The home hospitalization of frail elderly patients with advanced dementia

Palliative care for people with dementia living at home: A systematic review of interventions

“…We identified three studies evaluating specialist palliative care services 19–21 and five evaluating non-specialist palliative care interventions (Table 2). 22–27 One study on non-specialist palliative care intervention was reported in two articles. 22,23 Four of the studies presented evidence from the United States, 19,20,24,25 two from Italy, 22,23,27 and one each from the United Kingdom 26 and Japan.…”

“…22–27 One study on non-specialist palliative care intervention was reported in two articles. 22,23 Four of the studies presented evidence from the United States, 19,20,24,25 two from Italy, 22,23,27 and one each from the United Kingdom 26 and Japan. 21 Of the studies, four were RCTs, 21–24 two retrospective case-control studies, 19,25 one retrospective cross-sectional study 20 and one with an unclear study design.…”

“…21 Of the studies, four were RCTs, 21–24 two retrospective case-control studies, 19,25 one retrospective cross-sectional study 20 and one with an unclear study design. 27 All studies used quantitative methods, one of which also used qualitative methods. 20 All studies included both male and female participants, with the majority in their 80s and women.…”

“…These studies (one RCT and one unclear study design, both studies of weak quality) evaluated Home Hospitalisation Service. 22,27 They suggested that people with advanced dementia who received diagnostic and acute care at their own homes were less likely to be transferred to nursing homes and more likely to stay at home.…”

“…The majority of them also ensured the continuity of care by either directly facilitating the transitions of care between settings 19,20,25 or conducting multidisciplinary discussions and collaboration 21–23,27 and caregiver support meetings. 24 They also addressed the psychosocial domain by providing psychosocial support 19,20,22,23,25,27 or managing behavioural symptoms. 21,24 Four EAPC White Paper domains were rarely addressed by the interventions: applicability of palliative care, societal and ethical issues, prognostication and timely recognition of dying, and avoidance of overly aggressive, burdensome or futile treatments.…”