Tijdschrift voor gerontologie en geriatrie
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Tijdschr Gerontol Geriatr · Dec 2008
[End-of-life with dementia in Dutch antroposofic and traditional nursing homes].
Every year more than 20,000 people with dementia die in Dutch nursing homes and this number steadily increases. Therefore, the importance of good end-of-life care for these patients including physical, psychosocial and spiritual care is evident. Although the training standards for Dutch nursing home physicians and nurses share a common standard, the philosophy of a nursing home may affect end-of-life care strategies for the residents. ⋯ The anthroposophic nursing homes had significant higher scores on the 'Symptom Management' ((32.9 (SD 7.5) versus 26.9 (SD 9.5)), and 'Comfort Assessment in Dying' scales (34.0 (SD 3.9) versus 30.8 (SD 5.8)) and on its subscale Well Being (7.7 (SD 1.2) versus 6.7 (SD 2.1)). Our results suggest that death with dementia was more favourable in anthroposophic nursing homes than in regular homes. The results inform further prospective studies on nursing homes how this and other philosophies are translated into daily nursing home practice, including decision making in multi-disciplinary teams, family consultation, and complementary non-pharmacological therapies.
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Nursing homes (NH) are less well studied than hospices or hospitals as a setting for terminal care. The aim of this study is to identify the direct causes and underlying diseases of the terminal phase in Dutch nursing homes. ⋯ Providing good and timely palliative care to elderly patients in Dutch nursing homes is a major medical and societal challenge. In this study, the terminal phase of the mainly non-cancer patients is difficult to predict, and once diagnosed, little time is left.
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Tijdschr Gerontol Geriatr · Dec 2008
[Evaluation of units for short-term terminal care in nursing homes].
The Units for short-term terminal care in 10 nursing homes were evaluated in terms of (a) meeting minimum care requirements for organisation, personnel and expertise and (b) changes in outcomes in patients. Interview with staff members show that 69% of the care requirements were met. Requirements for expertise development were better met (77%), and requirements for personnel and team were met less well (58%). ⋯ We conclude that the minimum care requirements should be revised, taken into account the way the requirements are used in daily practise. The data seem to point at good quality of care. We advise a repetition of the last evaluation in 2003.