International reflections on caring for people with advanced dementia.
Yoshie Yumoto, W George Kernohan, Noriko Morioka and 1 others
PMID 30565293WHAT IT FOUND
People with advanced dementia often lose the ability to decide about end-of-life care.
UK services use advance care planning and specialist dementia comfort care; Japanese long-term care relies more on family-centered comfort care with less disease-specific symptom control.
Key findings
01Only 8% of people in England and Wales have completed advance care planning, while 36% of the U.K. population has written a will.
02In Japan, residents in nursing homes tend to undergo burdensome end-of-life interventions such as tube feeding, cardiopulmonary resuscitation, and hospital transfer.
03United Kingdom hospices have expanded palliative care for dementia into home and day-care settings, with dementia-friendly facilities using design and specialist staff.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The paper does not report patient outcomes or test whether any care model works. It is based on selected urban settings in Northern Ireland and Tokyo, so it may not represent other regions or countries. The literature search was exploratory, not a systematic review, and only English or Japanese sources were included. Nonparticipant observation and authors' reflections can describe what was seen, but they cannot prove that observed practices caused better care. The authors state that observational work cannot provide evidence of clinical effectiveness.
The easy way to misread this
Do not read this as proof that one country's dementia care is better or that advance care planning improves outcomes. It is a literature and observation review, and the authors state observational work cannot show clinical effectiveness.