Rebecca K F Lassell1, Laura T Moreines1, Matthew R Luebke2, Karandeep S Bhatti3, Kevin J Pain4, Abraham A Brody1,5, Elizabeth A Luth6,7. 1. Rory Meyers College of Nursing, Hartford Institute for Geriatric Nursing, New York University, New York, New York, USA. 2. Department of Human Development, Cornell University, Ithaca, New York, USA. 3. Neurology Department, Cooper University Hospital, Camden, New Jersey, USA. 4. Weill Cornell Medicine, Samuel J. Wood Library and C. V. Starr Biomedical Information Center, New York, New York, USA. 5. Grossman School of Medicine, Division of Geriatrics and Palliative Care, New York University, New York, New York, USA. 6. Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, USA. 7. Department of Family Medicine and Community Health, Rutgers University, New Brunswick, New Jersey, USA.
Abstract
BACKGROUND: Hospice care was initially designed for seriously ill individuals with cancer. Thus, the model and clinicians were geared toward caring for this population. Despite the proportion of persons living with dementia (PLWD) receiving hospice care substantially increased over the past 10 years, and their longer lengths of stay, established hospice interventions for this population are scarce. No systematic review has previously evaluated those interventions that do exist. We synthesized hospice intervention studies for PLWD, their families, and hospice professionals by describing the types of interventions, participants, outcomes, and results; assessing study quality; and identifying promising intervention strategies. METHODS: A systematic review was conducted using a comprehensive search of five databases through March 2021 and follow-up hand searches. Included studies were peer-reviewed, available in English, and focused on hospice interventions for persons with dementia, and/or care partners, and clinicians. Using pre-determined inclusion and exclusion criteria, data was extracted guided by the Cochrane Checklist, and quality was assessed using a 26-item Consolidated Standards of Reporting Trials (CONSORT) Checklist. RESULTS: The search identified 3235 unique studies in total, of which 10 studies met inclusion criteria. The search revealed three types of interventions: clinical education and training, usual care plus care add-on services, and "other" delivered to 707 participants (mostly clinicians). Five studies included underrepresented racial and ethnic groups. Outcomes measured knowledge and skills, psychosocial and health outcomes, feasibility, and acceptability, with significant improvements in six studies. Study quality was reflective of early-stage research with clinical education and training strategies showing deliberate progression towards real-world efficacy testing. IMPLICATIONS: Hospice interventions for PLWD are sparse and in early-phase research. More research is needed with rigorous designs, diverse samples, and outcomes considering the concordance of care.
BACKGROUND: Hospice care was initially designed for seriously ill individuals with cancer. Thus, the model and clinicians were geared toward caring for this population. Despite the proportion of persons living with dementia (PLWD) receiving hospice care substantially increased over the past 10 years, and their longer lengths of stay, established hospice interventions for this population are scarce. No systematic review has previously evaluated those interventions that do exist. We synthesized hospice intervention studies for PLWD, their families, and hospice professionals by describing the types of interventions, participants, outcomes, and results; assessing study quality; and identifying promising intervention strategies. METHODS: A systematic review was conducted using a comprehensive search of five databases through March 2021 and follow-up hand searches. Included studies were peer-reviewed, available in English, and focused on hospice interventions for persons with dementia, and/or care partners, and clinicians. Using pre-determined inclusion and exclusion criteria, data was extracted guided by the Cochrane Checklist, and quality was assessed using a 26-item Consolidated Standards of Reporting Trials (CONSORT) Checklist. RESULTS: The search identified 3235 unique studies in total, of which 10 studies met inclusion criteria. The search revealed three types of interventions: clinical education and training, usual care plus care add-on services, and "other" delivered to 707 participants (mostly clinicians). Five studies included underrepresented racial and ethnic groups. Outcomes measured knowledge and skills, psychosocial and health outcomes, feasibility, and acceptability, with significant improvements in six studies. Study quality was reflective of early-stage research with clinical education and training strategies showing deliberate progression towards real-world efficacy testing. IMPLICATIONS: Hospice interventions for PLWD are sparse and in early-phase research. More research is needed with rigorous designs, diverse samples, and outcomes considering the concordance of care.
Authors: Elizabeth A Luth; David J Russell; Abraham A Brody; Ritchell Dignam; Sara J Czaja; Miriam Ryvicker; Kathryn H Bowles; Holly G Prigerson Journal: J Am Geriatr Soc Date: 2019-11-21 Impact factor: 5.562
Authors: Shih-Yin Lin; Catherine E Schneider; Alycia A Bristol; Maureen Clancy; Sara A Sprague; Melissa Aldridge; Tara Cortes; Keith S Goldfeld; Jean S Kutner; Susan L Mitchell; Joseph W Shega; Bei Wu; Carolyn W Zhu; Abraham A Brody Journal: Gerontologist Date: 2022-02-09
Authors: Claire Ferguson; Marcia Y Shade; Julie Blaskewicz Boron; Elizabeth Lyden; Natalie A Manley Journal: Am J Hosp Palliat Care Date: 2020-01-24 Impact factor: 2.500