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Assessing End-of-Life Preferences with Video

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Assessing End-of-Life Preferences Using an Educational Video February 14, 2011 Introduction Although there have been great strides in improving end-of-life care in urban United States, rural patients with advanced dementia generally have not benefited from these advancements. The Foundation for Informed Medical Decision Making considers current methods of explaining end-of-life preferences to people with advanced dementia in a rural setting and offers suggestions about conveying the complex medical concepts to patients with lower health literacy. Currently, rural populations tend to use fewer medical interventions at the end of life than those in urban settings (Gessert, 2006). Although my current nursing position is not located in a rural setting, this information is equally applicable to my facility. In an effort to improve communication and understanding, video presentations offer patients an opportunity to better understand and make informed decisions about their care. Research and Limitations The Foundation for Informed Medical Decision Making carried out quantitative research based on scientific method. ...read more.


Conclusion As the population ages, care givers in both rural and urban settings will be called upon to provide end-of-life care for the increasing number of patients dying with dementia. There are many opportunities to advance end-of-life care for this vulnerable and underserved population. On an industry level, long term care facilities should look to end-of-life care for patients with dementia as an area ready for quality improvement. By implementing policies at admission to view video options for end-of-life preferences, patients and families can be assured a loved one receives the desired care. REFERENCE ARTICLE: Volandes, A, Ferguson, L, Davis, A, Hull, N, Green, M, Chang, Y, Deep, K, Paasche-Orlow, M. (2011). Assessing end-of-life preferences for advanced dementia. JOURNAL OF PALLIATIVE MEDICINE, 14(2), 169-179. ADDITIONAL REFERENCES: Gessert, CE., Haller IV, Kane, RL., Degenholtz, H. (2006). Rural-urban differences in medical care for nursing home residents with severe dementia at the end of life. Journal of American Geriatric Society, 54:1199-1205. Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. ...read more.


electricity to shock the heart; being placed on a breathing machine, also known as life support, in which a tube is placed down your throat into the lungs; and other medical procedures performed in the intensive care unit or ICU. The goal is to prolong life. Limited Care The goal of this category is to maintain physical and mental functions. Care will depend on your physical and mental functioning. Such care includes intravenous (IV) therapies like antibiotics and hospitalization. But does not include cardiopulmonary resuscitation/CPR and intensive care unit/ICU care. The goal is to maintain physical and mental functioning. Comfort Care The goal of this category is to maximize comfort. Only measures that comfort or relieve pain are performed. The aim is to relieve pain and to be kept as pain-free as possible. Comfort care does not include cardiopulmonary resuscitation/CPR, respirators, intensive care unit/ICU care, and generally would not include IV therapy or hospitalization. The goal is maximizing comfort and relieving pain. Imagine you have advanced dementia and became very ill and in need of medical treatment. ...read more.

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