Background: The literature indicates that palliative care for people with dementia needs to be enhanced. Objectives: To assess barriers to providing high-quality palliative dementia care and potential solutions to overcome these barriers, as perceived by physicians responsible for end-of-life care with dementia. Design: Cross-sectional study. Setting: The Netherlands. Participants: A representative sample of 311 elderly care physicians of whom 67% (n=207) responded. Measurements: A postal survey in 2013 containing open-ended items probing for barriers in the elderly care physicians’ practices and possible solutions. Answers were coded and grouped using qualitative content analysis and presented to expert physicians in 2021. Results: Barriers to palliative care in dementia were (1) beliefs held by family, healthcare professionals or the public that are not in line with a palliative care approach, (2) obstacles in recognizing and addressing care needs, (3) poor interdisciplinary team approach and consensus, (4) limited use or availability of resources, and (5) poor family support and involvement. Suggested solutions were improving communication and information transfer, and educating healthcare staff, families and the public about palliative care in dementia. Timely and frequent communication with the family, including advance care planning, and more highly skilled nursing staff were also proposed as solutions. Conclusions: The results suggest a strong need for ongoing education for healthcare professionals about palliative dementia care. Strengthening interprofessional collaboration and shared responsibility for advance care planning is also key. Increasing public awareness of the dementia trajectory and the need for a proactive approach call for a broader societal agenda setting.
MRS provided information on neural integrity (N-acetyl aspartate/ total creatine [NAA/tCr]), membrane turnover (total choline [tCho/ tCr]), and the glial marker myo-inositol (mI/tCr) from HC, ACC, and posterior cingulate cortex. Group differences were analysed using mixed models. Results: PME/PDE was higher after 4 weeks of test product compared to control (LS mean difference¼0.18, SEM¼0.06, p¼0.005). A similar effect was observed for PEth/ GPEth (LS mean difference¼0.22, SEM¼0.13, p¼0.091). Higher total choline after 4 weeks of test product compared to control was observed in the ACC and right hippocampus (LS mean differ-ence¼0.04 and 0.02; SEM¼0.02 and 0.01; p¼0.068 and 0.003, respectively). Significant group differences were found in nutritional blood markers, but not in other MRS measures. Conclusions: The current results suggest enhanced brain phospholipid formation compared to breakdown after 4 weeks intervention with Souvenaid in patients with mild AD. The observed effects indicate that Souvenaid not only raises circulating levels of nutrients and fatty acids, but also affects brain phospholipid metabolism in patients with mild AD, which confirms results from prior animal studies. This supports the hypothesis that Souvenaid enhances the formation of neuronal membranes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.