Palliative Care Consultation for Dementia

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Providence Rehabilitation & Healthcare Center, Yeadon, PA
Dementia+1 More
Palliative Care Consultation - Other
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether a nurse practitioner can successfully implement a palliative care intervention in nursing homes.

See full description

Eligible Conditions

  • Dementia
  • Palliative Care

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Palliative Care Consultation will improve 1 primary outcome and 1 secondary outcome in patients with Dementia. Measurement will happen over the course of 30 days post admission.

30 days post admission
Hospitalizations
Measure

Trial Safety

Trial Design

1 Treatment Group

Palliative Care Consultation in Post-Acute Care
1 of 1
Experimental Treatment

This trial requires 40 total participants across 1 different treatment group

This trial involves a single treatment. Palliative Care Consultation is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Palliative Care Consultation in Post-Acute Care
Other
Subjects will receive usual care plus a telehealth palliative care consultation by specialty providers who will document their findings in the Electronic Health Record (EHR), and communicate their findings and recommendations to the clinical team.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 30 days post admission
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 30 days post admission for reporting.

Who is running the study

Principal Investigator
J. C.
Joan Carpenter, Principal Investigator
University of Maryland, Baltimore

Closest Location

Providence Rehabilitation & Healthcare Center - Yeadon, PA

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 10 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
(1) PC provider
(2) Social Work (SW) NH champions
(3) post-acute care unit nursing staff and providers (including medical directors)
(4) NH leadership, information technology staff
(5) PLWD and their care partner(s).
Person Living with Dementia (PLWD)
documented dementia diagnosis
admitted for post-acute care
age ≥ 60 years
if unable to participate in a conversation or lacking capacity to make healthcare decisions as determined by the NH staff/providers, a care partner who can act as a surrogate decision maker in the PCC-PAC.

Patient Q&A Section

What causes dementia?

"Dementia is an umbrella term that covers many neurological and psychiatric conditions, although a specific underlying cause for each of these conditions is not known. Dementia is often multifactorial in nature and is likely to be caused by a combination of genetic factors, environmental exposures, and several risk factors that interact with each other to lead to deterioration of brain function." - Anonymous Online Contributor

Unverified Answer

What are the signs of dementia?

"Cognitive decline and memory decline are most commonly the first symptoms of dementia and there is the likelihood of other problems, often a very gradual process, occurring. Aspects the general practitioner can be involved in to reduce the burden of dementia on the patient and their family include informing the patient and family about symptom development, the need for further investigation and the available resources in their community. The GP should be mindful of the need to detect dementia even when the problem does not become evident till later stages of the condition." - Anonymous Online Contributor

Unverified Answer

What are common treatments for dementia?

"Physicians frequently prescribe medications for the treatment of cognitive symptoms of dementia. These medications may produce varying degrees of cognitive effects and even adverse drug reactions. The use of multiple medications to treat dementia is a frequent occurrence. The use of multiple medications raises the probability of adverse drug reactions. A more thorough review of the medication regimen may result in the avoidance of potentially injurious doses." - Anonymous Online Contributor

Unverified Answer

Can dementia be cured?

"Results from a recent clinical trial showed that in people with dementia and a caregiver they still want their carers to keep an eye and be there for them, even if it could mean a long period of time before they could start taking their own medications. This, coupled with the results of other studies of the effect of interventions on quality of life, is suggestive of the necessity of early identification of dementia and the early diagnosis, initiation and maintenance of optimum treatment." - Anonymous Online Contributor

Unverified Answer

How many people get dementia a year in the United States?

"About 65 million Americans could develop Alzheimer's disease at some point in time. A very sizable proportion of them may be undiagnosed during the year. However, many remain undiagnosed for a longer period between two and eight years. The proportion of the general population with undiagnosed dementia becomes high around the age group of 80 years." - Anonymous Online Contributor

Unverified Answer

What is dementia?

"Dementia is defined as a mental disorder characterized by intellectual decline. It can be of a rapid or slow deterioration. There are many forms of dementia, and the causes of cognitive dysfunction are many, including both neurodegenerative diseases and also a myriad of vascular illnesses. The most prevalent form of dementia worldwide is Alzheimer's disease. The first reported case of dementia was documented by Jean-Martin Charcot in 1873, based on autopsy results of patients with amyotrophic lateral sclerosis." - Anonymous Online Contributor

Unverified Answer

How serious can dementia be?

"With the progress of cognitive decline, individuals have to be educated, supported and empowered to protect themselves for the devastating impact that Alzheimer's disease has on life. The impact of dementia on everyday life and their families is devastating and it is important to empower them so that they can live fulfilling lives as they are going through this devastating disease." - Anonymous Online Contributor

Unverified Answer

Does palliative care consultation improve quality of life for those with dementia?

"The consultation may help to improve quality of life in the first 6 months of the palliative care consultation or a year before death, irrespective of age, duration or type of dementia. It may enable patients to take greater responsibility for their care, and provide a sense of pride in their ability to take care of themselves. Importantly the consultation cannot be regarded as standard care, but needs good organisation and support for patients and their family members." - Anonymous Online Contributor

Unverified Answer

Is palliative care consultation typically used in combination with any other treatments?

"PC is a common element of the multidisciplinary palliative care team. Patient-physician PC consultations occurred in half of the cases (n = 33/69). An overwhelming majority of PC consultations were preceded by other types of care, regardless of whether the initial consultation was for the patient or for caregivers (n = 50/69)." - Anonymous Online Contributor

Unverified Answer

Who should consider clinical trials for dementia?

"Most clinical trials for patients with mild or moderate dementia were sponsored by a research institute or specialty-specific nonprofit organization with a reputation for clinical utility. However, private organizations are more likely to sponsor and support larger clinical trials investigating the efficacy of potential medications for dementia." - Anonymous Online Contributor

Unverified Answer

Does dementia run in families?

"Findings from a recent study is important because it is one of the largest studies to examine the effects of genetic and environmental exposures on risk for dementia along the life-course. The finding that family history of dementia increases dementia risk in middle age, rather than beginning in adolescence, may be related to the timing of the clinical onset of familial AD, which is one of the earliest clinical signs of dementia. This information could help to identify the individuals at highest risk." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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