期刊
AMERICAN JOURNAL OF ALZHEIMERS DISEASE AND OTHER DEMENTIAS
卷 23, 期 4, 页码 319-325出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/1533317508316682
关键词
dementia; palliative care; end of life; nursing homes
资金
- New York State Department of Health
- Bureau of Long Term Care
Objective: To describe the meaning and practice of palliative care (PC) for nursing home (NH) residents with dementia at end of life (EOL). Design: Concurrent mixed methods (quantitative retrospective chart review and qualitative field study). Setting: Three NHs with varying approaches to EOL care: in-house non-Medicare hospice, Medicare hospice by outside agency, and Medicare hospice by outside agency plus specialized staff and comfort care unit. Results: Resident's course fluctuated between curative and comfort care, with a noticeable increase in symptoms right before death. Hospice care was short. Most died of complications of dementia. Families found care decisions based on residents' uncertain disease course difficult. Conclusion The role of PC for NH residents with dementia at EOL is complex and poorly understood. As they are in a residential setting, decisions need to he made about how residents live, as well as how they die, thus balancing quality of living/comfort with disease management.
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