Improving dementia care in nursing homes: experiences with a palliative care symptom-assessment tool (MIDOS)

Krumm, Norbert; Larkin, Philip; Connolly, Michael; Rode, Peter; Elsner, Frank

doi:10.12968/ijpn.2014.20.4.187

Cited by 20 publications

(39 citation statements)

References 9 publications

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Section: Treatmentmentioning

confidence: 99%

“…Nurses often struggle with understanding the nature of pain in PWD (Krumm, Larkin, Connolly, Rode, & Elsner, 2014). They cannot differentiate between the pure sensation of pain and other unpleasant emotions (Krumm et al, 2014). Even if nurses identify suspected pain in a PWD, determining pain location, intensity, and duration is far from a simple exercise (Kaasalainen et al, 2007).…”

Section: Treatmentmentioning

confidence: 99%

“…Nurses may conceptualize these behavioral symptoms from a psychological perspective rather than physical perspective. As a result, nurses may not prioritize treatment of physical problems and try instead to treat the nonphysical underlying cause of behavioral changes, such as psychosocial causes Krumm et al, 2014).…”

Section: Treatmentmentioning

confidence: 99%

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The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

Rababa

2018

Geriatric Nursing

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Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables. This study may provide a new understanding of the relationship between nurses' certainty, assessment scope, and patient outcomes for people with dementia. Improved understanding of this relationship and how it relates to the problem of unrelieved pain in people with dementia is crucial.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

Rababa

2018

Geriatric Nursing

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“…Proper symptom assessment is vital in symptom management and can avoid unnecessary suffering and improve patients' quality of life (Krumm, Larkin et al 2014, Ornstein, Wajnberg et al 2013. Although symptom relief is one of the most frequent interventions, in palliative care (Van Mechelen, Aertgeerts et al 2013) and one of the corner-stones of palliative care, symptoms are not always adequately treated (Laugsand, Jakobsen et al 2011).…”

Section: Symptoms In Palliative Carementioning

confidence: 99%

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

Erichsén¹

2015

Linköping Studies in Health Sciences. Thesis

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Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation. Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression. Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids. Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.

The series name Linköping University, Studies in Health Sciences, Thesis in the Licentiate thesis is incorrect. The correct name is Linköping Studies in Health Sciences. Thesis.

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“…This indicates the importance of well-functioning cooperation and trust in the team for good EoL care. The importance of good communication and well-functioning teamwork is also emphasized by others (Burns & McIlfatrick, 2015, Cunnigham et al, 2010, Gropelli & Sharer, 2013, Krumm et al, 2014, Liu, 2014, Newton et al, 2014.…”

Section: Following the Introduction Of Apsmentioning

confidence: 96%

Experiencing improved assessment and control of pain in end‐of‐life care when using the Abbey Pain Scale systematically

2020

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People with cognitive impairment at the end-of-life care (EoL care) often have their pain underdiagnosed and undertreated due to the lack of knowledge and lack of guidelines for systematic pain assessment. According to recommendations from The National Board of Health and Welfar [Socialstyrelsen] (2013a), systematic pain assessments in EoL care should have high priority in providing optimal treatment of pain. In Sweden, about 90,000 people die annually and it is estimated that about 80% of these would benefit from palliative care (The Swedish Palliative register, 2018). According to Statistics Sweden (2018), the expected number of people older than 65 years in 2030 will increase, especially those over 80 years. This indicates an increasing need of further development of palliative care. Good palliative care at the EoL means symptom relief of physical and mental pain, relief of social and existential problems, a multi-professional collaboration in taking care of people, as well as good communication and relationship with the patient and relatives (The National Board of Health & Welfar [Socialstyrelsen], 2013a, 2013b). 2 | BACKG ROU N D Many people living in nursing homes for the elders in Sweden have dementia and cognitive impairment (Lovenheim, Sandman, Kallin,

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Improving dementia care in nursing homes: experiences with a palliative care symptom-assessment tool (MIDOS)

Cited by 20 publications

References 9 publications

The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors

Experiencing improved assessment and control of pain in end‐of‐life care when using the Abbey Pain Scale systematically

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