| Improving Decision-Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial. | |
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MedLine Citation:
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PMID: 22091750 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. DESIGN: Cluster randomized controlled trial. SETTING: Twenty-four nursing homes in North Carolina. PARTICIPANTS: Residents with advanced dementia and feeding problems and their surrogates. INTERVENTION: Intervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. MEASUREMENTS: Primary outcome was the Decisional Conflict Scale (range: 1-5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use. RESULTS: Two hundred fifty-six residents and surrogate decision-makers were recruited. Residents' average age was 85; 67% were Caucasian, and 79% were women. Surrogates' average age was 59; 67% were Caucasian, and 70% were residents' children. The intervention improved knowledge scores (16.8 vs 15.1, P < .001). After 3 months, intervention surrogates had lower Decisional Conflict Scale scores than controls (1.65 vs 1.90, P < .001) and more often discussed feeding options with a healthcare provider (46% vs 33%, P = .04). Residents in the intervention group were more likely to receive a dysphagia diet (89% vs 76%, P = .04) and showed a trend toward greater staff eating assistance (20% vs 10%, P = .08). Tube feeding was rare in both groups even after 9 months (1 intervention vs 3 control, P = .34). CONCLUSION: A decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. |
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Authors:
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Laura C Hanson; Timothy S Carey; Anthony J Caprio; Tae Joon Lee; Mary Ersek; Joanne Garrett; Anne Jackman; Robin Gilliam; Kathryn Wessell; Susan L Mitchell |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-15 |
Journal Detail:
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Title: Journal of the American Geriatrics Society Volume: - ISSN: 1532-5415 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-11-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503062 Medline TA: J Am Geriatr Soc Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society. |
Affiliation:
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Division of Geriatric Medicine, University of North Carolina, Chapel Hill, North Carolina; Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina; Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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