Hospice Referrals of Patients With Alzheimer Disease in Southeastern Georgia

Upchurch, Linda A.; Thornton, Kathy

doi:10.1097/njh.0b013e3182423692

Cited by 2 publications

(9 citation statements)

References 37 publications

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“…High levels of staff turnover. (5) [38,41,43,44,46] Unfamiliarity with hospice admission criteria [62].…”

Section: Country Setting and Participantsmentioning

confidence: 99%

“…Out of the 34 studies, 24 studies recognised PC as a management step in the care of advanced dementia [31,33,34,[36][37][38][40][41][42][43][44][45][46][47][49][50][51]56,57,[59][60][61][62], whereas 7 studies rejected PC as a management step [29,30,32,35,[52][53][54][55]] and 3 of them did not discuss it in their research [39,48,58].…”

Section: Recognition Of Palliative Care As a Step In The Care Of Advamentioning

confidence: 99%

“…Few studies reported on policy related barriers to the provision of PC in dementia and included: lack of commissioning guidance on dementia [39], absence of key policy drivers with regard to advanced dementia care [43], the presence of regulations and government's policy promoting minimal and fragmented care [43], the use of Medicare skilled nursing facility benefit [60], Medicare hospice eligibility/admission criteria and requirements and reimbursement policies [35,52,[60][61][62]. Two studies discussed facilitators in this theme [52,55], one of which suggested Medicare benefits for advanced dementia and the other recommended the use of UK Mental Capacity Act [63] and the best interest approach to manage conflicts and disagreements over decision-making which were mentioned under the patients/carers theme.…”

Section: Policymentioning

confidence: 99%

“…The most cited barrier was the lack of awareness that dementia is a terminal/palliative condition [29,31,32,40,41,44,[52][53][54][55]59]. Other barriers included: lack of awareness of hospice availability to advanced dementia and unfamiliarity with hospice admission criteria [52,61,62] as well as the lack of awareness and beliefs in ACP and fear of legal consequences and blame [36,38,44,45,48,56]. Facilitators for this theme included: increasing awareness of the public and family regarding the nature of dementia and available services [40,41,47].…”

Section: G Attitude Awareness and Beliefsmentioning

confidence: 99%

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Factors influencing palliative care in advanced dementia: a systematic review

Mataqi

Aslanpour

2019

BMJ Support Palliat Care

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Background: Dementia is a progressive neurodegenerative life-limiting disease. The international literature indicates that patients with advanced dementia may benefit from palliative care provided during the end of life phase. However, evidence indicates that currently many fail to access such provision despite the increased recognition of their palliative needs. Aim: To investigate the factors influencing provision of palliative care services for people with advanced dementia. Method: A systematic review of mixed method studies written in English was undertaken. 11 electronic databases including Embase, Medline, PubMed, CINHAL and Scopus from 2008 to 2018 were searched.Narrative synthesis and content analysis were used to analyse and synthesise the data. Key findings:In total, 34 studies were included. 25 studies providing qualitative data, 6 providing quantitative data and 3 mixed methods studies. The findings identified organisational, healthcare professionals and patients related barriers and facilitators in provision of palliative care for people with advanced dementia from perspective of stakeholders across different care settings. The most commonly reported barriers are lack of skills and training opportunities of the staff specific to palliative care in dementia, lack of awareness that dementia is a terminal illness and a palliative condition, pain and symptoms assessment/management difficulties, discontinuity of care for patients with dementia and lack of co-ordination across care settings, difficulty communicating with the patient and the lack of advance care planning. Conclusions: Even though the provision of palliative care was empirically recognised as a care step in the management of dementia, there are barriers that hinder access of dementia patients to appropriate facilities. With dementia prevalence rising and no cure on the horizon, it is crucial that health and social care regulatory bodies integrate a palliative approach into their care using the identified facilitators to achieve optimal and effective palliative care in this population.

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“…High levels of staff turnover. (5) [38,41,43,44,46] Unfamiliarity with hospice admission criteria [62].…”

Section: Country Setting and Participantsmentioning

confidence: 99%

Section: Recognition Of Palliative Care As a Step In The Care Of Advamentioning

confidence: 99%

Section: Policymentioning

confidence: 99%

Section: G Attitude Awareness and Beliefsmentioning

confidence: 99%

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Factors influencing palliative care in advanced dementia: a systematic review

Mataqi

Aslanpour

2019

BMJ Support Palliat Care

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“…12 Além disso, nas fases mais avançadas, esses pacientes necessitam de uma assistência contínua de cuidadores para auxiliar nas necessidades fisiológicas, transportes e cuidados pessoais, como comer, tomar banho ou vestir-se, o que causa uma grande sobrecarga para os cuidadores. 13 Essas dificuldades, somadas à falta de apoio e orientação em saúde, podem contribuir para o aumento da necessidade de hospitalizações, dado que já é demonstrado na população brasileira, em um estudo que observa o aumento significativo do número de mortes em ambiente hospitalar em relação ao domicílio ao longo dos anos, representando um desafio econômico e social. 2 Apesar dessas necessidades, ainda é observada a alta prevalência de pacientes que recebem CPs já de forma tardia, em situações nas quais já têm excesso de sintomas ou já estão nos seus últimos dias de vida.…”

Section: Introductionunclassified

Barreiras associadas aos cuidados na demência: uma revisão da literatura

Santos¹

2018

Geriatr., Gerontol. Aging

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INTRODUÇÃO: A síndrome demencial destaca-se como importante causa de mortalidade e incapacidade na população. Apesar dos pacientes sofrerem elevada sobrecarga de sintomas e comorbidades, a introdução dos cuidados paliativos acontece de forma tardia em casos em que há excesso de sintomas ou proximidade da morte. OBJETIVO: Buscou-se realizar uma revisão integrativa da literatura que aborda os cuidados paliativos na síndrome demencial, identificando limitações e barreiras que impedem ou dificultam a introdução dos cuidados paliativos para pacientes com demência. MÉTODOS: Os termos e palavras-chave utilizados foram combinados nas bases de dados PubMed, Web of Knowledge e Scopus, e na Biblioteca Digital SciELO, para identificar os artigos dos últimos dez anos que abordassem as barreiras para introdução dos cuidados paliativos na demência. RESULTADOS: Foram identificados seis artigos que discutiam como principais barreiras: falta de conhecimento, imprevisibilidade da doença, ausência de critérios para indicação, falha na comunicação, acesso e recursos limitados, crenças e preconceitos em relação à morte e recusa por parte dos pacientes e familiares. CONCLUSÃO: É necessário investir na educação dos profissionais e da população sobre as indicações e a importância dos cuidados paliativos, e em estratégias de comunicação como forma de facilitar a introdução desses cuidados de forma eficaz para portadores de síndrome demencial. PALAVRAS-CHAVE: cuidados paliativos; cuidados a doentes terminais; demência; prognóstico.

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Hospice Referrals of Patients With Alzheimer Disease in Southeastern Georgia

Cited by 2 publications

References 37 publications

Factors influencing palliative care in advanced dementia: a systematic review

Factors influencing palliative care in advanced dementia: a systematic review

Barreiras associadas aos cuidados na demência: uma revisão da literatura

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