{"id":110,"date":"2016-12-01T16:14:12","date_gmt":"2016-12-01T21:14:12","guid":{"rendered":"https:\/\/med.sites.unc.edu\/pcare\/resources\/goals-of-care\/"},"modified":"2023-04-28T11:19:55","modified_gmt":"2023-04-28T15:19:55","slug":"goals-of-care","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/pcare\/about-palliative-care\/resources\/goals-of-care\/","title":{"rendered":"A Decision Aid about Goals of Care for Patients with Dementia"},"content":{"rendered":"

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Alzheimer\u2019s disease and related dementias are leading causes of functional dependency and death. Over 5 million Americans currently suffer from dementia, and 1 million have advanced disease with loss of meaningful communication and total functional dependency.<\/p>\n

Family members make difficult choices on behalf of persons with advanced dementia. Common decisions include life-sustaining treatment, tube feeding, treatment of infections, and hospital transfer for acute illness. Treatments should align with goals such as prolonging life, maintaining function, or promoting comfort.<\/p>\n

Shared decision-making helps patients and families to prioritize goals in order to guide treatment. Decision aids improve shared decision-making by informing and framing choices for patients or families. However, few decision aids are designed for dementia.<\/p>\n

In the Goals of Care*<\/em> study, a team of investigators developed and tested a decision aid for surrogate decision-makers for patients with advanced dementia, and found it effective to improve quality of end-of-life communication for nursing home residents with advanced dementia, and enhance some elements of palliative care.<\/p>\n

Hanson LC, Zimmerman S, Song M-K, Lin F-C, Rosemond C, Carey TS, et al. Effect of the Goals of Care Intervention for Advanced Dementia. JAMA Internal Medicine. 2016 Nov [epub ahead of print]<\/a><\/p>\n

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