Dementia Linked With Better End-of-Life Care for Patients With Respiratory Disease

Dementia was associated with better end-of-life care and death, as perceived by bereaved family members, for patients who died of noncancerous respiratory disease. Researchers published the finding in Palliative Medicine Reports.

“In contrast,” researchers wrote, “the duration of respiratory failure, using a ventilator at the time of death, or cause of death were not correlated with the quality of patient death and care.”

Study results were based on anonymous surveys completed by family members (half of whom were spouses) of 50 patients who had died of noncancerous respiratory disease at St Luke’s International Hospital in Tokyo, Japan. Primary diagnoses at death included pneumonia (58%), interstitial lung disease (30%), and chronic obstructive pulmonary disease (6%).

Overall mean scores were 77±15 on the Care Evaluation Scale (CES) and 79±15 on the Good Death Inventory (GDI), according to the study. Multiple linear regression analysis found the presence of dementia to be an independent factor associated with high scores on both scales.

“Of the items on the CES, the bereaved family members of dementia patients were highly satisfied with the following: ‘Physicians, nurses, and staff endeavored so that the patient’s hope would be accomplished’ and ‘There is good cooperation among staff members such as physicians and nurses,’” researchers reported. “Regarding the items on the GDI, they were satisfied with the following: ‘Physical and psychological comfort,’ ‘Maintaining hope and pleasure,’ and ‘Environmental comfort.’”

The results show the importance of addressing distress and pain in patients with dementia, the authors pointed out—factors which, they acknowledged, can be difficult to assess.

Reference:
Imai R, Mizuno A, Miyashita M, et al. Bereaved family members’ perceived care at the end of life for patients with noncancerous respiratory diseases. Palliat Med Rep. 2021;2(1):265-271. doi:10.1089/pmr.2021.0034