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Tube feeding AND dementia

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https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#1
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#2
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28572521/the-feeding-paradox-in-advanced-dementia-a-local-perspective
#3
J Kh Luk, F Hw Chan, E Hui, C Y Tse
Feeding problems are common in older people with advanced dementia. When eating difficulties arise tube feeding is often initiated, unless there is a valid advance directive that refuses enteral feeding. Tube feeding has many pitfalls and complications. To date, no benefits in terms of survival, nutrition, or prevention of aspiration pneumonia have been demonstrated. Careful hand feeding is an alternative to tube feeding with advanced dementia. In Hong Kong, the Hospital Authority has established clear ethical guidelines for careful hand feeding...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28562402/artificial-nutrition-and-hydration-in-people-with-late-stage-dementia
#4
Lenora Smith, Rita Ferguson
The progressive nature of dementia marks this disease as a terminal illness in the advanced stage, and palliative care rather than curative treatment is indicated. The use of feeding tubes to deliver artificial nutrition and hydration at end of life is often part of the plan of care for people with dementia. Current evidence, however, suggests that tube feeding in advanced dementia is not beneficial and the burdens of the procedure and the feedings themselves outweigh any benefits. Evidence also reveals that healthcare providers may lack evidence-based knowledge about artificial nutrition and hydration to adequately inform families and surrogate decision makers...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28473002/surrogate-prediction-of-quality-of-life-and-desire-for-treatment-a-guess-of-a-guess
#5
Scott Snyder, Halima Amjad
In conditions, such as dementia, stroke, or critical illness, clinicians often rely on substituted judgment through a surrogate to assist in medical decision making. Surrogates may face tough decisions regarding whether to pursue or forego surgery, tube feeding, and cardiopulmonary resuscitation. Surrogates often have little confidence in their decision (Majesko et al., 2012), though substituted judgment relies on the surrogate to determine the decision that the patient would have made. Prior studies suggest that surrogates predict patient preferences with only 68% accuracy (Shalowitz et al...
May 5, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28387447/withdrawn-interventions-for-fatigue-and-weight-loss-in-adults-with-advanced-progressive-illness
#6
REVIEW
Cathy Payne, Philip J Wiffen, Suzanne Martin
BACKGROUND: Fatigue and unintentional weight loss are two of the commonest symptoms experienced by people with advanced progressive illness. Appropriate interventions may bring considerable improvements in function and quality of life to seriously ill people and their families, reducing physical, psychological and spiritual distress. OBJECTIVES: To conduct an overview of the evidence available on the efficacy of interventions used in the management of fatigue and/or unintentional weight loss in adults with advanced progressive illness by reviewing the evidence contained within Cochrane reviews...
April 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28140779/social-ecological-perspectives-of-tube-feeding-older-adults-with-advanced-dementia-a-systematic-literature-review
#7
Joy W Douglas, Jeannine C Lawrence, Lori W Turner
Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use...
January 2017: Journal of Nutrition in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28032354/end-of-life-treatment-decisions-in-nursing-home-residents-dying-with-dementia-in-the-netherlands
#8
Simone A Hendriks, Martin Smalbrugge, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVE: The objective was to describe end-of-life treatment decisions for patients dying with dementia in various stages of dementia in long-term care facilities in the Netherlands with elderly care physicians responsible for treatment and care. METHODS: We present data collected in the nationally representative Dutch End of Life in Dementia study (2007-2011). Within 2 weeks after death, 103 physicians completed questionnaires about the last phase of life in 330 residents with dementia who resided in 1 of 34 participating long-term care facilities...
December 29, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27932700/predictors-of-enteral-tube-feeding-in-hospitalized-older-adults
#9
Milton Roberto Furst Crenitte, Thiago Junqueira Avelino-Silva, Daniel Apolinario, Jose Antonio Esper Curiati, Flavia Campora, Wilson Jacob-Filho
BACKGROUND: Despite general recognition that enteral tube feeding (ETF) is frequently employed in long-term care facilities and patients with dementia, remarkably little research has determined which factors are associated with its use in acutely ill older adults. In this study, we aimed to investigate determinants of ETF introduction in hospitalized older adults. METHODS: We examined a retrospective cohort of acutely ill patients, aged 60 years and older, admitted to a university hospital's geriatric ward from 2014-2015, in São Paulo, Brazil...
December 8, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27928446/gastrostomy-with-peritoneal-collar-versus-percutaneous-endoscopic-gastrostomy
#10
COMPARATIVE STUDY
C Tudor, C Branescu, C Savlovschi, A El-Khatib, H Pantu, A Nica, A M Dascalu, B Masoumeh, A S Tudor, S M Oprescu, D Serban
Aim. The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. Materials and method. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27843445/long-term-survival-of-patients-receiving-artificial-nutrition-in-japanese-psychiatric-hospitals
#11
Keiichi Abe, Ryuko Yamashita, Keiko Kondo, Keiko Takayama, Osamu Yokota, Yoshiki Sato, Mitsumasa Kawai, Hideki Ishizu, Tadao Nakashima, Hideki Hayashi, Kenji Nakata, Hiroyuki Asaba, Koichi Kadota, Kazuyoshi Tanaka, Yumi Morisada, Etsuko Oshima, Seishi Terada
BACKGROUND/AIMS: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. METHODS: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated...
September 2016: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/27833208/is-tube-feeding-futile-in-advanced-dementia
#12
Matthew C Lynch
It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding...
August 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27737522/percutaneous-endoscopic-gastrostomy-tube-insertion-in-neurodegenerative-disease-a-retrospective-study-and-literature-review
#13
Pamela Sarkar, Alice Cole, Neil J Scolding, Claire M Rice
BACKGROUND/AIMS: With the notable exceptions of dementia, stroke, and motor neuron disease, relatively little is known about the safety and utility of percutaneous endoscopic gastrostomy (PEG) tube insertion in patients with neurodegenerative disease. We aimed to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review in order to identify whether particular factors need to be considered to improve safety and outcome...
May 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/27652307/percutaneous-endoscopic-gastrostomy-peg-using-a-novel-large-caliber-introducer-technique-kit-a-retrospective-analysis
#14
Ezekiel Wong Toh Yoon, Kaori Yoneda, Shinya Nakamura, Kazuki Nishihara
BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) using the introducer technique is not only useful in patients with upper digestive tract stenosis but has been shown to reduce peristomal infection. In this study, we evaluated the safety and utility of a novel large-caliber introducer PEG kit (using 20 Fr size tube) compared with a push kit of similar size. PATIENTS AND METHODS: One hundred and thirty-six patients who received PEG at our hospital between January 2014 and December 2015 were retrospectively analyzed...
September 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27533163/tube-feeding-in-us-nursing-home-residents-with-advanced-dementia-2000-2014
#15
Susan L Mitchell, Vincent Mor, Pedro L Gozalo, Joseph L Servadio, Joan M Teno
No abstract text is available yet for this article.
August 16, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27505401/peg-insertion-in-patients-with-dementia-does-not-improve-nutritional-status-and-has-worse-outcomes-as-compared-with-peg-insertion-for-other-indications
#16
Ayman Abu R, Tawfik Khoury, Jonah Cohen, Shmuel Chen, Shaul Yaari, Saleh Daher, Ariel A Benson, Meir Mizrahi
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are commonly utilized as a method of enteral feeding in patients unable to obtain adequate oral nutrition. Although some studies have shown improved mortality in select populations, the safety and effectiveness of PEG insertion in patients with dementia compared with those with other neurological diseases or head and neck malignancy remains less well defined. OBJECTIVE: To evaluate the nutritional effectiveness, rate of rehospitalization, and risk of mortality among patients with dementia compared with patients with other neurological diseases or head and neck cancers who undergo PEG placement...
August 8, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27430902/-delirium-day-a-nationwide-point-prevalence-study-of-delirium-in-older-hospitalized-patients-using-an-easy-standardized-diagnostic-tool
#17
MULTICENTER STUDY
Giuseppe Bellelli, Alessandro Morandi, Simona G Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi
BACKGROUND: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy...
July 18, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27410259/advance-care-planning-in-dementia-do-family-carers-know-the-treatment-preferences-of-people-with-early-dementia
#18
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/27374872/behavioral-variant-frontotemporal-dementia-advanced-disease-stages-and-death-a-step-to-palliative-care
#19
J Diehl-Schmid, S Richard-Devantoy, T Grimmer, H Förstl, R Jox
OBJECTIVE: The aim of the present study was to gain insight into the living and care situation in advanced behavioral variant frontotemporal dementia (bvFTD), to describe symptoms and findings in advanced bvFTD, and to evaluate somatic comorbidities and circumstances of death. METHODS: Standardized interviews were conducted with family caregivers of 83 patients with bvFTD. Forty-four percent of the patients were already deceased at the time of the interview. RESULTS: At the time of the interview or death, respectively, 47% of the patients lived in a nursing home...
July 4, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27348795/withholding-versus-withdrawing-treatment-artificial-nutrition-and-hydration-as-a-model
#20
Emma Somers, Carl Grey, Valerie Satkoske
PURPOSE OF REVIEW: This article explores various cultural perspectives of withholding and withdrawing of life-sustaining treatment utilizing a case involving artificial nutrition and hydration (ANH) to guide ethical discussion. RECENT FINDINGS: In the United States, there is a general consensus in the medical, ethical, and legal communities that the withholding and withdrawing of life-sustaining treatment are morally equivalent at the end of life. Despite this consensus, the withdrawal of treatment is still emotionally difficult, particularly with ANH...
September 2016: Current Opinion in Supportive and Palliative Care
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