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Advance care planning and decision-making in dementia care - a literature review

MOUNTFORD, Wendy ; HARRISON DENING, Karen ; GREEN, Julie
Nursing older people, 15/07/2020, Pagination inconnue

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Motivations for people with cognitive impairment to complete an advance research directive - a qualitative interview study

JONGSMA, Karin ; PERRY, Julia ; SCHICKTANZ, Silke ; RADENBACH, Katrin
BMC psychiatry, 08/07/2020, vol.20, n°1, 9 p.

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Physicians' and public attitudes toward euthanasia in people with advanced dementia

BRINKMAN-STOPPELENBURG, Arianne ; EVENBLIJ, Kirsten ; PASMAN, H. Roeline W. ; VAN DELDEN, Johannes J. M. ; ONWUTEAKA-PHILIPSEN, Bregje D. ; VAN DER HEIDE, Agnes
Journal of the American Geriatrics Society, 11/07/2020, 10 p.

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Family caregiving at the end of life and hospice use - a national study of medicare beneficiaries

KUMAR, Vedika ; ANKUDA, Claire K. ; ALDRIDGE, Melissa D. ; HUSAIN, Mohammed ; ORNSTEIN, Katherine A.
Journal of the American Geriatrics Society, 30/06/2020, Pagination inconnue

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The trend of aggressive treatments in end-of-life care for older people with dementia after a policy change in Taiwan

HSU, Ying Hsin ; CHOU, Ming Yueh ; CHEN, Hsiu-Min ; CHANG, Wei-Cheng ; CHU, Che Sheng ; WANG, Yu-Chun ; HSU, Chiao-Lin ; LIANG, Chih-Kuang ; LEE, Ching-Chih ; LIN, Yu Te
Journal of the American Medical Directors Association, 06/2020, vol.21, n°6, p. 858-863.e1

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A netnographic approach - views on assisted dying for individuals with dementia

DEHKHODA, Aida ; OWENS, R. Glynn ; MALPAS, Phillipa J.
Qualitative health research, 20/06/2020, Pagination inconnue

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Palliative care needs and utilization of specialist services for people imminently dying with dementia - a national population-based study

DING, Jinfeng ; COOK, Angus ; QIN, Xiwen ; HO, Stephen C.H. ; JOHNSON, Claire E
International journal of nursing studies, 09/2020, vol.109, Pagination inconnue

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Deaths in dementia - a scoping review of prognostic variables

KAUR, Palvinder ; TAN, Woan Shin ; GUNAPAL, Pradeep Paul George ; DING, Yew Yoong ; ONG, Reuben ; WU, Huei Yaw ; HUM, Allyn
BMJ supportive and palliative care, 19/06/2020, Pagination inconnue

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Associations between end-of-life expenditures and hospice stay length vary by clinical condition and expenditure duration

HUNG, Peiyin ; HSU, Sylvia H. ; WANG, Shi-Yi
VALUE IN HEALTH, 06/2020, vol.23, n°6, p. 697-704

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Family caregiver perceptions of end of life in persons with and without dementia

COHEN-MANSFIELD, Jiska ; BRILL, Shai
Geriatric nursing, 06/2020, Pagination inconnue

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Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014 - a time-series cross-sectional analysis

XU, Wei ; WU, Changshan ; FLETCHER, Jason
BMC public health, 11/06/2020, vol.20, n°1, p. 1-13

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Exploring the issues of advance directives in patients with mild dementia in Taiwan

CHOU, H.H.
Acta medica Okayama, 06/2020, vol.74, n°3, p. 215-220

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Conceptual framework for assisted dying for individuals with dementia - views of experts not opposed in principle

DEHKHODA, Aida ; OWENS, Richard G. ; MALPAS, Phillipa J.
Dementia, 14/05/2020, Pagination inconnue

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Characteristics and outcomes of dementia patients who receive inpatient palliative care consultation

SHARDA, Neema ; ZIETLOW, Kahli ; WONG, Serena ; KUCHIBHATLA, Maragatha ; JOHNSON, Kimberly S.
Journal of the American Geriatrics Society, 16/05/2020, Pagination inconnue

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Thème : Médecine.

DEMENCE ; DEMARCHE PALLIATIVE ; CONSULTATION ; ETUDE RETROSPECTIVE ; PERSONNE AGEE

BACKGROUND/OBJECTIVES: acute hospitalization may be an ideal opportunity to introduce palliative care to dementia patients, who may benefit from symptom management and goals of care discussions. We know little about patients who receive inpatient palliative care consultations (IPCCs).
DESIGN: Retrospective analysis using electronic medical record.
SETTING: Tertiary academic medical center and affiliated community hospital.
PARTICIPANTS: Patients with dementia by International Classification of Diseases diagnosis, 65 years or older, hospitalized between July 1, 2015, and December 31, 2015.
MEASUREMENTS: We used 2 and t -test/Mann-Whitney U test to compare characteristics (living arrangement, advanced dementia markers, diagnoses of delirium and dementia with behavior disturbance, and admitting diagnosis) and outcomes (change in code status, length of stay [LOS], discharge disposition, and discharge medications for symptom management) of patients who did and did not receive IPCC. Patients were matched on sex, age, and race.
RESULTS: Among 927 hospitalized patients with dementia, 17% received IPCC (N = 157). Patients who received IPCC were more likely to be admitted from a nursing facility (35.7% vs 12.7%; P < .0001), experience delirium (71.3% vs 57.3%; P = .01), have behavior disturbance (23.6% vs 13.4%; P = .02), have a pressure ulcer at admission (26.1% vs 11.5%; P = .001), have hypernatremia (12.7% vs 3.2%; P = .002), and be bedbound (20.4% vs 3.2%; P < .000). Patients who received IPCC had a longer LOS (median = 5.9 vs 4.3 days; P = .004) and were more likely to be discharged to hospice (56% vs 3.1%; P < .0001). Patients with IPCC were more likely to have a discharge code status of do not attempt resuscitation (89% vs 46%). There was no significant difference in comfort medications at discharge between groups.
CONCLUSIONS: Patients who received IPCC had evidence of more advanced dementia. These patients were more likely to change their code status and enroll in hospice. IPCC may be useful to prioritize patient-centered care and discuss what matters most to patients and families.

Origine : PubMed

Advance care planning for people living with dementia - an umbrella review of effectiveness and experiences

WENDRICH-VAN DAEL, Annelien ; BUNN, Frances ; LYNCH, Jennifer ; PIVODIC, Lara ; VAN DEN BLOCK, Lieve ; GOODMAN, Claire
International journal of nursing studies, 20/03/2020, vol.107, p. 1-13

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Thème : Soins. Cote : eD02.03.00

PROJET SOIN ANTICIPE ; DEMENCE ; REVUE SYSTEMATIQUE ; EFFICACITE

BACKGROUND: End of life care is often inadequate for people with dementia. Advanced care planning (ACP) has the potential to improve outcomes for people with dementia. The aim of this review is to establish the strength of the evidence and provide decision makers with a clear understanding of what is known about ACP for people living with dementia.
DESIGN: Evidence synthesis including systematic reviews and primary studies. PROSPERO registration: CRD42018107718.
DATA SOURCES: PubMed, CINAHL Plus, SCOPUS, Social Care Online and Cochrane Library were searched (July 2018). No year limit applied. To be included, reviews had to evaluate effectiveness of ACP for people with dementia or report on views and experiences of ACP from the perspective of people with dementia, carers, or health and care professionals. Additional searches (September 2018) were conducted to identify recent primary studies not included in the reviews.
REVIEW METHODS: Data extraction was undertaken by one reviewer and checked by a second. Methodological quality was assessed using AMSTAR-2 and Joanna Briggs Institute instruments by two authors independently. Outcomes were categorized and tabulated to assess effectiveness. Qualitative data was analysed using thematic synthesis.
RESULTS: Nineteen reviews (163 unique studies) and 11 primary articles with a range of advance care planning definitions and of variable quality were included. Advance care planning was associated with decreased hospitalizations, increased concordance between care received and prior wishes and increased completion of advance care planning documents but quality of primary research was variable. Views of ACP for people with dementia can be clustered around six themes; 1) timing and tailoring, 2) willingness to engage, 3) roles and responsibilities of healthcare professionals, 4) relationships, 5) training and 6) resources needed. Diminishing decision-making capacity over time is a key overarching feature.
CONCLUSIONS: Advance care planning is acceptable for people with dementia and their carers and is associated with improved outcomes. Guidelines on which outcomes and which definition to use are necessary, as is research to test different approaches to ACP. Education on topics related to diminishing decision-making capacity is key to optimize advance care planning for people with dementia and their carers.

Origine : PubMed

Advance directives for dementia can elicit preferences to improve patient care

MEREL, Susan E. ; GASTER, Barak
Journal of the American Geriatrics Society, 06/05/2020, Pagination inconnue

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Medical ethics issues in dementia and end of life

ALLEN, William
Current psychiatry reports, 09/05/2020, vol.22, n°6, Pagination inconnue

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Social regulation activities in end-of-life - a qualitative study on completion of advance directives in Swiss nursing homes

DROZ MENDELZWEIG, M.
BMC palliative care, 23/04/2020, vol.19, n°1, p. 1-11

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Characteristics of people with dementia vs other conditions on admission to inpatient palliative care

DING, Jinfeng ; JOHNSON, Claire E. ; LEE, Yun Chong Olivia ; GAZEY, Angela ; COOK, Angus
Journal of the American Geriatrics Society, 24/04/2020, Pagination inconnue

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Thème : Médecine.

DEMENCE ; DEMARCHE PALLIATIVE ; AUSTRALIE ; SYMPTOME ; ANALYSE COMPARATIVE

OBJECTIVES: Our aim was to (1) describe the clinical characteristics and symptoms of people diagnosed with dementia at the time of admission to inpatient palliative care; and (2) compare the nature and severity of these palliative care–related problems to patients with other chronic diseases.
DESIGN: Descriptive study using assessment data on point of care outcomes (January 1, 2013, to December 31, 2018).
SETTING: A total of 129 inpatient palliative care services participating in the Australian Palliative Care Outcomes Collaboration.
PARTICIPANTS: A total of 29,971 patients with a primary diagnosis of dementia (n = 1,872), lung cancer (n = 19,499), cardiovascular disease (CVD, n = 5,079), stroke (n = 2,659), or motor neuron disease (MND, n = 862).
MEASUREMENTS: This study reported the data collected at the time of admission to inpatient palliative care services including patients' self-rated levels of distress from seven common physical symptoms, clinician-rated symptom severity, functional dependency, and performance status. Other data analyzed included number of admissions, length of inpatient stay, and palliative care phases.
RESULTS: At the time of admission to inpatient palliative care services, relative to patients with lung cancer, CVD, and MND, people with dementia presented with lower levels of distress from most symptoms (odds ratios [ORs] range from .15 to .80; P < .05 for all) but higher levels of functional impairment (ORs range from 3.02 to 8.62; P < .001 for all), and they needed more assistance with basic activities of daily living (ORs range from 3.83 to 12.24; P < .001 for all). The trends were mostly the opposite direction when compared with stroke patients. Patients with dementia tended to receive inpatient palliative care later than those with lung cancer and MND.
CONCLUSION: The unique pattern of palliative care problems experienced by people with dementia, as well as the skills of the relevant health services, need to be considered when deciding on the best location of care for each individual. Access to appropriately trained palliative care clinicians is important for people with high levels of physical or psychological concerns, irrespective of the care setting or diagnosis.

Origine : PubMed

Doctors can fulfil euthanasia request if patient develops dementia, rules Dutch supreme court

SHELDON, Tony
BMJ (Clinical research ed.), 24/04/2020, vol.369, Pagination inconnue

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