Analgesics use and withdrawal in people with dementia - a register-based Danish study and a systematic review.
CONCLUSIONS: In Denmark, use of opioids is higher in elderly with dementia compared to elderly without dementia. The evidence suggests that withdrawal of analgesics may aggravate pain but increases in pain scores may be of little clinical relevance in most people. Clinical trials investigating analgesics withdrawal are warranted. PMID: 31791478 [PubMed - in process]
Forty-five percent of U.S. hospice recipients have either a primary diagnosis of advanced dementia or dementia as a comorbidity. However, largely due to the lack of experience and knowledge of dementia-related symptomatology, hospice clinicians are underprepared to treat patients without hospice-specific dementia training programs.
Treatment-refractory psychosis (TRP) is a controversial term in the setting of the current societal stigma and medical understanding or misunderstanding of mental illness. However, there is recognition that patients with either advanced mental illness (i.e. schizophrenia) in the setting of terminal diseases such as cancer or certain neurologic diseases (i.e. Huntington's disease and Lewy body dementia) can result in psychotic states not amendable to conventional pharmacologic and non-pharmacologic treatments.
Historically, palliative care has primarily served individuals with serious physical illnesses. People with dementia and their families, however, represent a growing population in the United States who are increasingly accessing hospice and palliative care. It is not well understood how and how well the unique needs of this population are being met by the current scope and approaches of palliative care. In this concurrent session, we will discuss this topic in light of our original mixed-methods data collection, reviews of scholarly literature, and participation from attendees.
Dementia patients are at high risk for preventable hospital readmission. This population could benefit from expert consultation in SNF to reduce readmission rates. Community-based palliative medicine focusing on symptom management and goals of care in post-acute care facilities can lower unnecessary transitions, hospitalization, and emergency department visits; reduce length of stay; and lower Medicare expenditures.
Dementias are progressive and incurable, leading to a profound loss of cognitive function with a final phase characterized by reduced oral intake. The availability of medical nutrition has made treatment decisions more complex for surrogates, and despite studies and National Society recommendations to the contrary, many physicians continue to place feeding tubes in patients with dementia.
In patients with cognitive impairments who are unable to self-report pain, providers must rely on behavioral observation tools to assess and manage pain. Although frequently employed in medical-surgical units, evidence supporting the psychometric efficacy of the Pain in Advanced Dementia (PAINAD) for pain screening in older adults with delirium is lacking.
While most patients with Alzheimer's and Related Dementias (ADRD) prefer to die in nursing facilities, trends and factors associated with place of death for this population remain unknown.
By GRACE CORDOVANO PhD, BCPA Being a patient or a carepartner can be a lonely, powerless place. There’s no high powered legal or lobbying team to help support you in your or your loved one’s health care journey. There’s no PR team at your beck and call. There’s no advisory board, no executive committee, no assistants, no chatbots or AI-powered technology coming to the rescue. There’s no funding or a company sponsoring your efforts. There’s no course in how to be a professional patient or carepartner. There’s no one there in the stillness and dark of the night, when you ...
No more effective than placebo; and their help with sleep problems might be short-lived as tolerance develops Related items fromOnMedica Statins of small and uncertain benefit in primary prevention Pharmacists could offer high-dose statins direct to patients UK research reveals racial inequalities in diabetes care Fund specialist dementia training to improve care and save money New evidence on benzodiazepine link to Alzheimer ’s
Photo credit Tyler Jacobs Dear Carol: My husband and I are both 76 and have been healthy, though he’s had problems with high blood pressure. Lately, he’s begun to shuffle his feet as he walks. I try to remind him to pick up his feet because, well, it’s irritating, and it seems like an “old people” thing to do. I realize that we are old people, but we’ve kept up with things through our kids and grandkids and we both socialize and volunteer, so we’re considered young for our ages. This shuffling worries me because it seems to be a sign of worse to come. Am I over-reacting? Is this so...