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dementia AND palliative

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https://www.readbyqxmd.com/read/28622379/end-of-life-care-for-people-with-dementia-the-views-of-health-professionals-social-care-service-managers-and-frontline-staff-on-key-requirements-for-good-practice
#1
Richard Philip Lee, Claire Bamford, Marie Poole, Emma McLellan, Catherine Exley, Louise Robinson
BACKGROUND: Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia. METHODS AND FINDINGS: Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads...
2017: PloS One
https://www.readbyqxmd.com/read/28619956/a-longitudinal-modelling-study-estimates-acute-symptoms-of-community-acquired-pneumonia-recover-to-baseline-by-10%C3%A2-days
#2
Daniel G Wootton, Laura Dickinson, Henry Pertinez, Joanne Court, Odiri Eneje, Lynne Keogan, Laura Macfarlane, Sarah Wilks, Jane Gallagher, Mark Woodhead, Stephen B Gordon, Peter J Diggle
Our aims were to address three fundamental questions relating to the symptoms of community-acquired pneumonia (CAP): Do patients completely recover from pneumonia symptoms? How long does this recovery take? Which factors influence symptomatic recovery?We prospectively recruited patients at two hospitals in Liverpool, UK, into a longitudinal, observational cohort study and modelled symptom recovery from CAP. We excluded patients with cancer, immunosuppression or advanced dementia, and those who were intubated or palliated from admission...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28618899/development-of-a-caregiver-reported-measure-to-support-systematic-assessment-of-people-with-dementia-in-long-term-care-the-integrated-palliative-care-outcome-scale-for-dementia
#3
Clare Ellis-Smith, Catherine J Evans, Fliss Em Murtagh, Lesley A Henson, Alice M Firth, Irene J Higginson, Barbara A Daveson
BACKGROUND: Symptom burden is common for long-term care residents with dementia which if untreated compromises quality of life. Measurement tools can support assessment of symptoms and problems but are not widely used in long-term care settings. We developed the Integrated Palliative care Outcome Scale for Dementia derived from the Palliative care Outcome Scale, Palliative care Outcome Scale-Symptom and Integrated Palliative care Outcome Scale. AIM: To examine the content validity, acceptability and comprehension of Integrated Palliative care Outcome Scale for Dementia for routine use in long-term care settings for people with dementia and to refine Integrated Palliative care Outcome Scale for Dementia...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28601804/pain-related-palliative-care-challenges-in-people-with-advanced-dementia-call-for-education-and-practice-development-in-all-care-settings
#4
Marie Ernsth Bravell
No abstract text is available yet for this article.
June 10, 2017: Evidence-based Nursing
https://www.readbyqxmd.com/read/28590159/which-patients-die-in-their-preferred-place-a-secondary-analysis-of-questionnaire-data-from-bereaved-relatives
#5
Natasja Jh Raijmakers, Anke Je de Veer, Rosanne Zwaan, Jolien M Hofstede, Anneke L Francke
BACKGROUND: Previous studies on factors influencing the place of death have focused on cancer patients dying at home. However, home is not always the preferred place. AIM: To provide insight into the extent to which patients with various diseases die in their preferred place and into factors associated with dying in the preferred place. DESIGN: A secondary analysis of the data set of the evaluation study of the National Quality Improvement Programme for Palliative Care was undertaken to explore factors related to 'dying in the preferred place'...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28575866/catalpol-protects-synaptic-proteins-from-beta-amyloid-induced-neuron-injury-and-improves-cognitive-functions-in-aged-rats
#6
Zhiming Xia, Fengfei Wang, Shuang Zhou, Rui Zhang, Fushun Wang, Jason H Huang, Erxi Wu, Yongfang Zhang, Yaer Hu
Synapse loss is one of the common factors contributing to cognitive disorders, such as Alzheimer's disease (AD), which is manifested by the impairment of basic cognitive functions including memory processing, perception, problem solving, and language. The current therapies for patients with cognitive disorders are mainly palliative; thus, regimens preventing and/or delaying dementia progression are urgently needed. In this study, we evaluated the effects of catalpol, isolated from traditional Chinese medicine Rehmannia glutinosa, on synaptic plasticity in aged rat models...
May 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28574529/prospective-cohort-study-of-hospitalized-adults-with-advanced-cancer-associations-between-complications-comorbidity-and-utilization
#7
Peter May, Melissa M Garrido, Melissa D Aldridge, J Brian Cassel, Amy S Kelley, Diane E Meier, Charles Normand, Joan D Penrod, Thomas J Smith, R Sean Morrison
BACKGROUND: Inpatient hospital stays account for more than a third of direct medical cancer care costs. Evidence on factors driving these costs can inform planning of services, as well as consideration of equity in access. OBJECTIVE: To measure the association between hospital costs, and demographic, clinical, and system factors, for a cohort of adults with advanced cancer. DESIGN: Prospective multisite cohort study. SETTING: Four medical and cancer centers...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28562402/artificial-nutrition-and-hydration-in-people-with-late-stage-dementia
#8
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/28553880/dementia-behaviour-management-programme-at-home-impact-of-a-palliative-care-approach-on-care-managers-and-professional-caregivers-of-home-care-services
#9
Miharu Nakanishi, Kaori Endo, Kayo Hirooka, Taeko Nakashima, Yuko Morimoto, Eva Granvik, Lennart Minthon, Katarina Nägga, Atsushi Nishida
OBJECTIVES: Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. METHOD: Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour...
May 29, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28532225/pneumonia-in-nursing-home-patients-with-advanced-dementia-decisions-intravenous-rehydration-therapy-and-discomfort
#10
Jenny T van der Steen, Paola Di Giulio, Fabrizio Giunco, Massimo Monti, Simona Gentile, Daniele Villani, Silvia Finetti, Francesca Pettenati, Lorena Charrier, Franco Toscani
BACKGROUND: Comfort may be an appropriate goal in advanced dementia. Longitudinal studies on physician decision-making and discomfort assessed by direct observation are rare, and intravenous rehydration therapy is controversial. METHODS: To assess treatment decisions and discomfort in patients with advanced dementia and pneumonia and to compare by intravenous rehydration therapy, we used data from the observational multicenter Italian End of Life Observatory-Prospective Study On DEmentia patients Care...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28521070/drug-therapy-for-symptoms-associated-with-anxiety-in-adult-palliative-care-patients
#11
REVIEW
Susan Salt, Caroline A Mulvaney, Nancy J Preston
BACKGROUND: This is an update of a Cochrane Review first published in 2004 (Issue 1) and previously updated in 2012 (Issue 10). Anxiety is common in palliative care patients. It can be a natural response to the complex uncertainty of having a life-limiting illness or impending death, but it may represent a clinically significant issue in its own right. OBJECTIVES: To assess the effectiveness of drug therapy for treating symptoms of anxiety in adults with a progressive life-limiting illness who are thought to be in their last year of life...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28514961/how-many-people-will-need-palliative-care-in-2040-past-trends-future-projections-and-implications-for-services
#12
S N Etkind, A E Bone, B Gomes, N Lovell, C J Evans, I J Higginson, F E M Murtagh
BACKGROUND: Current estimates suggest that approximately 75% of people approaching the end-of-life may benefit from palliative care. The growing numbers of older people and increasing prevalence of chronic illness in many countries mean that more people may benefit from palliative care in the future, but this has not been quantified. The present study aims to estimate future population palliative care need in two high-income countries. METHODS: We used mortality statistics for England and Wales from 2006 to 2014...
May 18, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28504894/preventing-burdensome-transitions-of-nursing-home-residents-with-advanced-dementia-it-s-more-than-advance-directives
#13
Ruth Palan Lopez, Susan L Mitchell, Jane L Givens
BACKGROUND: Although a palliative approach to care is recommended for people with advanced dementia, many nursing home (NH) residents with dementia experience burdensome interventions such as hospital transfers at the end of life. OBJECTIVE: The goal of this study was to examine how decisions to transfer NH residents with advanced dementia are made, from the perspective of NH nurses and physicians. METHODS: A qualitative, descriptive method was used...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28485515/consensus-statement-of-the-international-summit-on-intellectual-disability-and-dementia-related-to-end-of-life-care-in-advanced-dementia
#14
Philip McCallion, Mary Hogan, Flavia H Santos, Mary McCarron, Kathryn Service, Sandy Stemp, Seth Keller, Juan Fortea, Kathleen Bishop, Karen Watchman, Matthew P Janicki
BACKGROUND: Adults with intellectual disability are affected by dementia at equivalent and elevated rates, many surviving into advanced age. End of life care and support considerations come into play among these individuals when most are in the advanced stage of dementia. METHODS: A preliminary report summarizing available literature and making initial recommendations was developed by a workgroup, reviewed by all conference participants and then was finalized by the workgroup...
May 9, 2017: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/28454534/palliative-care-for-people-with-dementia-in-the-terminal-phase-a-mixed-methods-qualitative-study-to-inform-service-development
#15
Jenny T van der Steen, Natashe Lemos Dekker, Marie-José H E Gijsberts, Laura H Vermeulen, Margje M Mahler, B Anne-Mei The
BACKGROUND: When entering the dying phase, the nature of physical, psychosocial and spiritual care needs of people with dementia and their families may change. Our objective was to understand what needs to be in place to develop optimal palliative care services for the terminal phase in the face of a small evidence base. METHODS: In 2015-2016, we performed a mixed-methods qualitative study in which we (1) analysed the domains and recommendations from the European Association for Palliative Care (EAPC) dementia white paper and identified those with particular relevance for the terminal phase; (2) performed a series of focus group discussions with Dutch family caregivers of people with dementia in variable stages; (3) conducted interviews with experts involved in 15 special forms of terminal care for people with dementia in five countries...
April 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#16
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
CONTEXT: U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES: The objective of this study was to examine the value of expanded palliative care access for NH residents with moderate-to-very severe dementia. METHODS: We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate-to-very severe dementia, and deaths in 2006-2010...
April 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28436189/medication-appropriateness-for-patients-with-dementia-approaching-the-end-of-their-life
#17
Hsien-Yeh Chuang, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
AIM: To examine medication use among patients with dementia towards the end of their life and to evaluate the appropriateness of medication use by using a nationwide database. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 6532 people with dementia that died between 2008 and 2012. For each person with dementia, data of medication use in the last month of outpatient setting (vs -12th month [baseline]) and last hospitalization (vs -3rd hospitalization [baseline]) before death were retrieved for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28428907/palliative-care-in-huntington-disease-personal-reflections-and-a-review-of-the-literature
#18
REVIEW
Christopher G Tarolli, Amy M Chesire, Kevin M Biglan
BACKGROUND: Huntington disease is a fatal, autosomal dominant, neurodegenerative disorder manifest by the triad of a movement disorder, behavioral disturbances, and dementia. At present, no curative or disease modifying therapies exist for the condition and current treatments are symptomatic. Palliative care is an approach to care that focuses on symptom relief, patient and caregiver support, and end of life care. There is increasing evidence of the benefit of palliative care throughout the course of neurodegenerative conditions including Parkinson disease and amyotrophic lateral sclerosis...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28402533/caregiver-perspectives-about-using-antipsychotics-and-other-medications-for-symptoms-of-dementia
#19
John William Kerns, Jonathan D Winter, Katherine M Winter, Christine C Kerns, Rebecca S Etz
Background and Objectives: To avoid "chemical restraints," policies and guidelines have been implemented to curb the use of medications for behavioral and psychological symptoms of dementia (BPSD). Antipsychotics have been particularly targeted because of their rare severe side effects. Consequently, caregiver directed non-pharmacologic therapies have increased while medication use for BPSD has diminished. Despite such initiatives, however, antipsychotics continue to be prescribed "off-label" for roughly 20% of nursing home patients...
April 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28330379/patient-self-defined-goals
#20
Sandra Ellen Schellinger, Eric Worden Anderson, Monica Schmitz Frazer, Cindy Lynn Cain
This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge of what goals are important beyond the physical-making existing disease-specific guidelines more holistic. Integration of goals of care discussions and documentation is standard for quality palliative care but not consistently executed into general and specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits for 160 patients with advanced heart failure, cancer, and dementia expected to die in 2 to 3 years...
January 1, 2017: American Journal of Hospice & Palliative Care
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