Palliative and End-of-life Care in Advanced Dementia: Evaluation of a Program of Organization of Care in Long-term Care

NCT ID: NCT01441726

Last Updated: 2015-03-31

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 175 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2012-09-30
• Study Completion Date: 2014-10-31

Brief Summary

Rationale: In Canada, as in most industrialized countries, Alzheimer's disease and other related dementia are increasingly prevalent in older people. At an advanced stage, institutionalization in a long-term care (LTC) setting will be the fate of a majority of patients. A structured palliative care approach is increasingly used for cancer patients, but is still rarely accessible in LTC institutions for older people with advanced or terminal dementia. This approach should include a more systematic detection and treatment of pain and other physical and psychological symptoms during the last weeks of life, as well as better communications between patients, families and care staff, particularly relating to advanced care directives. Objectives: The general objective of this study is to implement and evaluate a multidisciplinary and multidimensional program of palliative and end-of-life care for older persons with terminal dementia in LTC facilities. Methodology: The intervention program will include five components:

1. daily involvement of a nurse from the regular staff in the LTC facility as a change agent;

2. awareness sessions with administrators and staff on the importance of high quality palliative care in dementia;

3. a training program for physicians and all the staff involved in direct care of patients;

4. systematic discussions with families and distribution to families of a document on different aspects of palliative care in dementia;

5. systematic clinical care by regular staff for the control of pain, respiratory symptoms and mouth care. The program will be implemented in two LTC settings (one in Quebec City and one in Sherbrooke, Quebec, Canada), and results will be compared with the LTC control settings where usual care will be applied without implementation of the program.

Conditions

Dementia

Study Design

• Study Time Perspective: PROSPECTIVE

Study Groups

Training of staff

No interventions assigned to this group

No training of staff

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

Residents with advanced dementia with a score of 7 on the Reisberg scale

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Laval University

OTHER

Sponsor Role: lead

Responsible Party

René Verreault

Professeur titulaire

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Centre de santé et de services sociaux de la Vieille Capitale

Québec, Quebec, Canada

Countries

Canada

Other Identifiers

MOP-114881

Identifier Type: -

Identifier Source: org_study_id