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https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#1
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27903038/clinical-practice-guidelines-and-principles-of-care-for-people-with-dementia-in-australia
#2
Suzanne M Dyer, Kate Laver, Constance D Pond, Robert G Cumming, Craig Whitehead, Maria Crotty
BACKGROUND: Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 years, have a number of comorbidities and experience a trajectory of functional decline. General practitioners (GPs) have an important role in the diagnosis and management of people with dementia. The Cognitive Decline Partnership Centre's Clinical practice guidelines and principles of care for people with dementia (Guidelines) was recently approved by the National Health and Medical Research Council (NHMRC)...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27898260/inpatient-palliative-care-for-neurological-disorders-lessons-from-a-large-retrospective-series
#3
Ying Liu, Danielle Kline, Shanae Aerts, Jeanie M Youngwerth, Jean S Kutner, Stefan Sillau, Benzi M Kluger
BACKGROUND: Patients with neurological disorders are the second most common patient population to receive inpatient palliative care services after cancer; however, there have been few reports describing the characteristics and needs of this population. OBJECTIVE: To understand which patients with neurological diagnoses utilized these services, reasons for consultation, and whether patterns of use changed over time. DESIGN: Retrospective case series...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#4
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27885228/factors-associated-with-the-prognosis-of-elderly-patients-with-advanced-dementia-who-receive-palliative-care-from-geriatric-health-services-facilities
#5
Keizo Sakai, Yasuhiko Masuda, Kunio Miyanishi
AIM: The aim of the present study is to identify the factors associated with the prognosis of advanced dementia patients who are newly admitted to a geriatric health services facility. METHODS: This retrospective cohort study used data that were obtained on admission in the care-assessment of long-term care facility patients. The 177 participants with advanced dementia were admitted to our facility between 2006 and 2013. The association between the factors in the care-assessment and the three-month-mortality rates were examined throughout the year...
2016: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/27869300/changes-in-care-goals-and-treatment-orders-around-the-occurrence-of-health-problems-and-hospital-transfers-in-dementia-a-prospective-study
#6
Simone A Hendriks, Martin Smalbrugge, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVES: To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN: Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal observational study with up to 3.5 years of follow-up. SETTING: Long-term care facilities (N = 28) in the Netherlands. PARTICIPANTS: Newly admitted nursing home patients (N = 372) in various stages of dementia...
November 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27861375/trends-of-do-not-resuscitate-consent-and-hospice-care-utilization-among-noncancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2010-and-2014-a-hospital-based-observational-study
#7
Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Pesus Chou, Tzeng-Ji Chen, Shinn-Jang Hwang
Do-Not-Resuscitate (DNR) and hospice care are not only applied to cancer patients but also to patients with noncancer progressive illness. However, the trends of DNR consent and hospice utilization are not well explored for noncancer patients. This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27859597/quality-of-care-for-people-with-dementia-and-professional-caregivers-perspectives-regarding-palliative-care-in-japanese-community-care-settings
#8
Miharu Nakanishi, Kayo Hirooka, Yuko Morimoto, Atsushi Nishida
OBJECTIVE: Palliative care for dementia includes psychosocial interventions as first-line treatment for challenging behaviour. However, the national dementia plan in Japan contradicts recommendations for palliative care for dementia. This study aimed to examine the association between care quality for patients with dementia and professional caregivers' perspectives regarding palliative care for dementia in Japanese community care settings. METHODS: In total, 2116 professional caregivers from 329 agencies (217 in-home long-term care support providers; 29 small-scale, multiple home-care providers; and 83 group homes) in Tokyo prefecture, Japan, completed cross-sectional, paper-based questionnaires about 3603 people diagnosed with dementia, in May 2016...
November 17, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27849637/pneumonia-intake-problems-and-survival-among-nursing-home-residents-with-variable-stages-of-dementia-in-the-netherlands-results-from-a-prospective-observational-study
#9
Simone A Hendriks, Martin Smalbrugge, Arianne B van Gageldonk-Lafeber, Francisca Galindo-Garre, Maarten Schipper, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVES: We explored how pneumonia and intake problems affect survival in nursing home residents in variable stages of dementia. METHODS: In a longitudinal observational study (372 residents) with up to 3.5 years of follow-up, we examined relationships between dementia severity, the development of pneumonia, intake problems, and mortality using joint modeling, Cox models, and mediation analyses. Dementia severity was measured semiannually with the Bedford Alzheimer Nursing Severity-Scale (BANS-S)...
November 15, 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27821714/end-of-life-care-a-scoping-review-of-experiences-of-advance-care-planning-for-people-with-dementia
#10
Kerry Jones, Giles Birchley, Richard Huxtable, Linda Clare, Tony Walter, Jeremy Dixon
Despite increasing attention given to dementia by international governments and policy makers, the focus of end of life care has been on the dying trajectory of malignant disease. People with severe dementia have complex physical and psychological needs, yet the disease is not always recognised as terminal. Advance Care Planning involving people with dementia and their families can provide opportunities to discuss and later, initiate timely palliative care.We conducted a scoping review of studies exploring decisions associated with the EoLC of people with dementia...
November 7, 2016: Dementia
https://www.readbyqxmd.com/read/27815555/family-caregivers-conceptualisation-of-quality-end-of-life-care-for-people-with-dementia-a-qualitative-study
#11
Nathan Davies, Greta Rait, Laura Maio, Steve Iliffe
BACKGROUND: People with dementia have been described as the 'disadvantaged dying' with poor end-of-life care. Towards the end of life, people with dementia cannot report on the care they receive. It is therefore important to talk to caregivers; however, few have explored the views about end-of-life care from the caregivers' perspective. The majority of research on family caregivers has focussed on the burden and psychological impact of caring for a relative with dementia. AIM: This study aimed to explore the views of family caregivers about quality end-of-life care for people with dementia...
October 25, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27788646/best-possible-care-at-the-end-of-life-inside
#12
Scott Ralph
Lwing at HM Prison Norwich is not a conventional setting for healthcare. It is home to 15 prisoners with extra and palliative care needs, including dementia and cancer.
October 28, 2016: Nursing Older People
https://www.readbyqxmd.com/read/27742606/uk-end-of-life-care-services-in-dementia-initiatives-and-sustainability-results-of-a-national-online-survey
#13
Sarah Amador, Claire Goodman, Louise Robinson, Elizabeth L Sampson
BACKGROUND: People living and dying with non-cancer diagnoses, including dementia, have poorer access to generalist and specialist palliative care than people with cancer, and experience worse outcomes in terms of pain and symptom control, and quality and experience of care. In the UK, the National Council for Palliative Care (NCPC) ran a national survey of services for end-of-life care for people with dementia (2008) in which 16 services were identified, and reported on case studies and examples of good practice...
October 14, 2016: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/27726521/use-of-methadone-as-an-adjuvant-medication-to-low-dose-opioids-for-neuropathic-pain-in-the-frail-elderly-a-case-series
#14
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
December 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27633827/palliative-care-needs-and-symptoms-of-nursing-home-residents-with-and-without-dementia-a-cross-sectional-study
#15
Kirsten Hermans, Joachim Cohen, Nele Spruytte, Chantal Van Audenhove, Anja Declercq
AIM: The aims of the present study were: (i) to describe palliative care needs and symptoms of older adults anticipated to be in the last year of their life in Flemish nursing homes (Belgium); and (ii) to evaluate whether these needs differ between residents with and without dementia. METHODS: A cross-sectional study was carried out in 2014. Nurses and nursing assistants in 15 Flemish nursing homes (Belgium) completed the Palliative care Outcome Scale for 109 residents with palliative care needs...
September 16, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27590922/effect-of-a-home-based-palliative-care-program-on-healthcare-use-and-costs
#16
J Brian Cassel, Kathleen M Kerr, Donna K McClish, Nevena Skoro, Suzanne Johnson, Carol Wanke, Daniel Hoefer
OBJECTIVES: To evaluate the nonclinical outcomes of a proactive palliative care program funded and operated by a health system for Medicare Advantage plan beneficiaries. DESIGN: Observational, retrospective study using propensity-based matching. SETTING: A health system in southern California. PARTICIPANTS: Individuals who received the intervention between 2007 and 2014 (n = 368) were matched with 1,075 comparison individuals within each of four disease groups: cancer, chronic obstructive pulmonary disease, heart failure, and dementia...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27577723/trust-building-recruitment-strategies-for-researchers-conducting-studies-in-african-american-aa-churches-lessons-learned
#17
Gloria Bonner, Sharon Williams, Diana Wilkie, Alysha Hart, Glenda Burnett, Geraldine Peacock
BACKGROUND: An initial and vital important step in recruiting participants for church-based hospice and palliative care research is the establishment of trust and credibility within the church community. Mistrust of medical research is an extremely important barrier hindering recruitment in African American (AA) communities. A church-based EOL dementia education project is currently being conducted at four large urban AA churches. Church leaders voiced mistrust concerns of previous researchers who conducted investigations in their faith-based institutions...
August 30, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27565013/measuring-quality-of-life-of-cognitively-impaired-elderly-inpatients-in-palliative-care-psychometric-properties-of-the-qualid-and-cilq-scales
#18
Radka Bužgová, Radka Kozáková, Lucie Sikorová, Darja Jarošová
OBJECTIVES: The study aimed to assess the psychometric properties of the Czech versions of the Quality of Life in Late-Stage Dementia (QUALID) and the Cognitively Impaired Life Quality (CILQ) scales for use in the palliative care setting in terminally ill patients with cognitive impairment. METHODS: The sample comprised 306 cognitively impaired inpatients with advanced cancer and non-cancer conditions. In this cross-sectional study, two Quality of Life (QoL) measurements were performed at baseline and after five days...
August 26, 2016: Aging & Mental Health
https://www.readbyqxmd.com/read/27533892/populations-and-interventions-for-palliative-and-end-of-life-care-a-systematic-review
#19
Adam E Singer, Joy R Goebel, Yan S Kim, Sydney M Dy, Sangeeta C Ahluwalia, Megan Clifford, Elizabeth Dzeng, Claire E O'Hanlon, Aneesa Motala, Anne M Walling, Jaime Goldberg, Daniella Meeker, Claudia Ochotorena, Roberta Shanman, Mike Cui, Karl A Lorenz
IMPORTANCE: Evidence supports palliative care effectiveness. Given workforce constraints and the costs of new services, payers and providers need help to prioritize their investments. They need to know which patients to target, which personnel to hire, and which services best improve outcomes. OBJECTIVE: To inform how payers and providers should identify patients with "advanced illness" and the specific interventions they should implement, we reviewed the evidence to identify (1) individuals appropriate for palliative care and (2) elements of health service interventions (personnel involved, use of multidisciplinary teams, and settings of care) effective in achieving better outcomes for patients, caregivers, and the healthcare system...
September 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27533416/palliative-and-end-of-life-care
#20
Anne O'Reilly
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article discussed the difference between palliative care and end of life care. It explored the provision of dementia care in care homes and how to optimise palliative and end of life care.
August 17, 2016: Nursing Standard
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