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Goals of Care Conversations and Subsequent Advance Care Planning Outcomes for People with Dementia
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-08-24 , DOI: 10.3233/jad-210720
Heather Ma 1 , Rachel E Kiekhofer 2 , Sarah M Hooper 3 , Sarah Dulaney 2 , Katherine L Possin 2, 4 , Winston Chiong 2
Affiliation  

Background:Advance care planning has been shown to improve end of life decision-making for people with dementia. However, the impact of goals of care conversations between people with dementia and their caregivers has not been characterized. Objective:In this study, we evaluate the association between goals of care conversations and advance care planning outcomes. Methods:Retrospective advance care planning measures were collected via a questionnaire administered to 166 caregivers after the death of the person with dementia for whom they provided care. Results:At time of death, the majority of decedents with dementia had advance directives, health care agents, and previous goals of care conversations with their caregiver. Goals of care conversations were significantly associated with the perceived usefulness of advance directives, the perceived adherence to advance directives, and decedent dying at their desired place of death, but not with disagreements around end-of-life care. Conclusion:Our findings suggest that goals of care conversations are an important component of advance care planning. These findings support the development of interventions that facilitate such conversations between people with dementia and their caregivers.

中文翻译:

痴呆症患者的护理对话目标和后续预先护理计划结果

背景:预先护理计划已被证明可以改善痴呆症患者的临终决策。然而,痴呆症患者与其护理人员之间的护理对话目标的影响尚未得到表征。目的:在本研究中,我们评估了护理对话目标与预先护理计划结果之间的关联。方法:通过对 166 名护理人员提供护理的痴呆症患者死亡后进行的问卷调查,收集了回顾性的预先护理计划措施。结果:在死亡时,大多数患有痴呆症的死者都有预先指示、医疗保健代理人以及与他们的照顾者对话的先前护理目标。护理对话的目标与预先指示的感知有用性显着相关,对预先指示的遵守情况,以及死者在他们想要的死亡地点死亡,但在临终关怀方面没有分歧。结论:我们的研究结果表明,护理对话的目标是预先护理计划的重要组成部分。这些发现支持开发干预措施,以促进痴呆症患者与其护理人员之间的此类对话。
更新日期:2021-08-24
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