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Tube feeding AND dementia

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https://www.readbyqxmd.com/read/29736944/the-impact-of-dementia-special-care-units-on-quality-of-care-an-instrumental-variables-analysis
#1
Nina R Joyce, Thomas G McGuire, Stephen J Bartels, Susan L Mitchell, David C Grabowski
OBJECTIVE: To compare the quality of care following admission to a nursing home (NH) with and without a dementia special care unit (SCU) for residents with dementia. DATA SOURCES/STUDY SETTING: National resident-level minimum dataset assessments (MDS) 2005-2010 merged with Medicare claims and provider-level data from the Online Survey, Certification, and Reporting database. STUDY DESIGN: We employ an instrumental variable approach to address the endogeneity of selection into an SCU facility controlling for a range of individual-level covariates...
May 7, 2018: Health Services Research
https://www.readbyqxmd.com/read/29435712/antimicrobial-therapy-in-palliative-care-an-overview
#2
REVIEW
Filipa Macedo, Catarina Nunes, Katia Ladeira, Filipa Pinho, Nadine Saraiva, Nuno Bonito, Luísa Pinto, Francisco Gonçalves
In the advanced stages of illness, patients often face challenging decisions regarding their treatment and overall medical care. Terminal ill patients are commonly affected by infections. However, in palliative care, the use of antimicrobials can be an ethical dilemma. Deciding whether to treat, withhold, or withdraw the antimicrobial treatment for an infection can be difficult. Antimicrobial administration can lead to adverse outcomes but the two main benefits, longer survival and symptom relief, are the main reasons why physicians prescribe antimicrobial when treating terminally ill patients...
May 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29349584/-percutaneous-endoscopic-gastrostomy-in-geriatrics-indications-technique-and-complications
#3
Rainer Wirth
The technique of percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a semi-invasive approach for children with the need for a gastric fistula in order to avoid an operative intervention. The suture pull-through method was rapidly established and is now omnipresent. Because scientific evidence is broadly missing, there is some uncertainty about the indications in geriatric medicine. Guidelines do not recommend the insertion of a PEG in patients with severe dementia and malnutrition. Tube feeding is mainly recommended as a temporary method for patients who cannot take oral nutrition for more than 3 days or for whom the energy intake for more than 10 days presumably covers less than 50% of their needs, assuming that the overall prognosis is reasonable...
February 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29343186/association-between-palliative-care-and-life-sustaining-treatments-for-patients-with-dementia-a-nationwide-5-year-cohort-study
#4
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
March 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29178502/survival-times-with-and-without-tube-feeding-in-patients-with-dementia-or-psychiatric-diseases-in-japan
#5
Keiko Takayama, Keisuke Hirayama, Akihiko Hirao, Keiko Kondo, Hideki Hayashi, Koichi Kadota, Hiroyuki Asaba, Hideki Ishizu, Kenji Nakata, Kairi Kurisu, Etsuko Oshima, Osamu Yokota, Norihito Yamada, Seishi Terada
BACKGROUND: It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. METHODS: This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated...
November 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29157223/tube-feeding-decreases-pneumonia-rate-in-patients-with-severe-dementia-comparison-between-pre-and-post-intervention
#6
Shintaro Takenoshita, Keiko Kondo, Keiichi Okazaki, Akihiko Hirao, Keiko Takayama, Keisuke Hirayama, Hiroyuki Asaba, Kenji Nakata, Hideki Ishizu, Hiromi Takahashi, Hanae Nakashima-Yasuda, Yasue Sakurada, Kengo Fujikawa, Osamu Yokota, Norihito Yamada, Seishi Terada
BACKGROUND: It is widely supposed that there is no benefit, including extended survival and decreased rate of pneumonia, in patients with severe dementia receiving enteral tube feeding (TF). However, there have been few studies comparing the frequency of pneumonia before and after TF in severe dementia. METHODS: Nine psychiatric hospitals in Okayama Prefecture participated in this retrospective survey. All inpatients fulfilling the entry criteria were evaluated...
November 21, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29040344/dilemmas-for-guardians-of-advanced-dementia-patients-regarding-tube-feeding
#7
Efrat Gil, Maayan Agmon, Ayal Hirsch, Miriam Ziv, Anna Zisberg
Background: advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure...
January 1, 2018: Age and Ageing
https://www.readbyqxmd.com/read/28988414/upper-esophageal-sphincter-augmentation-reduces-pharyngeal-reflux-in-nasogastric-tube-fed-patients
#8
Hongmei Jiao, Ling Mei, Chenyang Liang, Yun Dai, Zhifang Fu, Lihong Wu, Patrick Sanvanson, Reza Shaker
OBJECTIVES/HYPOTHESIS: Aspiration of gastric refluxate is one of the most commonly observed complications among long-term nasogastric tube (NGT) fed patients. The upper esophageal sphincter (UES) pressure barrier is the main defense mechanism against pharyngeal reflux of gastric contents. Our objective was to investigate the efficacy and safety of the UES assist device (UES-AD) in preventing gastric reflux through the UES in long-term NGT-fed patients. STUDY DESIGN: Self-Controlled Case series...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28975616/percutaneous-feeding-tubes-in-individuals-with-advanced-dementia-are-physicians-choosing-wisely
#9
Marzena Gieniusz, Liron Sinvani, Andrzej Kozikowski, Vidhi Patel, Christian Nouryan, Myia S Williams, Nina Kohn, Renee Pekmezaris, Gisele Wolf-Klein
OBJECTIVES: To evaluate physician knowledge and perceptions about the American Board of Internal Medicine/American Geriatrics Society (ABIM/AGS) Choosing Wisely recommendations regarding percutaneous endoscopic gastrostomy (PEG) in individuals with advanced dementia. DESIGN: Multicenter, mixed-mode, anonymous questionnaire. SETTING: Three tertiary and four community hospitals in New York. PARTICIPANTS: Internal medicine physicians (N = 168)...
January 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28969014/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#10
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...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28906030/pathological-and-immunoblot-analysis-of-phosphorylated-tdp-43-in-sporadic-amyotrophic-lateral-sclerosis-with-pallido-nigro-luysian-degeneration
#11
Akiko Uchino, Mieko Ogino, Junko Takahashi-Fujigasaki, Saori Oonuma, Naomi Kanazawa, Sabine Kajita, Masaaki Ichinoe, Masato Hasegawa, Kazutoshi Nishiyama, Shigeo Murayama
Transactivation response DNA-binding protein 43 kDa (TDP-43) is a key protein of sporadic amyotrophic lateral sclerosis (ALS), and phosphorylated form of TDP-43 (p-TDP-43) is a major pathological protein that accumulates in sporadic ALS. p-TDP-43 is found not only in primary motor neurons, but often propagates to non-motor systems as well. However, pallido-nigro-luysian (PNL) degeneration (PNLD) is rarely associated with ALS. We describe here a 68-year-old ALS patient presenting severe PNLD. He had difficulty walking due to poor movement of his right leg, and was diagnosed as having Parkinson's disease because of akinesia...
September 14, 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/28855459/background-characteristics-and-clinical-features-of-elderly-patients-with-hyperglycemic-hyperosmolar-syndrome
#12
Takuya Yamaoka, Yoshiaki Tamura, Remi Kodera, Yuki Tsuboi, Ken Sato, Yuko Chiba, Seijiro Mori, Hideki Ito, Atsushi Araki
AIM: Few reports have described the characteristics of hyperglycemic hyperosmolar syndrome (HHS) in the elderly. We investigated the background characteristics and clinical features of 14 elderly patients with HHS. METHODS: HHS was diagnosed based on a blood glucose level of >600 mg/dL and an effective plasma osmolality [2 (Na) + glu/18] of >320 mOsm/kg. For 14 cases of HHS, we investigated the medical and social backgrounds of the patients, their clinical findings, and the outcomes...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28843527/factors-associated-with-the-trend-of-physical-and-chemical-restraint-use-among-long-term-care-facility-residents-in-hong-kong-data-from-an-11-year-observational-study
#13
Kuen Lam, Joseph S K Kwan, Chi Wai Kwan, Alice M L Chong, Claudia K Y Lai, Vivian W Q Lou, Angela Y M Leung, Justina Y W Liu, Xue Bai, Iris Chi
BACKGROUND: Negative effects of restraint use have been well-documented. However, the prevalence of restraints use has been high in long-term care facilities in Hong Kong compared with other countries and this goes against the basic principles of ethical and compassionate care for older people. The present study aimed to review the change in the prevalence of physical and chemical restraint use in long-term care facilities (LTCFs) over a period of 11 years in Hong Kong and to identify the major factors associated with their use...
August 23, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28746664/what-do-cochrane-systematic-reviews-say-about-non-pharmacological-interventions-for-treating-cognitive-decline-and-dementia
#14
REVIEW
Vitória Carvalho Vilela, Rafael Leite Pacheco, Carolina Oliveira Cruz Latorraca, Daniela Vianna Pachito, Rachel Riera
BACKGROUND: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo...
May 2017: São Paulo Medical Journal, Revista Paulista de Medicina
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
#15
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
#16
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...
December 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28572521/the-feeding-paradox-in-advanced-dementia-a-local-perspective
#17
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
#18
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
#19
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
#20
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
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