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Advance Care Planning in Dementia

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https://www.readbyqxmd.com/read/28933994/decision-making-for-people-living-with-dementia-by-their-carers-at-the-end-of-life-a-rapid-scoping-review
#1
Sue Barker, Mary Lynch, Jane Hopkinson
BACKGROUND: There are an increasing number of people living with dementia, as well as an expectation that care decisions are made collaboratively with those with the disease entering the end stage and their families. This has increased the burden on family carers. AIM: To explore the evidence on the decisional support needs of informal carers of people with end-stage dementia. DESIGN: A rapid scoping review was undertaken of peer-reviewed publications between 2000 and 2016, which included all health-care settings and the person's own home...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28933190/assessment-of-capabilities-in-persons-with-advanced-stage-of-dementia-validation-of-the-montessori-assessment-system-mas
#2
Jérôme Erkes, Cameron J Camp, Stéphane Raffard, Marie-Christine Gély-Nargeot And, Sophie Bayard
This study evaluated the validity and reliability of the Montessori Assessment System. The Montessori Assessment System assesses preserved abilities in persons with moderate to severe dementia. In this respect, this instrument provides crucial information for the development of effective person-centered care plans. A total of 196 persons with a diagnosis of dementia in the moderate to severe stages of dementia were recruited in 10 long-term care facilities in France. All participants completed the Montessori Assessment System, the Clinical Dementia Rating Scale and/or the Mini Mental State Examination and the Severe Impairment Battery-short form...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/28926294/predictors-of-death-in-the-hospital-for-patients-with-chronic-serious-illness
#3
Katy Hicks, Lois Downey, Ruth A Engelberg, James A Fausto, Helene Starks, Ben Dunlap, James Sibley, William Lober, Nita Khandelwal, Elizabeth T Loggers, J Randall Curtis
BACKGROUND: Most people prefer to die at home, yet most do not. Understanding factors associated with terminal hospitalization may inform interventions to improve care. OBJECTIVE: Among patients with chronic illness receiving care in a multihospital healthcare system, we identified the following: (1) predictors of death in any hospital; (2) predictors of death in a hospital outside the system; and (3) trends from 2010 to 2015. DESIGN: Retrospective cohort using death certificates and electronic health records...
September 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#4
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28922291/population-based-models-of-planning-for-palliative-care-in-older-people
#5
David C Currow, Jane Phillips, Meera Agar
PURPOSE OF REVIEW: Health service planning requires demographic, clinical, and health systems data and is unique to each health system. Planning for palliative care in older people must include patients and their carers. This review explores literature from the last 24 months. RECENT FINDINGS: The proportion of people living in skilled nursing facilities is increasing and many residents require quality palliative care. Simultaneously, the complexity of care for older people is also increasing...
September 16, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28901973/identifying-palliative-care-needs-in-people-with-dementia
#6
Mari Lloyd-Williams, Caroline Mogan, Karen Harrison Dening
PURPOSE OF REVIEW: Dementia is now recognized as a progressive life-limiting illness where many patients can benefit from access to palliative care. RECENT FINDINGS: The present review has focused on three areas namely, advanced care planning in supporting palliative care for dementia, hospice provision for people with dementia and provision of care within family home. In advanced care planning, there is little research on systematically developed and implemented advance care planning interventions or whether they achieve desired outcomes for end-of-life care...
September 8, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28880145/-dementia-care-in-germany
#7
M H van der Vaart
In Germany there are approximately 1.6 million people with dementia. A quarter of them live in a care home, often alongside residents who have a physical condition. The quality of nursing for physical conditions is good; although specialised dementia care is less developed, this lag is slowly being addressed. Medical care in German care homes is delivered by GPs. Preservation of life is the norm. Due to the lack of both advance care planning and a non-resuscitation policy, many care home residents with dementia undergo life-extending measures...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28880125/consensus-statement-of-the-international-summit-on-intellectual-disability-and-dementia-related-to-post-diagnostic-support
#8
Karen Dodd, Karen Watchman, Matthew P Janicki, Antonia Coppus, Claudia Gaertner, Juan Fortea, Flavia H Santos, Seth M Keller, Andre Strydom
OBJECTIVES: Post diagnostic support (PDS) has varied definitions within mainstream dementia services and different health and social care organizations, encompassing a range of supports that are offered to adults once diagnosed with dementia until death. METHOD: An international summit on intellectual disability and dementia held in Glasgow, Scotland in 2016 identified how PDS applies to adults with an intellectual disability and dementia. The Summit proposed a model that encompassed seven focal areas: post-diagnostic counseling; psychological and medical surveillance; periodic reviews and adjustments to the dementia care plan; early identification of behaviour and psychological symptoms; reviews of care practices and supports for advanced dementia and end of life; supports to carers/ support staff; and evaluation of quality of life...
September 7, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28872923/implementing-and-evaluating-an-interprofessional-minority-health-conference-for-social-work-and-healthcare-professionals
#9
Tiffany R Washington, Trina Salm Ward, Henry N Young, Pamela Orpinas, Llewellyn J Cornelius
Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state...
September 5, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28866906/end-of-life-care-for-advanced-dementia-patients-in-residential-care-home-a-hong-kong-perspective
#10
James K H Luk, Felix H W Chan
Dementia will become more common as the population ages. Advanced dementia should be considered as a terminal illnesses and end-of-life (EOL) care is very much needed for this disease group. Currently, the EOL services provided to this vulnerable group in Hong Kong, especially those living in residential care homes, is limited. The usual practice of residential care homes is to send older residents with advanced dementia to acute hospitals when they are sick, irrespective of their wish, premorbid status, diagnoses and prognosis...
August 28, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28836301/a-pilot-study-on-the-feasibility-of-training-nurses-to-formulate-multicomponent-oral-health-interventions-in-a-residential-aged-care-facility
#11
Alan Deutsch, Emma Siegel, Monica Cations, Clive Wright, Vasi Naganathan, Henry Brodaty
OBJECTIVES: This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. METHOD: Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste...
August 23, 2017: Gerodontology
https://www.readbyqxmd.com/read/28827062/the-effectiveness-of-advance-care-planning-in-improving-end-of-life-outcomes-for-people-with-dementia-and-their-carers-a-systematic-review-and-critical-discussion
#12
REVIEW
Josie Dixon, Maria Karagiannidou, Martin Knapp
CONTEXT: End of life care for people with dementia can be poor, involving emergency hospital admissions, burdensome treatments of uncertain value and under-treatment of pain and other symptoms. Advance care planning (ACP) is identified, in England and elsewhere, as a means of improving end of life outcomes for people with dementia and their carers. OBJECTIVE: To systematically and critically review empirical evidence concerning the effectiveness of ACP in improving end of life outcomes for people with dementia and their carers...
August 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28822692/complex-clinical-intersection-palliative-care-in-patients-with-dementia
#13
REVIEW
Ellen E Lee, Beverly Chang, Steven Huege, Jeremy Hirst
Because of the rapidly growing older population and increases in longevity, rates of dementia have been rising. Clinical challenges of treating dementia include limited resources and lack of curative therapies. Palliative care approaches improve quality of life and alleviate suffering for dementia patients at the end of life, although implementation may be limited by societal acceptance and feasibility. This review examines the published literature on pain assessments, pain and behavior interventions, tools for advanced care planning, and clinical concerns in dementia patients...
June 29, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28793905/the-liverpool-care-pathway-a-systematic-review-discarded-in-cancer-patients-but-good-enough-for-dying-nursing-home-patients
#14
Bettina S Husebø, Elisabeth Flo, Knut Engedal
BACKGROUND: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying people with dementia...
August 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28772095/advance-directives-among-nursing-home-residents-with-mild-moderate-and-advanced-dementia
#15
Jennifer Tjia, Marisa Dharmawardene, Jane L Givens
OBJECTIVE: To describe prevalence and content of AD documentation among NH residents by dementia stage. BACKGROUND: The prevalence of advance directives (ADs) among nursing home (NH) residents with mild, moderate, and advanced dementia remains unclear. METHODS: Population-based, cross-sectional study of all licensed NHs in five U.S. states. Subjects included all long-stay (>90 day) NH residents with dementia, aged ≥65 years, and a Cognitive Performance Scale (CPS) score ≥1 from the 2007 to 2008 Minimum Data Set 2...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28754053/complex-decision-making-in-patients-with-dementia-in-an-internal-medicine-department
#16
Ladislav Kabelka
With the increase of polymorbidity, extending life expectancy and improving treatment options for chronic diseases, the care for dementia is moving into other areas of medicine. The length and quality of life with advanced dementia is directly dependent on the quality of medical and nursing care, early detection and treatment of complications, nutritional support and palliative care plan. Significant is also the support for family carers. The key coordinators of care for patients with dementia are general practitioners (GPs), geriatricians, psychiatrists, and an increasingly important role play internists...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28754049/the-advance-care-planning-experiences-of-people-with-dementia-family-caregivers-and-professionals-a-synthesis-of-the-qualitative-literature
#17
Tony Ryan, Karwan M Amen, Jane McKeown
There exists compelling evidence that advance care planning (ACP) remains a key factor in the delivery of appropriate end of life care and facilitates the timely transition to palliative care for people with dementia. Take up of ACP within the dementia population is low, especially when compared with other conditions. Quantitative research has helped in identifying some of the key factors in enabling or inhibiting the use of ACP within the dementia population. Qualitative research can, however, shed further light upon the experiences of all...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28705196/better-palliative-care-for-people-with-a-dementia-summary-of-interdisciplinary-workshop-highlighting-current-gaps-and-recommendations-for-future-research
#18
Siobhán Fox, Carol FitzGerald, Karen Harrison Dening, Kate Irving, W George Kernohan, Adrian Treloar, David Oliver, Suzanne Guerin, Suzanne Timmons
BACKGROUND: Dementia is the most common neurological disorder worldwide and is a life-limiting condition, but very often is not recognised as such. People with dementia, and their carers, have been shown to have palliative care needs equal in extent to those of cancer patients. However, many people with advanced dementia are not routinely being assessed to determine their palliative care needs, and it is not clear why this is so. MAIN BODY: An interdisciplinary workshop on "Palliative Care in Neurodegeneration, with a focus on Dementia", was held in Cork, Ireland, in May 2016...
July 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28694253/implementing-the-compassion-intervention-a-model-for-integrated-care-for-people-with-advanced-dementia-towards-the-end-of-life-in-nursing-homes-a-naturalistic-feasibility-study
#19
Kirsten J Moore, Bridget Candy, Sarah Davis, Anna Gola, Jane Harrington, Nuriye Kupeli, Victoria Vickerstaff, Michael King, Gerard Leavey, Irwin Nazareth, Rumana Z Omar, Louise Jones, Elizabeth L Sampson
BACKGROUND: Many people with dementia die in nursing homes, but quality of care may be suboptimal. We developed the theory-driven 'Compassion Intervention' to enhance end-of-life care in advanced dementia. OBJECTIVES: To (1) understand how the Intervention operated in nursing homes in different health economies; (2) collect preliminary outcome data and costs of an interdisciplinary care leader (ICL) to facilitate the Intervention; (3) check the Intervention caused no harm...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28676293/attitudes-toward-advance-directives-among-patients-and-their-family-members-in-china
#20
Lin Kang, Xiao-Hong Liu, Jing Zhang, Pei-Yan Shan, Jie-Ping Wang, Ping Zhong, Xiao-Hong Du, Yu-Feng Du, Bao-Cheng Yu, Nan Wei, Hui-Ling Lou, Ou Bian, Huai-Hong Chen, Fan Lin, Hong-Lian Zhou, Wen He, Huai-Cong Long, Lu-Rong Hong, Hui Su, Jun-Nan Yang, Yong-Liang Jiang, Ye Shi, Jing Ning, Fang Liang, Zhong Wang, Ting Gong, Ming-Lei Zhu, Xiao-Hong Ning, Zhi-Jun Chen, Liang-Kung Chen
OBJECTIVES: Chinese people are generally unfamiliar with the concept of advance care planning or advance directives (ACP/ADs), which raises dilemmas in life-support choice and can even affect clinical decision making. To understand and address the issues involved better, we investigated the awareness of ACP/ADs in China, as well as people's attitudes toward medical autonomy and end-of-life care. DESIGN: A multicenter cross-sectional survey, conducted from August 1 to December 31, 2016...
July 1, 2017: Journal of the American Medical Directors Association
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