Nursing home residents with advanced dementia often face 'distressing' transfers, MDs find
2019-08-16 from cbc.ca
If everyone was more aware of dementia, it could improve comfort in a loved one's dying days, say Canadian geriatricians who found distressing medical procedures were common among nursing home residents, especially men.
The geriatric researchers published a study Friday in the journal JAMA Network Open on 27,000 nursing home residents in Ontario with advanced dementia who died. They focused on differences between men and women in receiving "burdensome interventions" in the last month of life. These included transfers to an emergency department to be mechanically ventilated and other invasive treatments.
While people with early-stage dementia can understand and communicate their needs, those in an advanced stage have profound memory impairment and are often unable to walk or recognize family members and may need help to eat, dress, groom and bathe.
Dr. Nathan Stall led the research, which he hopes will guide better care for frail, vulnerable older adults with advanced dementia.
"It really can be psychologically distressing for these individuals to be transferred out of their home to a foreign environment where all sorts of invasive things are happening to them," said Stall, a geriatrician and research fellow at Women's College Research Institute in Toronto. "It's thinking about how can we improve the quality of life for these people at the end of life."
When physicians and family members of people with dementia are asked what the goal of care should be at the end of life, more than 90 per cent say quality of life, he said.
Read more here