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Case 10 - “I Saw the Heavenly Gates”

End-of-Life Care in MNCD

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Primary health care providers and mental health professionals are likely to be engaged with family or care staff with questions regarding end-of-life care issues in those in the terminal stages of major neurocognitive disorders. Those who provide care in the long-term care setting should be familiar with issues regarding end-of-life care in MNCD. Palliative care is an approach to medical care that focuses on providing relief from pain, other symptoms, and the physical, emotional, and psychosocial stress that individuals with serious illnesses may experience. The primary goal of palliative care is to improve the quality of life for patients and their families, particularly when dealing with complex, chronic, or terminal medical conditions. Hospice care is appropriate for patients that are entering the terminal stage of illness and is provided through a licensed hospice agency. The hospice care model focuses on improving comfort and quality of life. It is a holistic approach that encompasses physical, emotional, social, and spiritual support and can be provided in almost any care setting.

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 46 - 51
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Schwartz, D. B., Posthauer, M. E., & O’Sullivan, M. J. (2021). Advancing nutrition and dietetics practice: Dealing with ethical issues of nutrition and hydration. Journal of the Academy of Nutrition and Dietetics, 121 (5), 823831. DOI: 10.1016/j.jand.2020.07.028. PMID: 32988795; PMCID: PMC7518202.CrossRefGoogle ScholarPubMed

Further Reading

Aldridge, M. D., Hunt, L., Husain, M., Li, L., & Kelley, A. (2022). Impact of comorbid dementia on patterns of hospice use. Journal of Palliative Medicine, 25 (3), 396404. https://doi.org/10.1089/jpm.2021.0055CrossRefGoogle ScholarPubMed
Bartley, M. M., Manggaard, J. M., Fischer, K. M., Holland, D. E., & Takahashi, P. Y. (2023). Dementia care in the last year of life: Experiences in a community practice and in skilled nursing facilities. Journal of Palliative Care, 38 (2), 135142. https://doi.org/10.1177/08258597221125607CrossRefGoogle Scholar
Dressler, G., Garrett, S. B., Hunt, L. J., Thompson, N., Mahoney, K., Sudore, R. L., Ritchie, C. S., & Harrison, K. L. (2021). “It’s case by case, and it’s a struggle”: A qualitative study of hospice practices, perspectives, and ethical dilemmas when caring for hospice enrollees with full-code status or intensive treatment preferences. Journal of Palliative Medicine, 24 (4), 496504. https://doi.org/10.1089/jpm.2020.0215CrossRefGoogle ScholarPubMed
Gilissen, J., Hunt, L., Tahir, P., & Ritchie, C. (2020). Protocol: Earlier initiation of palliative care in the disease trajectory of people living with dementia: A scoping review protocol. BMJ Open, 11 (6). https://doi.org/10.1136/bmjopen-2020-044502Google Scholar
Hui, D., Heung, Y., & Bruera, E. (2022). Timely palliative care: Personalizing the process of referral. Cancers, 14 (4) https://doi.org/10.3390/cancers14041047CrossRefGoogle ScholarPubMed
Lassell, K. F., Moreines, L. T., Luebke, M. R., Bhatti, K. S., Pain, K. J., Brody, A. A., & Luth, E. A. (2022). Hospice interventions for persons living with dementia, family members and clinicians: A systematic review. Journal of the American Geriatrics Society, 70 (7), 2134. https://doi.org/10.1111/jgs.17802CrossRefGoogle ScholarPubMed
Miranda, R., Bunn, F., Lynch, J., & Goodman, C. (2019). Palliative care for people with dementia living at home: A systematic review of interventions. Palliative Medicine, 33 (7), 726742. https://doi.org/10.1177/0269216319847092CrossRefGoogle Scholar
Mo, L., Geng, Y., Chang, Y. K., Philip, J., Collins, A., & Hui, D. (2021). Referral criteria to specialist palliative care for patients with dementia: A systematic review. Journal of the American Geriatrics Society, 69 (6), 1659. https://doi.org/10.1111/jgs.17070CrossRefGoogle ScholarPubMed
Parast, L., Tolpadi, A. A., Teno, J., Elliott, M. N., & Price, R. A. (2022). Variation in hospice experiences by care setting for patients with dementia. Journal of the American Medical Directors Association, 23 (9), 1480. https://doi.org/10.1016/j.jamda.2022.03.010CrossRefGoogle ScholarPubMed

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