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Factors Related to Establishing a Comfort Care Goal in Nursing Home Patients with Dementia: A Cohort Study among Family and Professional Caregivers.
- Source :
-
Journal of Palliative Medicine . Dec2014, Vol. 17 Issue 12, p1317-1327. 11p. - Publication Year :
- 2014
-
Abstract
- Background: Many people with dementia die in long-term care settings. These patients may benefit from a palliative care goal, focused on comfort. Admission may be a good time to revisit or develop care plans. Objective: To describe care goals in nursing home patients with dementia and factors associated with establishing a comfort care goal. Design: We used generalized estimating equation regression analyses for baseline analyses and multinomial logistic regression analyses for longitudinal analyses. Setting: Prospective data collection in 28 Dutch facilities, mostly nursing homes (2007-2010; Dutch End of Life in Dementia study, DEOLD). Results: Eight weeks after admission (baseline), 56.7% of 326 patients had a comfort care goal. At death, 89.5% had a comfort care goal. Adjusted for illness severity, patients with a baseline comfort care goal were more likely to have a religious affiliation, to be less competent to make decisions, and to have a short survival prediction. Their families were less likely to prefer life-prolongation and more likely to be satisfied with family-physician communication. Compared with patients with a comfort care goal established later during their stay, patients with a baseline comfort care goal also more frequently had a more highly educated family member. Conclusions: Initially, over half of the patients had a care goal focused on comfort, increasing to the large majority of the patients at death. Optimizing patient-family-physician communication upon admission may support the early establishing of a comfort care goal. Patient condition and family views play a role, and physicians should be aware that religious affiliation and education may also affect the (timing of) setting a comfort care goal. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CAREGIVERS
*CHI-squared test
*CONFIDENCE intervals
*DEMENTIA
*FAMILIES
*GOAL (Psychology)
*HUMAN comfort
*LONGITUDINAL method
*MEDICAL cooperation
*MEDICAL protocols
*NURSING home patients
*PALLIATIVE treatment
*QUESTIONNAIRES
*RELIGION
*RESEARCH
*RESEARCH funding
*T-test (Statistics)
*LOGISTIC regression analysis
*DATA analysis software
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 10966218
- Volume :
- 17
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Journal of Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 99974630
- Full Text :
- https://doi.org/10.1089/jpm.2014.0205