Progress in advance care planning among nursing home residents dying with advanced dementia-Does it make any difference in end-of-life care?

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ID: 53276
2019
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Ranked #11 of 21 articles by views in archives of gerontology and geriatrics

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Abstract
Increased awareness of the clinical course of nursing home residents with advanced dementia and advance care planning (ACP) has become the cornerstone of good palliative care.The aim of our study is to describe changes in ACP in the form of physician treatment orders (PTOs), symptom prevalence and possible burdensome interventions among nursing home (NH) residents who died between 2004-2009 and 2010-2013 METHODS: Retrospective study RESULTS: The number of PTOs regarding forgoing antibiotics or parenteral antibiotics, forgoing artificial nutrition or hydration or forgoing hospitalisation doubled between 2004-2009 and 2010-2013 (38.1% vs. 64.9%, p < 0.001; 40.0% vs. 81.7%, p < 0.001; 28.1% vs. 69.5%, p < 0.001, respectively). PTOs were also done significantly earlier in 2010-2013 than in 2004-2009. The prevalence of distressing symptoms and possible burdensome interventions remained unchanged, although the prevalence of consistency with the PTOs was high.Despite the increased number of PTOs, this had little effect on symptom prevalence and possible burdensome interventions experienced by NH residents in the last days of life.
Reference Key
konttila2019progressarchives Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Konttila, Tarja;Finne-Soveri, Ulla Harriet;Leskinen, Riitta;Niemelä, Katriina;Antikainen, Riitta;
Journal archives of gerontology and geriatrics
Year 2019
DOI
S0167-4943(19)30198-0
URL
Keywords
palliative care nursing home end-of-life care advance care planning advanced dementia physician treatment orders

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