End-of-Life Care for People With Dementia in Long-Term Care Settings

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This literature review addresses the outcomes of typical end-of-life-care for nursing home residents with advanced dementia. The author reviewed 158 research articles published between 1994 and 2004. Aggressive medical treatment for residents with advanced dementia is often inappropriate for medical reasons, has a low rate of success, and can have negative outcomes that hasten functional decline and death. Quality palliative care is an effective alternative to aggressive treatment and is closely related to staffing and training in nursing homes. Hospice is a valuable service for persons with advanced dementia, particularly in pain management, continuous involvement of the primary physician, and avoidance of hospitalization. Social support provided to caregivers is also important given their high levels of depressive symptoms and anxiety.

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