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Centre for Policy on Ageing | |
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Improving the end-of-life for people with dementia living in a care home
— an intervention study | | Author(s) | Gill Livingston |
| Journal title | International Psychogeriatrics, vol 25, no 11, November 2013 |
| Publisher | Cambridge University Press, November 2013 |
| Pages | pp 1849-1858 |
| Source | journals.cambridge.org/ipg |
| Keywords | Dementia ; Dying ; Terminal care ; Nursing homes ; Quality of life ; Evaluation. |
| Annotation | 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. The study recruited staff, residents with dementia, and their relatives from a 120-bed nursing home in London. The intervention was a ten-session manualised, interactive staff training programme. The study 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. 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 and dying in the care homes as opposed to hospital. Bereaved relatives' overall satisfaction increased from 7.5 pre-intervention to 9.1 post-intervention. Relatives reported increased consultation and satisfaction about decisions. Staff members were more confident about end-of-life planning and implementing advanced wishes. This small non-randomised 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. (JL). |
| Accession Number | CPA-131025214 A |
| Classmark | EA: CX: LV: LHB: F:59: 4C |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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