Improving the end-of-life for people with dementia living in a care home: an intervention study.

Abstract:

BACKGROUND:One in three adults, most of whom are living in a care home at the time, dies with dementia. Their end-of-life is often in hospital, where they may experience uncomfortable interventions without known benefit and die rapidly with uncontrolled pain and comfort needs. This study aimed to improve end-of-life care for people with dementia in a care home by increasing the number and implementation of advanced care wishes. METHODS:We recruited staff, residents with dementia, and their relatives from a 120-bed nursing home in London, UK. The intervention was a ten-session manualized, interactive staff training program. We compared advance care wishes documentation and implementation, place of death for residents who died, and themes from staff and family carers' after-death interviews pre- and post-intervention. RESULTS:Post-intervention there were significant increases in documented advance care wishes arising from residents' and relatives' discussions with staff about end-of-life. These included do not resuscitate orders (16/22, 73% vs. 4/28, 14%; p < 0.001); and dying in the care homes as opposed to hospital (22/29, 76% vs. 14/30, 47%; p < 0.02). Bereaved relatives overall satisfaction increased from 7.5 (SD = 1.3) pre-intervention to 9.1 (SD = 2.4) post-intervention; t = 17.6, p = 0.06. Relatives reported increased consultation and satisfaction about decisions. Staff members were more confident about end-of-life planning and implementing advanced wishes. CONCLUSION:This small non-randomized study is the first end-of-life care in dementia intervention to report an increase in family satisfaction with a reduction in hospital deaths. This is promising but requires further evaluation in diverse care homes.

journal_name

Int Psychogeriatr

authors

Livingston G,Lewis-Holmes E,Pitfield C,Manela M,Chan D,Constant E,Jacobs H,Wills G,Carson N,Morris J

doi

10.1017/S1041610213001221

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1849-58

issue

11

eissn

1041-6102

issn

1741-203X

pii

S1041610213001221

journal_volume

25

pub_type

杂志文章
  • The clinical course and interrelations of dementia related symptoms.

    abstract::ABSTRACTBackground:Dementia is a neurodegenerative syndrome that interferes with multiple aspects of life, including cognition, daily functioning, and behavior. Despite the large heterogeneity in symptom development, these three domains are seldom studied simultaneously. This study investigates how trajectories of the...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1017/S1041610217000321

    authors: Haaksma ML,Leoutsakos JS,Bremer JAE,Aalten P,Ramakers IHGB,Verhey FRJ,Olde Rikkert MGM,Melis RJF

    更新日期:2018-06-01 00:00:00

  • Bedside clinical and electrophysiological assessment: assessment of change in vulnerable patients.

    abstract::Current approaches to the diagnosis of delirium are based upon the recognition of symptoms that emerge in the pathological state. As an alternative, we propose an approach to case identification for research purposes based on the recognition of significant changes in the cognitive or cerebral state of the individual p...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/s104161029100073x

    authors: Katz IR,Mossey J,Sussman N,Muenz L,Harner R,Curlik Sm,Sands LP

    更新日期:1991-01-01 00:00:00

  • The Birmingham Relationship Continuity Measure: the development and evaluation of a measure of the perceived continuity of spousal relationships in dementia.

    abstract:BACKGROUND:Qualitative research has suggested that spousal carers of someone with dementia differ in terms of whether they perceive their relationship with that person as continuous with the premorbid relationship or as radically different, and that a perception of continuity may be associated with more person-centered...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610212001743

    authors: Riley GA,Fisher G,Hagger BF,Elliott A,Le Serve H,Oyebode JR

    更新日期:2013-02-01 00:00:00

  • ADHD symptoms across the lifespan in a population-based Swedish sample aged 65 to 80.

    abstract:BACKGROUND:The purpose of the study was to examine the attention deficit hyperactivity disorder (ADHD) symptomatology across the lifespan by comparing older individuals' self-reports about current ADHD symptoms and symptoms in childhood. METHODS:The 25-item Wender Utah Rating Scale (WURS) was initially administered in...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610212002050

    authors: Guldberg-Kjär T,Sehlin S,Johansson B

    更新日期:2013-04-01 00:00:00

  • Use of antipsychotic medications for the management of delirium: an audit of current practice in the acute care setting.

    abstract:OBJECTIVE:Despite delirium being common in older hospitalized people, little is known about its management. The aims of this study are (1) to describe the pharmacological management of delirium in an acute care setting as a baseline measure prior to the implementation of newly developed Australian guidelines; and (2) t...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610208008028

    authors: Tropea J,Slee J,Holmes AC,Gorelik A,Brand CA

    更新日期:2009-02-01 00:00:00

  • Older women who died by suicide: suicide means, sociodemographic and psychiatric risk factors, and other precipitating circumstances.

    abstract::ABSTRACTBackground:US suicide rates among older women have substantially increased over the past decade. We examined potential differences in sociodemographic and risk/precipitating factors among older female suicide decedents who died by drug overdose versus firearms, hanging/suffocation, and other means, and postmor...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610218000212

    authors: Choi NG,DiNitto DM,Sagna AO,Marti CN

    更新日期:2018-10-01 00:00:00

  • What would help me stop abusing? The family carer's perspective.

    abstract:BACKGROUND:A third of family members caring for people with dementia report acting abusively towards them, but there are currently no evidence-based interventions to reduce or prevent such behavior. Family carers who act abusively have not previously been consulted about what may help to reduce abuse. METHOD:We prospe...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S104161020800834X

    authors: Selwood A,Cooper C,Owens C,Blanchard M,Livingston G

    更新日期:2009-04-01 00:00:00

  • A double-blind, randomized clinical trial to assess the augmentation with nimodipine of antidepressant therapy in the treatment of "vascular depression".

    abstract:BACKGROUND:Cerebrovascular disease may cause "vascular depression" (VaD). Calcium channel-blockers are presumed treatments for cerebrovascular disease and might be expected to improve depression and prevent recurrence. OBJECTIVE:To examine the efficacy and tolerability of the use of nimodipine as an augmentation of fl...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1017/s1041610205001493

    authors: Taragano FE,Bagnatti P,Allegri RF

    更新日期:2005-09-01 00:00:00

  • To end life or to save life: ageism moderates the effect of message framing on attitudes towards older adults' suicide.

    abstract:BACKGROUND:Global suicide rates among older adults are very high. Public attitudes towards older adults' suicide may affect older adults upon their contemplating such an act. Previous research has demonstrated that message framing affects persons' judgments and decision making. Thus, message framing may have particular...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610216000636

    authors: Gamliel E,Levi-Belz Y

    更新日期:2016-08-01 00:00:00

  • A brief measure of predeath grief in dementia caregivers: the Caregiver Grief Questionnaire.

    abstract:OBJECTIVE:The study of predeath grief is hampered by measures that are often lengthy and not clearly differentiated from other caregiving outcomes, most notably burden. We aimed to validate a new 11-item Caregiver Grief Questionnaire (CGQ) assessing two dimensions of predeath grief, namely relational deprivation and em...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610219000309

    authors: Cheng ST,Ma DY,Lam LCW

    更新日期:2019-08-01 00:00:00

  • Levels and rates of depression among Chinese people living in Chinese ethno-specific and mainstream residential care in Sydney.

    abstract:BACKGROUND:This study aimed to examine the levels and rates of depression in Chinese residents living in ethno-specific nursing homes (NHs), and Chinese residents living in mainstream NHs in Sydney. Australia has a growing aging migrant population and rates of depression in NHs are high, but the prevalence of depressio...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S104161020999069X

    authors: Goh I,Low LF,Brodaty H

    更新日期:2010-03-01 00:00:00

  • Fears come true: the experiences of older care recipients and their family members of live-in foreign home care workers.

    abstract:BACKGROUND:Foreign home care services provided to frail older adults by individuals from the developing world are a global phenomenon. This study evaluated the challenges associated with live-in foreign home care from the perspective of older care recipients and their family members. METHODS:Qualitative interviews wer...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610209990421

    authors: Ayalon L

    更新日期:2009-08-01 00:00:00

  • The quality of the relationship perceived by spouses of people with young-onset dementia.

    abstract:BACKGROUND:Young-onset dementia (YOD) has a profound impact on spouses. However, little is known on how the quality of the relationship changes over time in YOD. This study aims to determine how the quality of the relationship changes over time and identify predictors of this change. METHODS:This study used data from ...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610220000332

    authors: Bruinsma J,Peetoom K,Millenaar J,Köhler S,Bakker C,Koopmans R,Pijnenburg Y,Verhey F,de Vugt M

    更新日期:2020-03-10 00:00:00

  • Cognitive function and risk for depression in old age: a meta-analysis of published literature.

    abstract:BACKGROUND:We assessed the relationship between cognitive impairment (including mild cognitive impairment with no signs of dementia, and dementia) and risk for depression in old age (60 years and older). METHODS:MEDLINE, EMBASE and the Cochrane Library database were used to identify potential studies. All of the clini...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章,meta分析,评审

    doi:10.1017/S1041610210000049

    authors: Huang CQ,Wang ZR,Li YH,Xie YZ,Liu QX

    更新日期:2011-05-01 00:00:00

  • A Bifactor and item response analysis of the geriatric anxiety inventory.

    abstract:BACKGROUND:Due to previously reported mixed findings, there is a need for further empirical research on the factorial structure of the commonly used Geriatric Anxiety Inventory (GAI). Therefore, the psychometric properties of the GAI and its short form version (GAI-SF) were evaluated in a psychogeriatric mixed in-and-o...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610217001004

    authors: Molde H,Hynninen KM,Torsheim T,Bendixen AB,Engedal K,Pachana NA,Nordhus IH

    更新日期:2017-10-01 00:00:00

  • Physician don't heal thyself: a descriptive study of impaired older doctors.

    abstract:BACKGROUND:The growing and welcome interest in the issues leading to distress and impairment in younger doctors has not been mirrored by a focus on the similar issues in older doctors which is surprising given the aging medical workforce. OBJECTIVES:To improve understanding of impairment in older doctors and to facili...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610207005431

    authors: Peisah C,Wilhelm K

    更新日期:2007-10-01 00:00:00

  • Neuropathology of vascular cognitive impairment and vascular dementia.

    abstract::Understanding of vascular substrates of cognitive decline in the elderly is evolving to include a major emphasis on the impact of small vessel disease (SVD). While existing concepts of multi-infarct dementia and strategic infarct dementia remain valid, they present difficulty in generalizing clinicopathological correl...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610203008998

    authors: Ince PG,Fernando MS

    更新日期:2003-01-01 00:00:00

  • Capgras syndrome in Dementia with Lewy Bodies.

    abstract:BACKGROUND:Capgras syndrome is characterized by the recurrent, transient belief that a person has been replaced by an identical imposter. We reviewed clinical characteristics of Dementia with Lewy Bodies (DLB) patients with Capgras syndrome compared to those without Capgras. METHODS:We identified 55 consecutive DLB pa...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610212002189

    authors: Thaipisuttikul P,Lobach I,Zweig Y,Gurnani A,Galvin JE

    更新日期:2013-05-01 00:00:00

  • Subjective depressive mood and regional cerebral blood flow in mild Alzheimer's disease.

    abstract:BACKGROUND:Depressive symptoms are common in patients with Alzheimer's disease (AD) and increase the caregiver burden, although the etiology and pathologic mechanism of depressive symptoms in AD patients remain unclear. In this study, we tried to clarify the cerebral blood flow (CBF) correlates of subjective depressive...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610213002573

    authors: Honda H,Terada S,Sato S,Oshima E,Ikeda C,Nagao S,Yokota O,Uchitomi Y

    更新日期:2014-05-01 00:00:00

  • Adapting psychotherapy for older patients with Parkinson's disease.

    abstract:BACKGROUND:Emotional distress associated with Parkinson's disease (PD) increases disease burden and decreases functioning. The literature supports the benefits of psychological interventions for amelioration of emotional distress in persons with PD. The objective of this study is to apply the Contextual Adult Lifespan ...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610216000569

    authors: Knight B,Dissanayaka NN,Pachana NA

    更新日期:2016-10-01 00:00:00

  • Suicidal behavior and assisted suicide in dementia.

    abstract:BACKGROUND:Concerns about suicide risk in people with dementia have been increasing in recent years along with a discourse about rational suicide and assisted suicide. METHODS:A systematic narrative literature review of suicidal behavior and assisted suicide in persons with dementia. RESULTS:Most studies that have ex...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章,评审

    doi:10.1017/S1041610215000629

    authors: Draper BM

    更新日期:2015-10-01 00:00:00

  • Through the eyes of others - the social experiences of people with dementia: a systematic literature review and synthesis.

    abstract::ABSTRACTBackground:Psychosocial models suggest that the lived experience of dementia is affected by interpersonal factors such as the ways in which others view, talk about, and behave toward the person with dementia. This review aimed to illuminate how informal, everyday interpersonal relationships are experienced by ...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610216002374

    authors: Patterson KM,Clarke C,Wolverson EL,Moniz-Cook ED

    更新日期:2018-06-01 00:00:00

  • Comparisons of guardianship laws and surrogate decision-making practices in China, Japan, Thailand and Australia: a review by the Asia Consortium, International Psychogeriatric Association (IPA) capacity taskforce.

    abstract:BACKGROUND:The International Psychogeriatric Association (IPA) capacity taskforce was established to promote the autonomy, proper access to care, and dignity of persons with decision-making disabilities (DMDs) across nations. The Asia Consortium of the taskforce was established to pursue these goals in the Asia-Pacific...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S104161021400266X

    authors: Tsoh J,Peisah C,Narumoto J,Wongpakaran N,Wongpakaran T,O'Neill N,Jiang T,Ogano S,Mimura M,Kato Y,Chiu H

    更新日期:2015-06-01 00:00:00

  • The effect of continuing professional education on health care outcomes: lessons for dementia care.

    abstract:BACKGROUND:This review presents an overview of the published literature on the effectiveness of continuing professional education (CPE), which includes continuing medical education (CME) of different health care professionals in healthcare settings, for improving patient management and patient outcomes. This review sum...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章,评审

    doi:10.1017/S1041610209008746

    authors: Rampatige R,Dunt D,Doyle C,Day S,van Dort P

    更新日期:2009-04-01 00:00:00

  • Drug-related problems in community-dwelling primary care patients screened positive for dementia.

    abstract:BACKGROUND:Older people have a higher risk of drug-related problems (DRPs). However, little is known about the prevalence of DRPs in community-dwelling people who screened positive for dementia. Our study aimed to determine (1) the prevalence and types of DRPs and (2) the socio-demographic and clinical variables associ...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610217001442

    authors: Wucherer D,Thyrian JR,Eichler T,Hertel J,Kilimann I,Richter S,Michalowsky B,Zwingmann I,Dreier-Wolfgramm A,Ritter CA,Teipel S,Hoffmann W

    更新日期:2017-11-01 00:00:00

  • Does bipolar disorder have a benign course?

    abstract::Written records have been describing extreme states of emotions since ancient Greece (Angst and Marneros, 2001), but Aretaeus of Cappadocia (which is geographically located in modern Turkey) was probably the first to outline the close relationship between depression and mania nearly 2000 years ago: "I think that melan...

    journal_title:International psychogeriatrics

    pub_type: 社论

    doi:10.1017/S1041610216001423

    authors: Almeida OP

    更新日期:2016-11-01 00:00:00

  • Cardiovascular health and cognitive functioning among centenarians: a comparison between the Tokyo and Georgia centenarian studies.

    abstract::ABSTRACTObjectives:Centenarians have survived into very late life, but whether they reach very old age in good health remains unclear. The purpose of this study was to compare the cardiovascular health status and cognitive functioning of centenarians in the United States with centenarians in Japan. DESIGN, SETTING, A...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610218001813

    authors: Martin P,Gondo Y,Arai Y,Ishioka Y,Johnson MA,Miller LS,Woodard JL,Poon LW,Hirose N

    更新日期:2019-04-01 00:00:00

  • Apolipoprotein epsilon4 status is associated with behavioral symptoms in nursing home residents with dementia.

    abstract:BACKGROUND:While the relationship of apolipoprotein E (APOE) to behavioral symptoms of dementia (BSD) has been studied in community-dwelling persons with AD, it has received limited attention within the nursing home (NH) population. The aim of this study was to examine the association between APOE genotype and BSD in N...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610209009235

    authors: Woods DL,Bushnell B,Kim H,Geschwind D,Cummings J

    更新日期:2009-08-01 00:00:00

  • Family group conferencing in dementia care: an exploration of opportunities and challenges.

    abstract:BACKGROUND:The Family Group Conference (FGC) is an approach to partnership working which brings together service users, their support network and care professionals in a family-led decision making forum. Evidence, though limited, indicates that that FGC can enhance outcomes for service providers and their users. This s...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610215001507

    authors: Górska S,Forsyth K,Prior S,Irvine L,Haughey P

    更新日期:2016-02-01 00:00:00

  • Only death and taxes.

    abstract::Most people who work in aged care have a fair idea of what is meant by cognitive impairment or decline, and we have some moderately robust instruments for detecting it and measuring change over time. Frailty is much more difficult to define, but like hard core pornography (Stewart, 1964), many of us "know it when we s...

    journal_title:International psychogeriatrics

    pub_type: 杂志文章

    doi:10.1017/S1041610217000060

    authors: Ames D

    更新日期:2017-04-01 00:00:00