study
#6
Simone A Hendriks, Martin Smalbrugge, Arianne B van Gageldonk-Lafeber, Francisca Galindo-Garre, Maarten Schipper, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVES: We explored how pneumonia and intake problems affect survival in nursing home residents in variable stages of dementia. METHODS: In a longitudinal observational study (372 residents) with up to 3.5 years of follow-up, we examined relationships between dementia severity, the development of pneumonia, intake problems, and mortality using joint modeling, Cox models, and mediation analyses. Dementia severity was measured semiannually with the Bedford Alzheimer Nursing Severity-Scale (BANS-S)...
November 15, 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27821714/end-of-life-care-a-scoping-review-of-experiences-of-advance-care-planning-for-people-with-dementia
#7
Kerry Jones, Giles Birchley, Richard Huxtable, Linda Clare, Tony Walter, Jeremy Dixon
Despite increasing attention given to dementia by international governments and policy makers, the focus of end of life care has been on the dying trajectory of malignant disease. People with severe dementia have complex physical and psychological needs, yet the disease is not always recognised as terminal. Advance Care Planning involving people with dementia and their families can provide opportunities to discuss and later, initiate timely palliative care.We conducted a scoping review of studies exploring decisions associated with the EoLC of people with dementia...
November 7, 2016: Dementia
https://www.readbyqxmd.com/read/27807088/shared-decision-making-for-people-living-with-dementia-in-extended-care-settings-protocol-for-a-systematic-review
#8
Rachel Daly, Frances Bunn, Claire Goodman
INTRODUCTION: Approximately 450 000 people in the UK are living in care homes, 70% of whom are thought to have dementia or significant memory problems. This means that they may need support with day-to-day decisions about their health and care. Shared decision-making interventions can have a positive impact on patient outcomes. They recognise an individual's rights to make decisions about their care or treatment and support person-centred approaches to care delivery. METHODS: A systematic review of studies designed to assess, implement, measure and/or explore shared decision-making with cognitively impaired adults in (or transferrable to) an extended care setting, with a view to answering the research question: How can people living with dementia and cognitive impairment be included in day-to-day decisions about their health and care in extended care settings? The systematic review will be started in May 2016...
November 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27780889/decision-making-on-behalf-of-people-living-with-dementia-how-do-surrogates-decision-makers-decide
#9
Deirdre Fetherstonhaugh, Linda McAuliffe, Michael Bauer, Chris Shanley
BACKGROUND: For people living with dementia, the capacity to make important decisions about themselves diminishes as their condition advances. As a result, important decisions (affecting lifestyle, medical treatment and end of life) become the responsibility of someone else, as the surrogate decision-maker. This study investigated how surrogate decision-makers make important decisions on behalf of a person living with dementia. METHODS: Semi-structured interviews were conducted with 34 family members who had formally or informally taken on the role of surrogate decision-maker...
October 25, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27765378/a-systematic-review-of-effectiveness-of-decision-aids-to-assist-older-patients-at-the-end-of-life
#10
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27751558/research-priorities-to-reduce-the-global-burden-of-dementia-by-2025
#11
REVIEW
Hiral Shah, Emiliano Albanese, Cynthia Duggan, Igor Rudan, Kenneth M Langa, Maria C Carrillo, Kit Yee Chan, Yves Joanette, Martin Prince, Martin Rossor, Shekhar Saxena, Heather M Snyder, Reisa Sperling, Mathew Varghese, Huali Wang, Marc Wortmann, Tarun Dua
At the First WHO Ministerial Conference on Global Action Against Dementia in March, 2015, 160 delegates, including representatives from 80 WHO Member States and four UN agencies, agreed on a call for action to reduce the global burden of dementia by fostering a collective effort to advance research. To drive this effort, we completed a globally representative research prioritisation exercise using an adapted version of the Child Health and Nutrition Research Initiative method. We elicited 863 research questions from 201 participants and consolidated these questions into 59 thematic research avenues, which were scored anonymously by 162 researchers and stakeholders from 39 countries according to five criteria...
November 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27544017/advance-care-planning-for-nursing-home-residents-with-dementia-influence-of-we-decide-on-policy-and-practice
#12
Sophie Ampe, Aline Sevenants, Tinne Smets, Anja Declercq, Chantal Van Audenhove
OBJECTIVES: (1) To pilot 'we DECide' in terms of influence on advance care planning policy and practice in nursing home dementia care units. (2) To investigate barriers and facilitators for implementing 'we DECide'. METHODS: This was a pre-test-post-test study in 18 nursing homes. Measurements included: compliance with best practice of advance care planning policy (ACP-audit); advance care planning practice (ACP criteria: degree to which advance care planning was discussed, and OPTION scale: degree of involvement of residents and families in conversations)...
August 10, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27505003/correction-advance-care-planning-in-dementia-do-family-carers-know-the-treatment-preferences-of-people-with-early-dementia
#13
Karen Harrison Dening, Michael King, Louise Jones, Victoria Vickerstaff, Elizabeth L Sampson
[This corrects the article DOI: 10.1371/journal.pone.0159056.].
2016: PloS One
https://www.readbyqxmd.com/read/27490070/care-of-patients-at-the-end-of-life-advance-care-planning
#14
Richard J Ackermann
Advance directives are legal documents that give instructions about how to provide care when patients develop life-threatening illnesses and can no longer communicate their wishes. Two types of documents are widely used-a living will and a durable power of attorney for health care. Most states also authorize physician orders for life-sustaining treatment. Physicians should encourage patients, particularly those with severe chronic or terminal conditions, to prepare advance directives. Medicare now reimburses billing codes for advance care consultations...
August 2016: FP Essentials
https://www.readbyqxmd.com/read/27460046/the-extended-palliative-phase-of-dementia-an-integrative-literature-review
#15
Elizabeth Hanson, Amanda Hellström, Åsa Sandvide, Graham A Jackson, Rhoda MacRae, Anna Waugh, Wilson Abreu, Debbie Tolson
This article presents an integrative literature review of the experience of dementia care associated with the extended palliative phase of dementia. The aim was to highlight how dementia is defined in the literature and describe what is known about the symptomatology and management of advanced dementia regarding the needs and preferences of the person with dementia and their family carer/s. There was no consistent definition of advanced dementia. The extended palliative phase was generally synonymous with end-of-life care...
July 26, 2016: Dementia
https://www.readbyqxmd.com/read/27410259/advance-care-planning-in-dementia-do-family-carers-know-the-treatment-preferences-of-people-with-early-dementia
#16
Karen Harrison Dening, Michael King, Louise Jones, Victoria Vickestaff, Elizabeth L Sampson
BACKGROUND AND AIMS: When a person with dementia (PWD) has lost the ability to make treatment decisions, clinicians often rely on family carers to know and articulate these preferences with assumed accuracy. This study used the Life Support Preferences Questionnaire (LSPQ) to explore whether family carers' choices show agreement with the end of life care preferences of the person with dementia for whom they care and what factors influence this. METHODS: A cross-sectional study interviewing 60 dyads (a person with early dementia and preserved capacity and their family carer) each completing a modified LSPQ...
2016: PloS One
https://www.readbyqxmd.com/read/27332611/palliative-and-end-of-life-care-for-people-living-with-dementia-in-care-homes-part-1
#17
Gary Mitchell, Joanne Agnelli, Jessie McGreevy, Monica Diamond, Herlindina Roble, Elaine McShane, Joanne Strain
The terms palliative and end of life care are often used interchangeably and healthcare practitioners may perceive that palliative care is only appropriate during the terminal stages of an illness. This article, the first of two parts, provides healthcare practitioners with an overview of the concept of palliative care. It explains how this can be differentiated from end of life care and how it should be commenced in a timely manner, so that people who are living with dementia can contribute to the planning of their future care and death...
June 22, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27271683/fidelity-to-a-behavioral-intervention-to-improve-goals-of-care-decisions-for-nursing-home-residents-with-advanced-dementia
#18
Laura C Hanson, Mi-Kyung Song, Sheryl Zimmerman, Robin Gilliam, Cherie Rosemond, Latarsha Chisholm, Feng-Chang Lin
BACKGROUND/AIMS: Ensuring fidelity to a behavioral intervention implemented in nursing homes requires awareness of the unique considerations of this setting for research. The purpose of this article is to describe the goals of care cluster-randomized trial and the methods used to monitor and promote fidelity to a goals of care decision aid intervention delivered in nursing homes. METHODS: The cluster randomized trial tested whether a decision aid for goals of care in advanced dementia could improve (1) the quality of communication and decision-making, (2) the quality of palliative care, and (3) the quality of dying for nursing home residents with advanced dementia...
December 2016: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/27231081/health-care-professionals-perspectives-of-advance-care-planning-for-people-with-dementia-living-in-long-term-care-settings-a-narrative-review-of-the-literature
#19
(no author information available yet)
This comprehensive synthesis of published literature from a team in Northern Ireland focused on the perspectives of healthcare professionals in relation to ACP for people with dementia living in long-term care settings. From the 14 papers discussed, the authors identified that people with dementia are often not recognised as having a terminal illness. Four key themes were identified: ■ Early integration and planning for palliative care in dementia is important. ■ Healthcare professionals' perspectives on ACP are influenced by ethical and moral concerns including presumptions regarding capacity of the person with dementia towards ACP and the impact of the increased role of the family in the decision-making processes...
May 27, 2016: Nursing Older People
https://www.readbyqxmd.com/read/27231080/uptake-of-a-newly-implemented-advance-care-planning-program-in-a-dementia-diagnostic-service
#20
(no author information available yet)
Through a three-stage project in a specialist memory clinic in Australia, researchers introduced ACP to clients with mild cognitive impairment or recently diagnosed dementia and their families. Clients and carers were initially posted a survey assessing completed documentation for future care, understanding of the principles of ACP and willingness to receive further information. Those wanting more information were invited to a seminar introducing the ACP programme and service. Participants wanting to complete ACP documentation could make an appointment with the ACP clinicians...
May 27, 2016: Nursing Older People
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