Palliative Care for people with dementia

Pallhome

At a glance

Project leader : Prof. Dr. Andrea Luise Koppitz
Project team : Georg Bosshard, Hannele Hediger, Prof. Dr. Daniela Händler-Schuster, Lorenz Imhof
Project budget : CHF 97'000
Project status : completed
Funding partner : Foundation (schweizerische Alzheimervereinigung)

Description

Background

39% of people living in Swiss nursing homes suffer from dementia. Detailed data about type and course of symptoms displayed by these patients in their terminal phase are lacking.

Methods

This descriptive, retrospective study analysed 65 nursing documents from deceased people with dementia in four nursing homes in the canton of Zurich, Switzerland.

Results

Difficulties with mobility (81%), pain (71%) and sleep disturbance (63%) were the most frequent of the 10 identified symptoms. Towards the end of life, difficulties with mobility, sleep disturbance, agitation and other neuropsychiatric symptoms, such as episodes of depression, decreased (decrescent pattern), while pain, feeding problems, breathing abnormalities, apathy and anxiety increased (crescent pattern). Courses of pain were documented in 17% of the nursing records.

76% of the residents had been visited on a daily basis by next of kin in their last seven days, compared with only one third of residents previously. Furthermore, daily communication between healthcare professionals and next of kin tripled during this period.

Conclusions

The documented prevalence of a high and increasing level of pain towards the end of life, combined with the lack of documented courses of pain, shows potential for improvement in pain relief and pain identification for patients with dementia in their terminal phase.

The increasing number of visits by next of kin and the increasingly intensive contact between healthcare professionals and next of kin in the last seven days are a strong that the end of life can be predicted relatively well predicted by the involved participants and appropriate reactions follow.

Further information

http://www.project.zhaw.ch/...

Publications

Koppitz, Andrea Luise; Bosshard, Georg; Händler-Schuster, Daniela; Hediger, Hannele; Imhof, Lorenz,

2015.

Type and course of symptoms demonstrated in the terminal and dying phases by people with dementia in nursing homes.

Zeitschrift für Gerontologie und Geriatrie.

48(2), pp. 176-183.

Available from: https://doi.org/10.1007/s00391-014-0668-z
Kipfer, Stephanie; Koppitz, Andrea Luise,

2014.

Häufige Symptome bei sterbenden Menschen mit Demenz.

NOVAcura.

45(10), pp. 46-49.

Available from: https://doi.org/10.1024/1662-9027/a000045
Koppitz, Andrea Luise; Dreizler, Jutta; Waldboth, Veronika; Imhof, Lorenz,

2014.

Sterben mit Demenz im Pflegeheim.

Pflegewissenschaft.

16(1), pp. 28-40.
Probst, Sebastian; Koppitz, Andrea Luise,

2011.

Palliative Wundversorgung : eine Herausforderung für Pflegefachpersonen [poster].

In:

SBK-Kongress, Montreux, 18.-20. Mai 2011.
Koppitz, Andrea Luise; Probst, Sebastian,

2011.

Palliative Pflege : eine Herausforderung im Spital- und Heimalltag für Pflegefachpersonen.

In:

DBfK, SBK, ÖKV Dreiländerkongress, Konstanz, Deutschland, 2011.

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