International research of palliative care for dementia patients

Czech version

Authors: M. Stolička; R. Bužgová
Authors‘ workplace: Vedoucí: doc. PhDr. Darja Jarošová, Ph. D. ; Ústav ošetřovatelství a porodní asistence ; Lékařská fakulta ; Děkan: doc. MUDr. Arnošt Martínek, CSc. ; Ostravská univerzita, Ostrava
Published in: Prakt. Lék. 2012; 92(6): 346-351
Category: Of different specialties

Overview

The aim of this study was to find and analyse the research on the issue of palliative care for patients with dementia. As a source of data, the following databases were used (1990–2011): Medline, EBSCO, Bibliomedica, ProQuest, Google Scholar, The Cochrane Collaboration. Twelve research studies and one systematic survey were included in the analysis. These studies dealt with some of the following topics: decision-making in palliative care, identifying quality of life and quality of care, problems of self-harming, estimation of survival and palliative sedation. Problems such as nutritional support, hydration and the use of restraints are the most common issues surrounding the critical decisions. The family participates in the decision to start antibiotic therapy, tracheal suction, the initiation or discontinuation of artificial nutrition and hydration infusions. Most of these critical decisions affect patient quality of life and the length of survival. An active solution to the identified problem is usually prefered than a decision to withhold or stop treatment. At the end of life, the quality of care is usually evaluated by the levels of symptoms (pain, shortness of breath, agitation and problems with food - difficulty in swallowing and loss of appetite). Improving the quality of life requires adequate treatment of pain, shortness of breath, problems with nutrition, and the recognition and treatment of behavioural disorders.

In the case of seniors with dementia the problem of pain is much less often solved and they are less frequently indicated for hospice care. Assessment tools for quality of care are important in order to evaluate the functional status of terminally ill patients, nutrition assessment and cognitive status, prognostic tools for predicting survival and assessment tools for quality of life.

Key words:
palliative care, patients with dementia

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