Observational studyBMC geriatrics2014
Symptoms and treatment when death is expected in dementia patients in long-term care facilities.
Observational study in BMC geriatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Identifying and Managing Pain in People with Alzheimer's Disease and Other Types of Dementia: A Systematic Review.CNS drugs · 2016Pooled it
- Improving comfort in people with dementia and pneumonia: a cluster randomized trial.BMC medicine · 2016Trial
- Caregiver Experiences with Dementia-Related Feeding/Eating Difficulties.Healthcare (Basel, Switzerland) · 2024Article
- Using Palliative Leaders in Facilities to Transform Care for People with Alzheimer's Disease (UPLIFT-AD): protocol of a palliative care clinical trial in nursing homes.BMC palliative care · 2023Article
- End-of-life care for people with advanced dementia and pain: a qualitative study in Swedish nursing homes.BMC nursing · 2021Article
- Trajectories of Symptoms in Nursing Home Residents after a Transfer to the Emergency Department.The journal of nutrition, health & aging · 2021Article
- Palliative Care in Advanced Dementia.Frontiers in psychiatry · 2020Review
- End of life care for long-term care residents with dementia, chronic illness and cancer: prospective staff survey.BMC geriatrics · 2019Article
- Hospice care education needs of nursing home staff in South Korea: a cross-sectional study.BMC palliative care · 2019Article
- Opioid, antipsychotic and hypnotic use in end of life in long-term care facilities in six European countries: results of PACE.European journal of public health · 2019Article
- End-of-life experiences in dementia with Lewy bodies: Qualitative interviews with former caregivers.PloS one · 2019Article
- What enables good end of life care for people with dementia? A multi-method qualitative study with key stakeholders.BMC geriatrics · 2018Article
- Exploring healthcare assistants' role and experience in pain assessment and management for people with advanced dementia towards the end of life: a qualitative study.BMC palliative care · 2017Article
- Development of a model for integrated care at the end of life in advanced dementia: A whole systems UK-wide approach.Palliative medicine · 2016Article
- Commentary to: "Timely dying in dementia: Use patients' judgments and broaden the concept of suffering." Timely dying, suffering in dementia, and a role for family and professional caregivers in preventing it.Alzheimer's & dementia (Amsterdam, Netherlands)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough dementia at the end of life is increasingly being studied, we lack prospective observational data on dying patients. In this study symptoms were observed in patients with dementia in the last days of life.
methodsWhen the elderly care physicians in two Dutch nursing homes expected death within one week, symptoms of (dis)comfort, pain and suffering were observed twice daily. For this the Pain Assessment in Advanced Dementia (PAINAD; range 0-10), Discomfort Scale-Dementia of Alzheimer Type (DS-DAT; range 0-27), End-Of-Life in Dementia-Comfort Assessment in Dying (EOLD-CAD; range 14-42) and an adapted version of the Mini-Suffering State Examination (MSSE; range 0-9), were used. Information on care, medical treatment and treatment decisions were also collected.
resultsTwenty-four participants (median age 91 years; 23 females), were observed several times (mean of 4.3 observations (SD 2.6)), until they died. Most participants (n = 15) died from dehydration/cachexia and passed away quietly (n = 22). The mean PAINAD score was 1.0 (SD 1.7), DS-DAT 7.0 (SD 2.1), EOLD-CAD 35.1 (SD 1.7), and MSSE 2.0 (SD 1.7). All participants received morphine, six received antibiotics, and rehydration was prescribed once.
conclusionIn these patients with dementia and expected death, a low symptom burden was observed with validated instruments, also in dehydrated patients without aggressive treatment. A good death is possible, but might be enhanced if the symptom burden is regularly assessed with validated instruments. The use of observation tools may have influenced the physicians to make treatment decisions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.