Journal of the American Geriatrics Society
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Multicenter Study
Association between depressive symptoms and sleep disturbances in community-dwelling older men.
To examine the association between depressive symptoms and subjective and objective measures of sleep in community-dwelling older men. ⋯ Depressive symptoms have a strong, graded association with subjective sleep disturbances and are moderately associated with objectively measured prolonged sleep latency. Future studies should address temporality of depression and sleep disturbances.
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Randomized Controlled Trial Multicenter Study
Determining care management activities associated with mastery and relationship strain for dementia caregivers.
To identify specific care management activities within a dementia care management intervention that are associated with 18-month change in caregiver mastery and relationship strain. ⋯ Home assessments for specific needs of caregivers and persons with dementia are associated with improvements in caregivers' sense of mastery. Future work is needed to determine whether this increase is sustained over time and decreases the need for institutionalization.
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Multicenter Study Comparative Study
Pain, dyspnea, and the quality of dying in long-term care.
To evaluate the relationship between pain, dyspnea, and family perceptions of the quality of dying in long-term care. ⋯ For residents dying in long-term care, pain and dyspnea were not associated with a poorer quality of dying as perceived by families of deceased residents. Instead, dyspnea may alert staff to the need for care. Initiatives to improve the quality of dying in long-term care should focus not only on physical symptoms, but also on the alleviation of nonphysical sources of suffering at the end of life.
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Multicenter Study Comparative Study
Do palliative consultations improve patient outcomes?
To determine whether inpatient palliative consultation services improve outcomes of care. ⋯ Palliative consultations improve outcomes of care, and earlier consultations may confer additional benefit.
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Multicenter Study Comparative Study
Symptom experience of dying long-term care residents.
To describe the end-of-life symptoms of nursing home (NH) and residential care/assisted living (RC/AL) residents, compare staff and family symptom ratings, and compare how staff assess pain and dyspnea for cognitively impaired and cognitively intact residents. ⋯ In NHs and RC/AL, dying residents have high rates of physical symptoms and need for more-effective palliation of symptoms near the end of life.