Death and dying with dementia

Type:

Research Article

Description:

This exploratory study examined general practitioners’ (GPs) perspectives on delivering end-of-life care in the New Zealand residential aged care context. Results included the finding that GP training in end-of-life care, especially for those with dementia, was reported as ad hoc and done through informal mentoring between GPs.

Keywords:

general practice, professional roles and responsibilities, qualitative research, relationships.

Type:

Article, Practice

Description:

This article describes the development of a toolkit for interdisciplinary team members to use to improve care for people with dementia or delirium in a hospice inpatient unit. An occupational therapist and two nurses identified that caring for the increasing number of people with dementia and delirium in the unit was a challenge for staff. The authors took a collaborative quality improvement approach to address the problem, engaging both the hospice interdisciplinary team and external community partners. The overall aim was to establish, reinforce and maintain best practice of care for people with a cognitive impairment.

Keywords:

palliative care, care, hospice

Type:

Research article

Description:

This study aimed to explore carer experiences of inpatient unit hospice care for people with dementia, delirium and related cognitive impairment, following implementation of the Te Kete Marie (TKM) initiative aimed at improving care for this patient group. Semi-structured interviews were undertaken with 10 carers. The findings suggest that carer confidence is enhanced by: staff awareness and response to individual patient needs, interests and preferences, as well as carer requirements for information and consultation; an environment that engenders experience of comfort, safety, flexibility, privacy and outdoor connection; carer preparedness for patients who subsequently transition home or to alternative residential care.

Keywords:

palliative care, care, hospice

Type:

Research article

Description:

The aim of this study was to compare symptoms before death in long term care for those with cancer, dementia or chronic illness. Staff in random 61 long-term care facilities across New Zealand completed questionnaires after each resident’s death that occurred in a 3-month period.

Keywords:

death, dying, aged residential care, long term care

Type:

Article

Description:

The aim of this study was to examine predictors of mortality in dementia in consecutive referrals to a New Zealand memory service that includes Māori, Pacific Islander, and NZ European patients. The risk of death in people with dementia was increased by age and lower cognitive score at baseline and was reduced by cholinesterase inhibitors. Compared to NZ Europeans, antipsychotics increased the risk of death three‐fold in Māori  and Pacific Islanders.

Keywords:

cause of death; antipscyhotic; cholinesterase inhibitor; Māori; Pasifika

Type:

Research article

Description:

An exploratory qualitative study of 23 New Zealanders who had been carers or provided support for a family member with dementia who had died within five years of the interview was undertaken. The overarching theme, ‘ordinary everyday conversations’, describes how informal conversations and discussions within the family relating to preferences at the end of life had been embedded in interactions within the families over years.

Keywords:

dementia; family members; Advance Care Planning; ordinary conversations; Wills

Type:

Research article

Description:

Supportive Hospice and Aged Residential Exchange (SHARE) integrates specialist palliative care nursing into aged care facilities including dementia care. Pilot results indicate that the intervention overall is seen by staff as a success. Building relationships with key stakeholders is essential for model implementation.

Keywords:

palliative care, services, aged residential care

Type:

Research article

Description:

In-depth interviews were conducted with 26 family members who were most involved in the care of residents who had died within the last year. There was little evidence that a well-managed transition to a palliative approach to care was being initiated. The needs of residents dying with advanced dementia added to the challenges of palliative care provision.

Keywords:

palliative care, services , family members, aged residential care

Type:

Essay article

Description:

In October 2008 Baroness Warnock, medical ethicist and veteran British governmental advisor, claimed that an individual afflicted with dementia may have a moral duty to die when their continued living “wastes” the lives of others and the resources of the National Health Service. In this paper a New Zealand lecturer in clinical ethics concludes that no-one has a moral duty to die, especially not those who are afflicted with dementia.

Keywords:

ethics, death, attitudes, stigma

Type:

Research article

Description:

Information about traditional end-of-life care customs was gathered from Māori New Zealanders. How health and palliative care services helped or hindered families to use their customs within different health care settings was also examined, including in the context of loved ones with dementia.

Keywords:

end-of-life care, Māori

Type:

Research article

Description:

The objective of this study was to examine variation in place of death of older people dying from dementia in countries across 4 continents. Place of death of older people who died from a dementia-related disease differs substantially between countries, which might point to organizational differences in end-of-life care provision.

Keywords:

place of death, dementia, end-of-life care, death certificates, death