Identification of the palliative phase in people with dementia: a variety of opinions between healthcare professionals

BMC Palliative Care

Research Article

Kris Vissers¹  Yvonne Engels¹  Hélène Kerhervé²  Maria Forycka³  Wojciech Leppert³  Birgit Jaspers⁴  Lukas Radbruch⁴  Raymond Koopmans⁵  Rabih Chattat⁶  Elena Mariani⁶  Jasper van Riet Paap⁷  Myrra Vernooij-Dassen⁸ 

[1] Department of Anaesthesiology, Pain and Palliative Medicine, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands;Department of Geriatrics, Broca Hospital, AP-HP, 54-56 rue Pascal, 75013, Paris, France;Department of Palliative Medicine, Poznan University of Medical Sciences, 61-245, Poznan, Poland;Department of Palliative Medicine, Universitätsklinikum Bonn, Sigmund-Freud-Street 25, 53127, Bonn, Germany;Department of Palliative Care, Malteser Hospital Bonn /Rhein-Sieg, Bonn, Germany;Department of Primary and Community Care, Radboud university medical center, P.O. 6500 HB, Nijmegen, The Netherlands;Radboud Alzheimer Centre, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands;Joachim en Anna, Centre for specialized geraitric care, Nijmegen, The Netherlands;Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy;Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands;Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands;Radboud Alzheimer Centre, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands;Kalorama Foundation, Nijmegen, The Netherlands;

关键词: Palliative care;    Dementia;    Long-term care;    Nursing home;    Staff views;    Europe;   

DOI  :  10.1186/s12904-015-0053-8

 received in 2014-12-04, accepted in 2015-10-26,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundPeople with dementia can benefit from a palliative care approach. Recommendations, such as those of the EAPC have been proposed to strengthen the provision of palliative care for this group of patients. Yet, it remains challenging for professionals to identify when a person with dementia is in need of palliative care. The objective of this study therefore was to explore when professionals in long-term care settings consider a person with dementia in need of palliative care.MethodsTeams with in total 84 professionals working in 13 long-term care settings from 6 countries (France, Germany, Italy, Norway, Poland and the Netherlands) received a case-vignette concerning a person with dementia recently admitted to a nursing home. Teams were asked to discuss when they considered people with dementia eligible for palliative care. The constant comparative method was used to analyse their answers.ResultsThree different time points in the disease trajectory when people with dementia were considered to be eligible for palliative care were extracted: (1) early in the disease trajectory; (2) when signs and symptoms of advanced dementia are present; and (3) from the time point that curative treatment of co-morbidities is futile. Yet, none of these time points was uniformly considered by the professional teams across Europe. In some cases, professionals working in the same nursing home didn’t even reach consensus when considering persons with dementia eligible for palliative care.ConclusionThe results of the study identified that professionals across Europe have different opinions regarding the time point when to consider a person with dementia in need of palliative care.

【 授权许可】

CC BY   
© van Riet Paap et al. 2015