Their last 6 months: suffering and survival of end-stage dementia patients

Aminoff, Bechor Zvi; Adunsky, Abraham

doi:10.1093/ageing/afl067

Cited by 101 publications

(84 citation statements)

References 25 publications

(28 reference statements)

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“…Tube feeding varied between 4% and 39% in several US studies [39,45,47,63,66], and was 73% in Israel [67]. Hospitalization shortly before death was frequent in multi-site studies in US nursing homes [45,47,66].…”

Section: Symptoms and Treatment At The End Of Lifementioning

confidence: 99%

“…The results of selected studies have been integrated in a recent review, showing considerable unmet needs in families [85]. Through the beginning of 2010 (Box 1, Table 1), at least 45 studies [28,[33][34][35][36][37][38][40][41][42][43]46,47,52,60,61,63,65,66,80,[86][87][88][89][90][91][92][93][94][95][96][97][98][99]110] in another 26 publications [39,44,45,53,54,64,67,69,[111][112][113][114][115]…”

Section: Research Trends In Dementia At the End Of Lifementioning

confidence: 99%

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Dying with Dementia: What We Know after More than a Decade of Research

Steen

2010

JAD

224

177

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Abstract. Death with dementia is increasingly common. Although prognostication is difficult, it is an incurable life-limiting illness for which palliative care for the patient is often appropriate. Dementia patients are otherwise at risk of overtreatment with burdensome and possibly non-beneficial interventions and undertreatment of symptoms. Although recent studies indicate encouraging trends of improved palliative care, little evidence supports effectiveness of specific treatments. As of January 2010, at least 45 studies, almost all performed after 2000, have reported on treatment, comfort, symptom burden, and families' satisfaction with care. Over half (25; 56%) of these studies were in US settings, and most were small or retrospective. Few randomized trials and prospective observational studies have been performed so far, but several promising studies have been completed recently or are underway in various countries. Guidelines for care and treatment, still mostly consensus-based, support the benefits of advance care planning, continuity of care, and family and practitioner education. Assessment tools for pain, prognosis, and family evaluations of care have been developed and some have been shown to be effective in clinical practice. With increasing numbers of well-designed, large-scale studies, research in the next decade may result in better evidence-based guidelines and practice.

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Section: Symptoms and Treatment At The End Of Lifementioning

confidence: 99%

Section: Research Trends In Dementia At the End Of Lifementioning

confidence: 99%

Dying with Dementia: What We Know after More than a Decade of Research

Steen

2010

JAD

224

177

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“…It was also found that the suffering level of end-stage dementia (ESD) patients [18,19] and the struggle of family members [20] escalated during the dying process, until demise. Established correlations could hypothetically be explained by the enhanced level of the patients' body entropy.…”

Section: Discussionmentioning

confidence: 99%

End Stage Dementia and Entropy Definition of Suffering

Aminoff¹

2009

TOGERIMJ

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Abstract:Objectives: A new definition of human suffering and satisfaction according to the entropy hypothesis may facilitate comprehension of health, disease and the aging process.Methods: A cohort study of 71 patients (28 females, 43 males), with very advanced dementia, who died in our ward during the study period. The intense suffering level of end-stage dementia patients was evaluated by the Mini-Suffering State Examination (MSSE) scale.Results: Suffering level in end-stage dementia has a significant correlation with short survival, advancing age, more severe illness, malnutrition, the existence of decubitus ulcers, and the administration of medications. Established correlations could be explained by the enhanced level of the patients' body entropy.Discussion: Suffering and satisfaction are functional levels of human entropy.An elevated level of human entropy is a measure of disorder, a process of aging and torment of the patient.

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“…Life expectancy is more emphatically curtailed by dementia than it is by other psychiatric syndromes (Jolley & Baxter, 1997). Yet the evidence for suboptimal care persists, especially in the terminal phase (Wilden & Wright, 2002), with studies in the USA and Israel confirming the somewhat dismal picture (Mitchell et al, 2004;Aminoff & Adunsky, 2006).…”

Section: Is There a Need For Improved Palliative Care In Dementia?mentioning

confidence: 99%

Palliative care in dementia: issues and evidence

Hughes¹,

Jolley²,

Jordan³

et al. 2007

Adv. psychiatr. treat

102

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Palliative care is an approach that stands well with the aims of person-centred dementia care. There is no doubt that the standards of care for many people with advanced dementia are poor. There is a lack of good-quality evidence, however, to support any particular approach for palliative care in dementia. Still, there are a number of areas in relation to caring for people with severe dementia where a palliative approach might be beneficial. In general, the relevant decisions have to be made on an individual basis but within a palliative framework. Advance care planning is likely to be crucial in encouraging this process. There is certainly a moral imperative behind the idea that care at the end of life for people with dementia should be improved.

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Their last 6 months: suffering and survival of end-stage dementia patients

Cited by 101 publications

References 25 publications

Dying with Dementia: What We Know after More than a Decade of Research

Dying with Dementia: What We Know after More than a Decade of Research

End Stage Dementia and Entropy Definition of Suffering

Palliative care in dementia: issues and evidence

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