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dementia AND palliative

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https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#1
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: 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 21, 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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28326805/a-retrospective-analysis-of-care-in-patients-with-dementia-hospitalized-at-a-tertiary-medical-center
#6
Riddhi Patira, Huaqing Zhao, Ausim Azizi
BACKGROUND: Hospitalization is an opportunity to address various aspects related to management of dementia, including the goals of care to avoid futile care. We studied the prevalence of these factors when patients with dementia are hospitalized. DESIGN: One hundred and thirty-one charts of patients with dementia admitted to a single university-based hospital were retrospectively reviewed. Data were collected and analyzed for age, gender, the severity of dementia, co-morbidities, co-existing vascular dementia, reversible causes of dementia, mental status scores, medications, consultations, procedures, complications, availability of advance directives, decision-maker, code status, and goals of care discussion...
March 22, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28316557/achieving-prudent-dementia-care-palliare-an-international-policy-and-practice-imperative
#7
Debbie Tolson, Anne Fleming, Elizabeth Hanson, Wilson de Abreu, Manuel Lillo Crespo, Rhoda Macrae, Graham Jackson, Simona Hvalič-Touzery, Iva Holmerová, Pirkko Routasalo
This paper examines the provision of integrated advanced dementia care within seven European countries and critically reviews the potential contribution of the Prudent Healthcare perspective as a starting point for reform. Progressive efforts to innovate, promote quality and integrate care are tempered with the reality of resource constraints. Some policy makers in Europe and North America have turned their attention to the principles of Prudent Healthcare as a potential mechanism to maximise benefits for patients within available resources...
December 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28306661/referring-patients-to-hospice-or-palliative-care
#8
Kathleen Broglio, Anne Walsh
NPs care for patients with chronic diseases such as heart failure, chronic obstructive pulmonary disease, cancer, and dementia. As the disease progresses or patients age, disease-related symptoms may become increasingly burdensome, and these patients may benefit from hospice or palliative care. NPs can guide individuals in this process to optimize care and support at the end of life.
April 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28192226/use-of-preventive-medication-in-patients-with-limited-life-expectancy-a-systematic-review
#9
REVIEW
Arjun Poudel, Patsy Yates, Debra Rowett, Lisa M Nissen
CONTEXT: Optimal prescribing in patients with limited life expectancy (LLE) remains unclear. OBJECTIVES: This study systematically reviews the published literature regarding the use of preventive medication in patients with reduced life expectancy. METHODS: A systematic literature search was conducted using three databases (MEDLINE, EMBASE, and CINAHL). Articles published in English from January 1995 to December 2015 were retrieved for analysis to identify peer-reviewed, observational studies assessing use of preventive medications in patients with LLE...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28184974/-causes-of-death-in-amyotrophic-lateral-sclerosis-results-from-the-rhineland-palatinate-als-registry
#10
J Wolf, A Safer, J C Wöhrle, F Palm, W A Nix, M Maschke, A J Grau
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is associated with an increased mortality. Knowledge of possible causes of death could lead to an individualization of the palliative treatment concept and result in a differentiated palliative treatment pathway. Currently, only few systematic data are available on the heterogeneity of causes of death associated with ALS. OBJECTIVE: Analysis of the various causes of death in a prospective population-based German cohort of ALS patients...
February 9, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28152436/an-individualized-coaching-program-for-patients-with-acute-ischemic-stroke-feasibility-study
#11
P Vanacker, D Standaert, N Libbrecht, I Vansteenkiste, D Bernard, L Yperzeele, G Vanhooren
OBJECTIVES: An individualized stroke care program was developed to match patients' education with their needs regarding stroke knowledge, secondary prevention and rehabilitation. Our purpose was to assess feasibility of in-hospital and post-discharge, personalized stroke coaching service. METHODS: Acute ischemic stroke patients enrolled in ASTRAL-B stroke registry (Sint-Lucashospital, Bruges Belgium) with: (a) hospitalization between 12/2014-12/2015, (b) hospital-to-home discharge, and (c) without cognitive decline, were selected...
March 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28135810/post-acute-care-facility-as-a-discharge-destination-for-patients-in-need-of-palliative-care-in-brazil
#12
Luiz Guilherme L Soares, André M Japiassu, Lucia C Gomes, Rogéria Pereira
Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28112072/physicians-perceptions-of-suffering-in-people-with-dementia-at-the-end-of-life
#13
Jenny T van der Steen, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen
OBJECTIVE: Our aim was to describe physicians' perceptions of the suffering of their patients who are dying with dementia, many of whom are incompetent with regard to decision making and have difficulty with communicating about the source of their distress and with identifying related factors. METHOD: We analyzed data from the nationally representative observational Dutch End-of-Life in Dementia (DEOLD) cohort study (2007-2011), which involved 34 long-term care facilities...
January 23, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28078441/-palliative-care-in-nursing-homes-results-of-a%C3%A2-survey-about-knowledge-and-self-efficacy-of-nursing-staff
#14
O Kada, H Janig, G Pinter, K Cernic, R Likar
BACKGROUND: Nursing homes are confronted more and more with palliative care patients, which present a challenge for nursing and medical personnel. Deficits in the palliative care of geriatric patients have been repeatedly demonstrated and many nursing home residents, especially those suffering from dementia, are undersupplied regarding pain management. OBJECTIVES: The present study was carried out to measure the knowledge and self-efficacy of nursing staff in the province of Carinthia (Austria) regarding palliative care of nursing home residents...
January 11, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28078098/transfer-of-nursing-home-residents-to-emergency-departments-organizational-differences-between-nursing-homes-with-high-vs-low-transfer-rates
#15
Marie Kirsebom, Mariann Hedström, Ulrika Pöder, Barbro Wadensten
AIM: To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department. DESIGN: Explorative. METHOD: In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department...
January 2017: Nursing Open
https://www.readbyqxmd.com/read/28063859/assessing-palliative-care-content-in-dementia-care-guidelines-a-systematic-review
#16
REVIEW
Pamela Durepos, Abigail Wickson-Griffiths, Afeez Abiola Hazzan, Sharon Kaasalainen, Vasilia Vastis, Lisa Battistella, Alexandra Papaioannou
CONTEXT: Families of persons with dementia continue to report unmet needs during end of life (EOL). Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPGs) and an integrative palliative approach. OBJECTIVES: We aimed to assess palliative care content in dementia CPGs to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care Association "Square of Care...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060462/end-of-life-care-for-people-dying-with-dementia-in-general-practice-in-belgium-italy-and-spain-a-cross-sectional-retrospective-study
#17
Yolanda W H Penders, Gwenda Albers, Luc Deliens, Guido Miccinesi, Tomás Vega Alonso, Maite Miralles, Sarah Moreels, Lieve Van den Block
AIM: To describe and compare end-of-life care for people with mild or severe dementia in general practice in Belgium, Italy and Spain, in terms of place of care, place of death, treatment aims, use of specialized palliative care and communication with general practitioners (GPs). METHODS: Cross-sectional retrospective survey was carried out of nationwide networks of GPs in Belgium, Italy and Spain, including patients who died aged 65 years or older in 2009-2011 and were judged by the GP to have had dementia (n = 1623)...
January 6, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28056634/relating-cause-of-death-with-place-of-care-and-healthcare-costs-in-the-last-year-of-life-for-patients-who-died-from-cancer-chronic-obstructive-pulmonary-disease-heart-failure-and-dementia-a-descriptive-study-using-registry-data
#18
Annicka Gm van der Plas, Mariska G Oosterveld-Vlug, H Roeline W Pasman, Bregje D Onwuteaka-Philipsen
BACKGROUND: The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients. AIM: Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia. DESIGN: Data from insurance company Achmea (2009-2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands...
January 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28049547/palliative-care-during-the-final-week-of-life-of-older-people-in-nursing-homes-a-register-based-study
#19
Jonas Smedbäck, Joakim Öhlén, Kristofer Årestedt, Anette Alvariza, Carl-Johan Fürst, Cecilia Håkanson
OBJECTIVE: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. METHOD: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics...
January 4, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28043897/natural-products-against-alzheimer-s-disease-pharmaco-therapeutics-and-biotechnological-interventions
#20
REVIEW
Abhijit Dey, Raktim Bhattacharya, Anuradha Mukherjee, Devendra Kumar Pandey
Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress...
March 2017: Biotechnology Advances
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