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Advance Care Planning in Dementia

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https://www.readbyqxmd.com/read/29147055/assistive-technologies-for-people-with-dementia-ethical-considerations
#1
Belinda Bennett, Fiona McDonald, Elizabeth Beattie, Terry Carney, Ian Freckelton, Ben White, Lindy Willmott
The sustainable development goals (SDGs) adopted by the United Nations in 2015 include a new target for global health: SDG 3 aims to "ensure healthy lives and promote well-being for all at all ages." Dementia care of good quality is particularly important given the projected increase in the number of people living with the condition. A range of assistive technologies have been proposed to support dementia care. However, the World Health Organization estimated in 2017 that only one in 10 of the 1 billion or more people globally who could benefit from these technologies in some way actually has access to them...
November 1, 2017: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/29134465/current-role-for-biomarkers-in-clinical-diagnosis-of-alzheimer-disease-and-frontotemporal-dementia
#2
REVIEW
Nasim Sheikh-Bahaei, Seyed Ahmad Sajjadi, Aimee L Pierce
Purpose of review Alzheimer's disease (AD) and frontotemporal dementia can often be diagnosed accurately with careful clinical history, cognitive testing, neurological examination, and structural brain MRI. However, there are certain circumstances wherein detection of specific biomarkers of neurodegeneration or underlying AD pathology will impact the clinical diagnosis or treatment plan. We will review the currently available biomarkers for AD and frontotemporal dementia (FTD) and discuss their clinical importance...
November 14, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29106536/the-intersection-of-intellectual-disability-and-dementia-report-of-the-international-summit-on-intellectual-disability-and-dementia
#3
Karen Watchman, Matthew P Janicki
An International Summit on Intellectual Disability and Dementia, held in Glasgow, Scotland (October 13-14, 2016), drew individuals and representatives of numerous international and national organizations and universities with a stake in issues affecting adults with intellectual disability (ID) affected by dementia. A discussion-based consensus process was used to examine and produce a series of topical reports examining three main conceptual areas: (a) human rights and personal resources (applications of the Convention for Rights of People with Disabilities and human rights to societal inclusion, and perspectives of persons with ID), (b) individualized services and clinical supports (advancing and advanced dementia, post-diagnostic supports, community supports and services, dementia-capable care practice, and end-of-life care practices), and (c) advocacy, public impact, family caregiver issues (nomenclature/terminology, inclusion of persons with ID in national plans, and family caregiver issues)...
November 2, 2017: Gerontologist
https://www.readbyqxmd.com/read/29067336/diagnostic-dilemmas-in-alzheimer-s-disease-room-for-shared-decision-making
#4
REVIEW
Wiesje M van der Flier, Marleen Kunneman, Femke H Bouwman, Ronald C Petersen, Ellen M A Smets
The launch of the NIA-AA research criteria for Alzheimer's disease (AD) diagnosis illustrates the large advances that have been made in the field of AD diagnosis. These new possibilities however also introduce new dilemmas into the consulting room, and this provides room for shared decision making (SDM). SDM refers to clinicians and patients (and/or their caregivers) working together to decide which care plan best fits individual patients and their lives, when there is more than one reasonable option. Here, we describe how SDM in the diagnosis of AD promotes patient-centered care, as it helps to adapt the diagnostic process to the patients' values and preferences...
September 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/28988561/discussing-advance-care-planning-insights-from-older-people-living-in-nursing-homes-and-from-family-members
#5
Francesca Ingravallo, Veronica Mignani, Elena Mariani, Giovanni Ottoboni, Marie Christine Melon, Rabih Chattat
BACKGROUND: Evidence concerning when and in which manner older people living in nursing homes (NHs) would prefer to discuss advance care planning (ACP) is still scarce. This study explored the attitudes of NH residents and family members toward ACP and their opinions as to the right time to broach the subject, the manner in which it should be approached, and the content of ACP. METHODS: This was a qualitative study using face-to-face interviews with 30 residents (age range 66-94), and 10 family members from 4 Italian NHs...
October 9, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28982489/palliative-care-in-neurology
#6
REVIEW
Maisha T Robinson, Robert G Holloway
Palliative medicine is a specialty that focuses on improving the quality of life for patients with serious or advanced medical conditions, and it is appropriate at any stage of disease, including at the time of diagnosis. Neurologic conditions tend to have high symptom burdens, variable disease courses, and poor prognoses that affect not only patients but also their families and caregivers. Patients with a variety of neurologic conditions such as Parkinson disease, dementia, amyotrophic lateral sclerosis, brain tumors, stroke, and acute neurologic illnesses have substantial unmet needs that can be addressed through a combination of primary and specialty palliative care...
October 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28958054/shifting-paradigms-advance-care-planning-for-pain-management-in-older-adults-with-dementia
#7
Staja Star Booker, Rashida D Booker
Ensuring effective pain management is an important quality of life (and death) issue for older adults with dementia, particularly since they are more vulnerable to under-assessment and under-treatment of pain. Yet, pain management decisions are often made by health care providers and caregivers with little to no input on the older adult's with dementia values for pain management. The Institute of Medicine (IOM) has recognized the revolutionary imperative to change the manner in which pain care is planned and coordinated...
April 1, 2017: Gerontologist
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
#8
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
#9
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
#10
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
#11
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
#12
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...
December 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28901973/identifying-palliative-care-needs-in-people-with-dementia
#13
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...
December 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28880145/-dementia-care-in-germany
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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