ArticlePloS one2018
Guiding practitioners through end of life care for people with dementia: The use of heuristics.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses 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
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- The Impact and Role of Artificial Intelligence (AI) in Healthcare: Systematic Review.Current topics in medicinal chemistry · 2025Pooled it
- Palliative Care in Early Dementia.Journal of pain and symptom management · 2024Pooled it
- Co-design development of a decision guide on eating and drinking for people with severe dementia during acute hospital admissions.Health expectations : an international journal of public participation in health care and health policy · 2023Pooled it
- Enteral tube feeding for people with severe dementia.The Cochrane database of systematic reviews · 2021Pooled it
- Co-Designing a Palliative Dementia Care Framework to Support Holistic Assessment and Decision Making: The EMBED-Care Framework.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Acceptability of Using a Decision Aid to Support Family Carers of People With Dementia Towards the End of Life: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Co-design of the EMBED-Care Framework as an intervention to enhance shared decision-making for people affected by dementia and practitioners, comprising holistic assessment, linked with clinical decision support tools: A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Personalized Technological Support for Informal Caregivers of Older People with Dementia: A Co-Design Approach Involving Potential End Users and Healthcare Professionals in Three Focus Groups in Italy.Healthcare (Basel, Switzerland) · 2023Article
- Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings.Frontiers in medicine · 2023Article
- A feasibility study of a decision aid to support family carers of people with severe dementia or those towards the end-of-life.Palliative medicine · 2022Article
- Practitioner Bias as an Explanation for Low Rates of Palliative Care Among Patients with Advanced Dementia.Health care analysis : HCA : journal of health philosophy and policy · 2022Article
- Challenges faced during the COVID-19 pandemic by family carers of people living with dementia towards the end of life.BMC health services research · 2021Article
- Developing an applied model for making decisions towards the end of life about care for someone with dementia.PloS one · 2021Article
- Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians' and nurse practitioners' perceptions.BMC palliative care · 2020Article
- Supporting families in end-of-life care and bereavement in the COVID-19 era.International psychogeriatrics · 2020Article
- Euthanasia requests in dementia cases; what are experiences and needs of Dutch physicians? A qualitative interview study.BMC medical ethics · 2019Article
- Article
- How Can Speech and Language Therapists be Supported to Make Decisions Regarding Communication Therapy for People With Dementia? A Realist Theory-Development Study.International journal of language & communication disordersArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEnd of life care (EOLC) for people with dementia can present a multitude of challenges and difficult decisions for practitioners. These challenges may include assessment and management of difficulties with eating and swallowing, responding to agitation, treating pain, and managing recurrent infections. Practitioners sometimes lack both confidence in making end of life decisions and guidance. This study developed an alternative to lengthy guidelines, in the form of heuristics which were tested in clinical settings. The aim of this study was to test the usability and acceptability of a set of heuristics which could be used by practitioners providing EOLC for people with dementia in a variety of clinical and care settings.
methodsA three phase co-design process was adopted: 1) Synthesis of evidence and outputs from interviews and focus groups with family carers and practitioners, by a co-design group, to develop heuristics; 2) Testing of the heuristics in five clinical or care settings for six months; 3) Evaluation of the heuristics at three and six months using qualitative individual and group interviews.
resultsFour heuristics were developed covering: eating and swallowing difficulties, agitation and restlessness, reviewing treatment and interventions at the end of life, and providing routine care. The five sites reported that the heuristics were simple and easy to use, comprehensive, and made implicit, tacit knowledge explicit. Four themes emerged from the qualitative evaluation: authority and permission; synthesis of best practice; providing a structure and breaking down complexity; and reassurance and instilling confidence.
conclusionUse of heuristics is a novel approach to end of life decision making in dementia which can be useful to both experienced and junior members of staff making decisions. Heuristics are a practical tool which could overcome a lack of care pathways and direct guidance in end of life care for people with dementia.
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.