attitudes

Cause of death in Alzheimer's disease: a cohort study

TODD, S., BARR, S., A.P.
QJM: monthly journal of the As
2013

In this prospective study, Todd et al.

(2013) examined the cause of death recorded on death certificates in an cohort of patients with Alzheimer’s disease in NI and compared these findings with expected death rates from the population to determine the accuracy of death certificate completion for a cohort of people with AD. The study found that AD was recorded on almost two-thirds of death certificates of AD subjects who died during follow-up. It found significant excess mortality in the AD group when compared with the NI population and that AD and pneumonia were the most significant underlying causes of death in the AD group. To explain differences between findings in the AD group compared with a control group, the authors conjecture that cause of death documented may be affected by the physician’s knowledge of the patient or reflect the approach to management of patients with end-stage dementia. 

Challenges that specialist palliative care nurses encounter when caring for patients with advanced dementia

BARBER, J., MURPHY, K.
International journal of palliative nursing
2011

In a literature review examining specialist palliative care for people with dementia Barber and Murphy (2011) reported that there is very little information available about end-of-life care in advanced dementia from the viewpoint of the SPC nurse.

The review suggests that expertise in both dementia care and palliative care needs to be combined and that further research is required to establish guidelines to assist with specialist training of staff.

Guidelines for nursing homes delivering end-of-life care to residents with dementia across the island of Ireland

CAHILL, S., DORAN, D., WATSON, M.
Quality in Ageing & Older Adults
2010

Cahill et al.

(2010) found that bereaved spouses of people with dementia who had been living in nursing homes were generally satisfied with the end of life care that their relatives had received and valued good personal care underpinned by a person-centred philosophy, being kept informed of their relatives’ care and having an opportunity to participate in appropriate decision-making at the end of life.     

A cross-national cross-sectional survey of the attitudes and perceived competence of final-year medicine, nursing and pharmacy students in relation to end-of-life care in dementia

DE WITT JANSEN, B., WECKMANN, M., NGUYEN, C.M., PARSONS, C., HUGHES, C.M.
Palliative medicine
2013

De Witt Jansen et al. (2013) compared the attitudes to people with dementia of final year medical, nursing and pharmacy student groups in the US and NI, and also examined perceived levels of confidence and competence in providing end of life care.

They found that students across the three professions in both the US and NI held positive attitudes towards people with dementia but reported different levels of competence in end of life care that was largely linked to differences in disciplinary training   

Assessment of factors that influence physician decision making regarding medication use in patients with dementia at the end of life

PARSONS, C., MCCORRY, N., MURPHY, K., BYRNE, S., O'SULLIVAN, D., O'MAHONY, D., PASSMORE, P., PATTERSON, S., HUGHES, C.
International journal of geriatric psychiatry
2014

Parsons et al.

(2014) assessed the extent to which patient-related factors and physician's country of practice influenced decision making among hospital physicians and GPs regarding withholding or discontinuing key medications in patients with end-stage dementia in NI and in ROI. The study evidences uncertainty and variation around the prescribing of antibiotics and the discontinuation of anti-dementia medication. There was less variability in decision-making related to statins and anti-psychotic drugs. The authors found that for all medications, care setting and physician's country of practice had the strongest and most consistent effects on decision making. 

Quality of end-of-life care for dementia patients during acute hospital admission: a retrospective study in Ireland

AFZAL, N., BUHAGIAR, K., FLOOD, J., COSGRAVE, M.
General hospital psychiatry
2010

In a retrospective case study review, Afzal et.al. (2010) analysed potential differences in quality of end of life care for people with dementia during their final hospital stay compared to people without dementia.

 The study highlights potential inequalities and concludes that people diagnosed with dementia have less access to palliative care, and their caregivers are given less opportunity to take part in decisions about treatment. 

Dementia knowledge and attitudes of the general public in Northern Ireland: an analysis of national survey data

MCPARLAND, P., DEVINE, P., INNES, A., GAYLE, V.
International Psychogeriatrics, 24(10)
2012

Mc Parland et al. (2012) explored the knowledge and attitudes of the general public to dementia.

 They found that while there is a reasonable level of knowledge about dementia, the general public hold overwhelmingly negative attitudes towards dementia and that stereotypical, stigmatising views of people with dementia dominate understandings.

Community pharmacists and people with dementia: a cross-sectional survey exploring experiences, attitudes, and knowledge of pain and its management

BARRY, H.E., PARSONS, C., PASSMORE, A.P., HUGHES, C.M
International Journal of Geriatric Psychiatry, 28(10)
2013

Barry et al. (2013) examine the knowledge and experience of community pharmacists in managing pain in people with dementia.

 They found that community pharmacists had a positive person-centred attitude towards people with dementia, a good knowledge of the use of anti-psychotic medications but were uncertain about the difficulties people in the later stages of dementia may have with swallowing and were unsure about pain assessment and management.

An exploration of nursing home managers' knowledge of and attitudes towards the management of pain in residents with dementia

BARRY, H.E., PARSONS, C., PASSMORE, A.P., HUGHES, C.M.
International Journal of Geriatric Psychiatry, 27(12)
2012

Barry et al. (2012) explore the levels of knowledge and attitudes of nursing home managers towards the management of pain in residents with dementia.

While most respondents evidenced a good knowledge of pain experience in residents with dementia, there was little indication that recognised pain assessment or management tools are used, and surprisingly few respondents had received recent training on pain management. The authors identify the need for further research to identify the factors affecting the prescribing of analgesics for people with dementia in care settings.

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