ArticleJournal of the American Geriatrics Society2020
"I Don't Have Time to Sit and Talk with Them": Hospitalists' Perspectives on Palliative Care Consultation for Patients with Dementia.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Palliative Care in Early Dementia.Journal of pain and symptom management · 2024Pooled it
- Referral criteria to specialist palliative care for patients with dementia: A systematic review.Journal of the American Geriatrics Society · 2021Pooled it
- Family Caregivers' Perspectives on Challenges and Support Needs in Hospital-Based Palliative Care for Persons Living With Dementia.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Disease and Race-Based Differences in Inpatient Palliative Care Consultation in Cancer and Noncancer Serious Illnesses.Journal of the American Geriatrics Society · 2025Article
- Interprofessional collaboration between hospital-based palliative care teams and hospital ward staff: A realist review.PloS one · 2025Review
- A shared decision-making model about care for people with severe dementia: A qualitative study based on nutrition and hydration decisions in acute hospitals.International journal of geriatric psychiatry · 2023Article
- Communication between the multidisciplinary team and families regarding nutrition and hydration for people with severe dementia in acute hospitals: a qualitative study.Age and ageing · 2022Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesSpecialty palliative care for hospitalized patients with dementia is widely recommended and may improve outcomes, yet rates of consultation remain low. We sought to describe hospitalists' decision-making regarding palliative care consultation for patients with dementia.
designDescriptive qualitative study.
settingSeven hospitals within a national nonprofit health system.
participantsHospitalist physicians. MEASUREMENTS: Individual semistructured interviews. We used thematic analysis to explore factors that influence hospitalists' decision to consult palliative care for patients with dementia.
resultsA total of 171 hospitalists were eligible to participate, and 28 (16%) were interviewed; 17 (61%) were male, 16 (57%) were white, and 18 (64%) were in practice less than 10 years. Overall, hospitalists' decisions to consult palliative care for patients with dementia were influenced by multiple factors across four themes: patient, family caregiver, hospitalist, and organization. Consultation was typically only considered for patients with advanced disease, particularly those receiving aggressive care or with family communication needs (navigating conflicts around goals of care and improving disease and prognostic understanding). Hospitalists' limited time and, for some, a lack of confidence in palliative care skills were strong drivers of consultation. Palliative care needs notwithstanding, most hospitalists would not request consultation if they perceived families would be resistant to it or had limited availability or involvement in caregiving. Additional barriers to referral at the organization level included a hospital culture that conflated palliative and end-of-life care and busy palliative care teams at some hospitals.
conclusionHospitalists described a complex consultation decision process for involving palliative care specialists in the care of patients with dementia. Systematic identification of hospitalized patients with dementia most likely to benefit from palliative care consultation and strategies to overcome modifiable family and organization barriers are needed. J Am Geriatr Soc 68:2365-2372, 2020.
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