Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

3 results

  • Chapter 12 - Societal and Ethical Views on End-of-Life Decisions in Dementia

  • Edited by Mathieu Vandenbulcke, KU Leuven, Belgium, Rose-Marie Dröes, Erik Schokkaert, KU Leuven, Belgium
  • Book:
    Dementia and Society
    Published online:
    26 May 2022
    Print publication:
    09 June 2022, pp 233-250

  • Summary

    Most people in contemporary western societies do not die suddenly, but from organ failure or dementia after a period with declining health due to chronic-progressive disease. With increasing options for care and treatment, decisions about useful or desirable treatment and care are made in the last phase of life of most people. In this chapter, we report on three categories of end-of-life decisions that are made in dementia care. First, decisions primarily aimed at alleviating pain and other symptoms or improving quality of life in other ways, while possible effects on length of life are deemed irrelevant compared to that aim. Second, decisions around life-sustaining treatments or treatments to cure acute or co-morbid conditions which may or may not affect length and quality of life. Examples of such treatments are cardiopulmonary resuscitation, use of antibiotics, and artificial nutrition and hydration. Third, decisions around terminating life, e.g. euthanasia. For all these decisions, we focus on clinical as well as on some societal and ethical perspectives.

  • A systematic review of religious beliefs about major end-of-life issues in the five major world religions

  • Rajshekhar Chakraborty, Areej R. El-Jawahri, Mark R. Litzow, Karen L Syrjala, Aric D. Parnes, Shahrukh K. Hashmi
  • Journal:
    Palliative & Supportive Care / Volume 15 / Issue 5 / October 2017
    Published online by Cambridge University Press:
    19 January 2017, pp. 609-622
  • Objective:

    The objective of this study was to examine the religious/spiritual beliefs of followers of the five major world religions about frequently encountered medical situations at the end of life (EoL).

    Method:

    This was a systematic review of observational studies on the religious aspects of commonly encountered EoL situations. The databases used for retrieving studies were: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Observational studies, including surveys from healthcare providers or the general population, and case studies were included for review. Articles written from a purely theoretical or philosophical perspective were excluded.

    Results:

    Our search strategy generated 968 references, 40 of which were included for review, while 5 studies were added from reference lists. Whenever possible, we organized the results into five categories that would be clinically meaningful for palliative care practices at the EoL: advanced directives, euthanasia and physician-assisted suicide, physical requirements (artificial nutrition, hydration, and pain management), autopsy practices, and other EoL religious considerations. A wide degree of heterogeneity was observed within religions, depending on the country of origin, level of education, and degree of intrinsic religiosity.

    Significance of results:

    Our review describes the religious practices pertaining to major EoL issues and explains the variations in EoL decision making by clinicians and patients based on their religious teachings and beliefs. Prospective studies with validated tools for religiosity should be performed in the future to assess the impact of religion on EoL care.

  • Predictors of survival in nursing home patients with severe dementia in whom artificial nutrition and hydration forgone

  • H. Roeline W. Pasman, Bregje D. Onwuteaka-Philipsen, Didi M. W. Kriegsman, Marcel E. Ooms, Gerrit van der Wal, Miel W. Ribbe
  • Journal:
    International Psychogeriatrics / Volume 18 / Issue 2 / June 2006
    Published online by Cambridge University Press:
    18 January 2006, pp. 227-240

  • Background: To investigate the characteristics of patients in whom artificial nutrition and hydration (ANH) is forgone, duration of survival after the decision and factors that are associated with duration of survival.

    Methods: Observational study based on written questionnaires in 32 Dutch nursing homes. Of 178 nursing home patients with dementia, their treating nursing home physician (NHP) filled in a questionnaire directly after the decision was made to forgo ANH. The maximum follow-up was 6 weeks. Cox proportional hazards analysis was used to determine predictors of survival.

    Results: Decisions to forgo ANH in Dutch nursing homes were made most often in patients with severe dementia who also had an acute illness. More than half the patients (59%) died within 1 week after the decision. Patients with dyspnea and/or apathy were more likely to die during follow-up than patients without these symptoms. Patients who were considered more severely ill by the NHP were more likely to die than those who were considered less severely ill. The presence of restlessness indicated a higher chance of survival.

    Conclusions: The clinical judgment of the NHP of the severity of illness appeared to be a strong predictor of patient survival. NHPs should not rely solely on their clinical judgment concerning survival, but they should also consider the presence or absence of dyspnea, apathy and restlessness.