Hanson, Laura C., Carey, Timothy S., Caprio, Anthony J., Lee, Tae Joon, Ersek, Mary, Garrett, Joanne, Jackman, Anne, Gilliam, Robin, Wessell, Kathryn, Mitchell, Susan L.

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 […]

Hanson, Laura C., Carey, Timothy S., Caprio, Anthony J., Lee, Tae Joon, Ersek, Mary, Garrett, Joanne, Jackman, Anne, Gilliam, Robin, Wessell, Kathryn, Mitchell, Susan L.

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 […]

Rubright, Jonathan, Sankar, Pamela, Casarett, David J., Gur, Ruben, Xie, Sharon X., Karlawish, Jason

Objectives: Early and progressive cognitive impairments of patients with Alzheimer disease (AD) hinder their capacity to provide informed consent. Unfortunately, the limited research on techniques to improve capacity has shown mixed results. Therefore, the authors tested whether a memory and organizational aid improves the performance of patients with AD on measures of capacity and competency […]

Volandes, Angelo E., Mitchell, Susan L., Gillick, Muriel R., Chang, Yuchiao, Paasche-Orlow, Michael K.

Introduction: When patients are unable to make important end-of-life decisions, doctors ask surrogate decision makers to provide insight into patients’ preferences. Unfortunately, multiple studies have shown that surrogates’ knowledge of patient preferences is poor. We hypothesized that a video decision tool would improve concordance between patients and their surrogates for end-of-life preferences.; Objective: To compare […]

van der Steen, Jenny T., Albers, Gwenda, Licht-Strunk, Els, Muller, Martien T., Ribbe, Miel W.

Background: The clinical impact of risk score use in end-of-life settings is unknown, with reports limited to technical properties.; Methods: We conducted a mixed-methods study to evaluate clinical impact of a validated mortality risk score aimed at informing prognosis and supporting clinicians in decision-making in dementia patients with pneumonia. We performed a trial (n = […]

Teno, Joan M., Mitchell, Susan L., Kuo, Sylvia K., Gozalo, Pedro L., Rhodes, Ramona L., Lima, Julie C., Mor, Vincent

Objectives: To examine family member’s perceptions of decision-making and outcomes of feeding tubes.; Design: Mortality follow-back survey. Sample weights were used to account for oversampling and survey design. A multivariate model examined the association between feeding tube use and overall quality of care rating regarding the last week of life.; Setting: Nursing homes, hospitals, and […]

Snyder, E. Amanda, Caprio, Anthony J., Wessell, Kathryn, Lin, Feng Chang, Hanson, Laura C.

Objectives: In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, […]