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Type and course of symptoms demonstrated in the terminal and dying phases by people with dementia in nursing homes = Symptome und Symptomverläufe bei Menschen mit Demenz in der Terminal- und Sterbephase in Pflegeheimen

Koppitz, A. ; Bosshard, G. ; Schuster, D.H. ; Hediger, H. ; Imhof, L.

In: Zeitschrift für Gerontologie und Geriatrie, 2015, vol. 48, no. 2, p. 176-183

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    Title
    • Type and course of symptoms demonstrated in the terminal and dying phases by people with dementia in nursing homes
    Translated Title ()
    • Symptome und Symptomverläufe bei Menschen mit Demenz in der Terminal- und Sterbephase in Pflegeheimen
    Author
    • Koppitz, A.. Institute of Nursing, Zurich University of Applied Sciences (ZHAW), Technikumstr. 71, 8404, Winterthur, Switzerland
    • Bosshard, G.. Clinic for Geriatric Medicine, and Center on Aging and Mobility, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
    • Schuster, D.H.. Institute of Nursing, Zurich University of Applied Sciences (ZHAW), Technikumstr. 71, 8404, Winterthur, Switzerland
    • Hediger, H.. Institute of Nursing, Zurich University of Applied Sciences (ZHAW), Technikumstr. 71, 8404, Winterthur, Switzerland
    • Imhof, L.. Institute of Nursing, Zurich University of Applied Sciences (ZHAW), Technikumstr. 71, 8404, Winterthur, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Zeitschrift für Gerontologie und Geriatrie, 2015, vol. 48, no. 2, p. 176-183. Springer Berlin Heidelberg
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:333055
    Summary
    Background: In all, 39 % of people living in Swiss nursing homes suffer from dementia. Detailed data about type and course of symptoms displayed by these patients in their terminal phase are lacking. Methods: This descriptive, retrospective study analysed 65nursing documents from deceased people with dementia in four nursing homes in the canton of Zurich, Switzerland. Results: Difficulties with mobility (81 %), pain (71 %) and sleep disturbance (63 %) were the most frequent of the 10identified symptoms. Towards the end of life, difficulties with mobility, sleep disturbance, agitation and other neuropsychiatric symptoms, such as episodes of depression, decreased (decrescent pattern), while pain, feeding problems, breathing abnormalities, apathy and anxiety increased (crescent pattern). Courses of pain were documented in 17 % of the nursing records. In addition, 76 % of the residents had been visited on a daily basis by next of kin in their last 7days, compared with only one third of residents previously. Furthermore, daily communication between healthcare professionals and next of kin tripled during this period. Conclusion: The documented prevalence of a high and increasing level of pain towards the end of life, combined with the lack of documented courses of pain, shows potential for improvement in pain relief and pain identification for patients with dementia in their terminal phase. The increasing number of visits by next of kin and the increasingly intensive contact between healthcare professionals and next of kin in the last 7days are a strong indicator that the end of life can be predicted relatively well by the involved participants and appropriate reactions follow.