Trial record 7 of 24 for:    Open Studies | "Hospice Care"

Palliative and End-of-life Care in Advanced Dementia: Evaluation of a Program of Organization of Care in Long-term Care

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2013 by Laval University
Sponsor:
Information provided by (Responsible Party):
René Verreault, Laval University
ClinicalTrials.gov Identifier:
NCT01441726
First received: September 7, 2011
Last updated: April 23, 2013
Last verified: April 2013
  Purpose

Rationale: In Canada, as in most industrialized countries, Alzheimer's disease and other related dementia are increasingly prevalent in older people. At an advanced stage, institutionalization in a long-term care (LTC) setting will be the fate of a majority of patients. A structured palliative care approach is increasingly used for cancer patients, but is still rarely accessible in LTC institutions for older people with advanced or terminal dementia. This approach should include a more systematic detection and treatment of pain and other physical and psychological symptoms during the last weeks of life, as well as better communications between patients, families and care staff, particularly relating to advanced care directives. Objectives: The general objective of this study is to implement and evaluate a multidisciplinary and multidimensional program of palliative and end-of-life care for older persons with terminal dementia in LTC facilities. Methodology: The intervention program will include five components:

  1. daily involvement of a nurse from the regular staff in the LTC facility as a change agent;
  2. awareness sessions with administrators and staff on the importance of high quality palliative care in dementia;
  3. a training program for physicians and all the staff involved in direct care of patients;
  4. systematic discussions with families and distribution to families of a document on different aspects of palliative care in dementia;
  5. systematic clinical care by regular staff for the control of pain, respiratory symptoms and mouth care. The program will be implemented in two LTC settings (one in Quebec City and one in Sherbrooke, Quebec, Canada), and results will be compared with the LTC control settings where usual care will be applied without implementation of the program.

Condition
Dementia

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Palliative and End-of-life Care in Advanced Dementia: Evaluation of a Program of Organization of Care in Long-term Care Settings

Resource links provided by NLM:


Further study details as provided by Laval University:

Primary Outcome Measures:
  • Family satisfaction with terminal care [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    Family Perception of Care Scale (FPCS): 25-item validated instrument including 4 components, yielding a score from 25 (negative perception) to 175 (highest positive perception of quality of palliative care)

  • Comfort scale in last two weeks of life [ Time Frame: 2 weeks ] [ Designated as safety issue: No ]
    Comfort Assessment in Dying with Dementia (CAD-EOL): 14-item validated instrument including 4 sub-scales, yielding a score from 14 (low comfort level) to 42 (highest comfort level).


Estimated Enrollment: 175
Study Start Date: September 2012
Estimated Study Completion Date: October 2014
Estimated Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Groups/Cohorts
Training of staff
No training of staff

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Residents in long term care settings

Criteria

Inclusion Criteria:

Residents with advanced dementia with a score of 7 on the Reisberg scale

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01441726

Locations
Canada, Quebec
Centre de santé et de services sociaux de la Vieille Capitale Recruiting
Quebec City, Quebec, Canada, G1S 2A4
Contact: Lise Bélanger    418-529-0931 ext 6488    lise.belanger@csssvc.qc.ca   
Sponsors and Collaborators
Laval University
  More Information

No publications provided

Responsible Party: René Verreault, Professeur titulaire, Laval University
ClinicalTrials.gov Identifier: NCT01441726     History of Changes
Other Study ID Numbers: MOP-114881
Study First Received: September 7, 2011
Last Updated: April 23, 2013
Health Authority: Canada: Canadian Institutes of Health Research

Keywords provided by Laval University:
Advanced dementia
Quality
Terminal care

Additional relevant MeSH terms:
Dementia
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders
Mental Disorders

ClinicalTrials.gov processed this record on September 16, 2014