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Vital conversations with family in the nursing home: preparation for end-stage dementia care


Reinhardt, Joann P., Chichin, Eileen, Posner, Laurie, Kassabian, Simon


Journal Of Social Work In End-Of-Life & Palliative Care, Volume: 10, No.: 2, Pages.: 112-126

Year of Publication



Family members of persons with advanced dementia may be asked to make complex treatment decisions without having adequate knowledge regarding the risks and benefits. This 6-month, prospective, randomized trial tested the effect of an intervention consisting of a face-to-face, structured conversation about end-of-life care options with family members of nursing home residents with advanced dementia. A comparison group received only social contact via telephone. Structured conversations between a palliative care team and intervention group family members included goals of care and how best to achieve those goals, and provision of psychosocial support. Psychosocial support was also provided via telephone at three 2-month intervals. Family members participated in three telephone interviews: baseline, 3, and 6 months. Specific advance directives for persons with dementia were extracted from medical records. Results showed that intervention families had higher satisfaction with care than comparison families at the 6-month time point, and they were more likely to have decided on medical options listed in residents’ advance directives (Do Not Resuscitate, Intubate, Hospitalize) over time. Study findings reinforce the need for increased education and support for families around issues of end-of-life care decisions for advanced dementia.;

Bibtex Citation

@article{Reinhardt_2014, doi = {10.1080/15524256.2014.906371}, url = {}, year = 2014, month = {apr}, publisher = {Informa {UK} Limited}, volume = {10}, number = {2}, pages = {112--126}, author = {Joann P. Reinhardt and Eileen Chichin and Laurie Posner and Simon Kassabian}, title = {Vital Conversations with Family in the Nursing Home: Preparation for End-Stage Dementia Care}, journal = {Journal of Social Work in End-Of-Life {&} Palliative Care} }


adult, advance care planning, advance directives, advanced dementia, aged, attitude to death, dementia, endoflife communication, family, female, humans, male, middle aged, nursing, nursing homes, nursing staff, organization administration, professionalfamily relations, prospective studies, psychology, terminal care, treatment discussions

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Satisfaction with care/services


Nursing Homes

Type of Interventions

End of Life Care, Intervention for Carers, Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Social Work Support

End of Life Care

Palliative Care