Podcast: Improving Advanced Dementia Care in Nursing Homes

Today's GeriPal podcast features Laura Hanson, Geriatrician and Palliative Medicine physician at the University of North Carolina, Chapel Hill.  Laura discusses her recent JAMA RCT of a goals of care intervention for nursing home residents with advanced dementia.

Here is a link to the decision aid, including video.

Key excerpts from the podcast:

Laura: That is followed by an in-person discussion. I want to emphasize that, because I think that a video decision aid alone without anchoring to the clinicians who are actually delivering care is not going to be as powerful.

We did have a number of family caregivers who said, "I can't choose between function and comfort." That, I think, tells us something about what families want from us and what they're hoping for for the care of somebody with late stage dementia. It allows us to think about the things that we do that might actually cause functional deterioration, like overmedication, or prolonged hospitalization with time in bed that then can turn around and result in a functional impairment that otherwise wouldn't have occurred. I take that to heart as a clinician.

We conducted this study in a time period and in a location when population health was not a priority. It's important to recognize that moving forward with the emergence of population health and with new quality standards for nursing homes that will penalize them for readmissions, as well as hospitals. This is a high risk, high transfer population, and there may be new incentives for physicians to become more involved in, at least, the transitional care of this advanced dementia population. 

Enjoy!

By: Alex Smith, @AlexSmithMD

GeriPal Podcasts can be found on:

• iTunes
• Google Play Music
• Soundcloud
• Stitcher

-------


Produced by: Sean Lang-Brown