Jenny T van der Steen

....

..Selective participation in retrospective studies of families recruited after the patient's death may threaten generalizability of reports on end-of-life experiences...

..Families of patients with dementia may need support in difficult end-of-life decision making. Such guidance may be culturally sensitive...

..To evaluate a booklet on comfort care in dementia from the perspective of family with relevant experience, and assess nursing home resident and family factors associated with evaluations...

..In conclusion, there is a high need for written information on palliative care. The booklet is highly appreciated. A further improved version may support professional and family caregivers in practice...

..5, CI 0.6 - 6.3). Death from pneumonia may cause great suffering in dementia patients. If confirmed in a study with different case mix and treatments, antibiotics may be used to decrease discomfort even when death is imminent...

..Pitfalls included the large amount of time required for equating study procedures and variables and the need for additional funding...

..To explore how physicians treating nursing home residents with dementia and pneumonia in the Netherlands consider prognosis in their treatment decision...

..The End-of-Life in Dementia (EOLD) scales comprise the most specific set of instruments developed for evaluations of patients' end of life by their families. It is not known whether the EOLD scales are useful for cross-national comparisons...

..The prognostic score is potentially useful for an important group of patients with pneumonia, but further implementation research and inclusion of prognostic instruments in training curricula is needed...

....

..To test if care to relief suffering in patients with dementia who become ill with pneumonia is improving, we compared treatments in cohorts of patients with dementia and pneumonia a decade apart...

..The clinical impact of risk score use in end-of-life settings is unknown, with reports limited to technical properties...

..With increasing numbers of well-designed, large-scale studies, research in the next decade may result in better evidence-based guidelines and practice...

..Families of patients with advanced dementia need to be informed about the course of the dementia and comfort care. Conditional for health care providers educating families is their knowledge and comfort in family education...

..To compare treatment of nursing home residents with dementia and lower respiratory tract infection (LRI) in Missouri and the Netherlands...

..These studies will provide insight into interventions that are most likely to improve end of life care of patients with dementia in the respective countries and elsewhere...

..To assess decline and improvement in functional characteristics, cognition and restraint use after a lower respiratory tract infection (LRI) and describe variation by dementia severity...

..We aim to validate a risk score that uses Minimum Data Set (MDS) to estimate 6-month mortality for nursing home residents with advanced dementia...

..Appropriate training of nursing home physicians who know their patients well may be required for this...

..To assess whether the severity of dementia is related to unfavorable outcomes of nursing home-acquired pneumonia and how this relationship is mediated...

..To help decision makers plan treatment, the authors assessed clinical predictors of mortality from nursing home-acquired pneumonia in patients with dementia...

..The results reflect the importance of explicit goals for medical interventions in patients with end-stage dementia where life-prolonging treatments may be seen as prolonging suffering...

..Generalizability of clinical predictors for mortality from lower respiratory infection (LRI) in nursing home residents has not been assessed for residents with dementia...

..Accurately defining severe dementia is important for care and prognosis, but is not explicitly included in the Minimum Data Set (MDS)...

..Few large prospective studies have been conducted...

..To examine long-term mortality and its determinants in nursing home residents with dementia diagnosed with a lower respiratory tract infection (LRI)...

..Design. Prospective studies in The Netherlands and the American state of Missouri...

..This study should provide the first empirical data on whether pneumonia is a "friend" or an "enemy" of demented patients and promote a debate on appropriate palliative care...

....

..However, little information exists on what factors influence this complex decision-making process...

..Given the importance of using appropriate instruments to evaluate the quality of care (QOC) and quality of dying (QOD) in LTC, we compared the validity and reliability of ten available instruments commonly used for these purposes...

..The results indicate that the POS is an appropriate instrument to assess not only cancer patients, but also non-cancer and (moderately) severely demented patients...

..For use in individual patients, results are probably too strongly affected by the chosen time fluctuations of assessment. For this purpose, the current rater assessment instructions should be adapted and tested...

....

..Long-term care (LTC) settings have become a significant site for end-of-life care; consequently, instruments that assess the quality of dying and care may be useful in these settings...

..For more targeted palliative care, more information is needed about the patient characteristics, symptoms, direct causes and underlying diseases, and incidence of terminally ill NH patients. These aspects are examined in this study...

..To compare available instruments and investigate which best measure the quality of end-of-life care (QOC) and quality of dying (QOD) in long term care settings, in terms of validity, reliability, and feasibility...

..This model may help researchers to plan studies and to choose appropriate outcomes, and assist caregivers in planning spiritual care...

..This article outlines the study protocol...

..Focusing on these settings, this article aims to provide a comprehensive overview of the literature available on antibiotic use, antibiotic resistance, and strategies to reduce antibiotic resistance...