scholarly journals Perceptions of Family Decision-makers of Nursing Home Residents With Advanced Dementia Regarding the Quality of Communication Around End-of-Life Care

2018 ◽  
Vol 19 (10) ◽  
pp. 879-883 ◽  
Author(s):  
Mark Toles ◽  
Mi-Kyung Song ◽  
Feng-Chang Lin ◽  
Laura C. Hanson
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Decision Makers ◽  
Life Care ◽  
Advanced Dementia ◽  
Family Decision

scholarly journals Advance care planning preferences in Chinese nursing home residents: results from two cross-sectional studies in Hong Kong and Taiwan

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xinyi Xu ◽  
Shu-Wen Tu ◽  
Chia-Chin Lin
Keyword(s):  
Hong Kong ◽  
Nursing Home ◽  
End Of Life ◽  
Advance Directive ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Completion Rate ◽  
Life Care ◽  
Term Care

Abstract Background The proportion of hospital deaths has declined in the past few decades, while the proportions of nursing home deaths have increased. This trend of increasing deaths in long-term care facilities underlines the importance of improving end-of-life care provisions in these settings to meet individual preferences and needs. Under these circumstances, a comprehensive understanding of end-of-life care preferences in local nursing home residents can help healthcare professionals and policymakers develop strategies to increase the advance directive completion rate and quality of care. This study aimed to explore and compare advance directive and end-of-life care preferences of nursing home residents in Hong Kong and Taiwan. Methods A structured questionnaire was developed by the research team to investigate advance directive and end-of-life care preferences in older Chinese nursing home residents. Nursing home residents with frail or pre-frail status and over the age of 64 were invited to participate in the study, and information on demographics, functional status, advance directive experiences, and end-of-life care expectations was collected through questionnaire interviews. Results A total of 325 eligible participants from 32 facilities completed the survey, including 238 older residents in Hong Kong and 87 in Taiwan. A significantly lower proportion of the Hong Kong residents had completed an advance directive compared with the Taiwanese (3 vs. 13%, p = 0.001). Among participants who did not have an advance directive, 46% of the Taiwanese participants said they would consider completing one in the future, compared with 20% of the Hong Kong participants (p < 0.001). A total of 79% of the Hong Kong participants and 80% of the Taiwanese participants responded that prolonging life in the given hypothetical dying scenario was “not important” (p = 0.76). Only 14% of participants in Hong Kong and 18% of participants in Taiwan reported prior occurrence of end-of-life care discussions with family members or health professionals (p = 0.37). Conclusions This paper adds evidence in support of improving end-of-life communication and the advance directive completion rate in nursing homes in Hong Kong and Taiwan. Further research is necessary to explore cross-cultural differences in end-of-life preferences and its applications in predicting decision-making and the quality of end-of-life care.

Guilt as an Influencer in End-of-Life Care Decisions for Nursing Home Residents With Advanced Dementia

2022 ◽  
Vol 48 (1) ◽  
pp. 22-27
Author(s):  
Ashley Roach ◽  
Anita H. Rogers ◽  
Meghan Hendricksen ◽  
Ellen P. McCarthy ◽  
Susan L. Mitchell ◽  
...  
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Life Care ◽  
Advanced Dementia

scholarly journals Quality of dying and quality of end-of-life care of nursing home residents in six countries: An epidemiological study

2018 ◽  
Vol 32 (10) ◽  
pp. 1584-1595 ◽  
Author(s):  
Lara Pivodic ◽  
Tinne Smets ◽  
Nele Van den Noortgate ◽  
Bregje D Onwuteaka-Philipsen ◽  
Yvonne Engels ◽  
...  
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
Epidemiological Study ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Life Care ◽  
Quality Of Dying

scholarly journals Do Palliative Care Teams in Nursing Homes Improve the Quality of End-of-Life Care for Nursing Home Residents?

2019 ◽  
Author(s):  
Helena Temkin-Greener Helena Temkin-Greener ◽  
Dana Mukamel ◽  
Susan Ladwig ◽  
Thomas , Caprio ◽  
Sally Norton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Life Care ◽  
Palliative Care Teams

scholarly journals Aging and Advanced Dementia Matters: End-of-Life Care in Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 520-521
Author(s):  
Ruth Lopez ◽  
Ellen McCarthy ◽  
Meghan Hendricksen ◽  
Susan McLennon ◽  
Anita Rogers ◽  
...  
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
Racial Differences ◽  
End Of Life Care ◽  
Feeding Tube ◽  
Nursing Home Care ◽  
Life Care ◽  
Advanced Dementia ◽  
Southeastern Us ◽  
Intensity Of Care

Abstract Over 5 million Americans have dementia, and the majority will die in nursing home (NHs). While comfort is the main goal of care for most NH residents with advanced dementia, they commonly receive burdensome and costly interventions such as hospital transfers and feeding tubes that are of little clinical benefit. Despite 20 years of research and numerous experts and associations advocating a palliative approach to care, quantitative studies continue to demonstrate striking and persistent regional, facility, and racial differences, including: greater intensity care among African American versus White residents; greater intensity of care in the Southeastern US; and wide variation in care among NHs in the same region of the country. The reasons for these differences are poorly understood. Assessment of Disparities and Variation for Alzheimer’s disease in Nursing home Care at End of life (ADVANCE) is a 3-year, NIA funded qualitative study of 16 NHs in 4 regions of the country which aims to explain regional and racial factors influencing feeding tube and hospital transfer rates. The purpose of this presentation is to present the methodology established in this study and to highlight factors challenging and enabling implementation of the study protocol. To date, data have been collected in 11 NHs, and include 135 staff interviews, 40 proxy interviews, and nearly 800 hours of observation. These findings demonstrate that although challenging, large qualitative research is possible and holds promise as an effective method to illuminate complex processes influencing end-of-life care for NH residents with advanced dementia.

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