TY - JOUR

T1 - Physical and Psychological Distress Are Related to Dying Peacefully in Residents with Dementia in Long-Term Care Facilities

AU - EURO IMPACT

AU - De Roo, Maaike L.

AU - Albers, Gwenda

AU - Deliens, Luc

AU - De Vet, Henrica C.W.

AU - Francke, Anneke L.

AU - Van Den Noortgate, Nele

AU - Van Den Block, Lieve

AU - De Groote, Zeger

AU - Brearley, Sarah

AU - Caraceni, Augusto

AU - Cohen, Joachim

AU - Francke, Anneke

AU - Harding, Richard

AU - Higginson, Irene J.

AU - Kaasa, Stein

AU - Linden, Karen

AU - Miccinesi, Guido

AU - Onwuteaka-Philipsen, Bregje

AU - Pardon, Koen

AU - Pasman, Roeline

AU - Pautex, Sophie

AU - Payne, Sheila

AU - Lucdeliens,

PY - 2015/7

Y1 - 2015/7

N2 - Context Although dying peacefully is considered an important outcome of high-quality palliative care, large-scale quantitative research on dying peacefully and the factors associated with a peaceful death is lacking. Objectives To gain insight into how many residents with dementia in long-term care facilities die peacefully, according to their relatives, and whether that assessment is correlated with observed physical and psychological distress. Methods This was a retrospective cross-sectional study of deceased nursing home residents in a representative sample of long-term care facilities in Flanders, Belgium (2010). Structured post-mortem questionnaires were completed by relatives of the resident, who were asked to what extent they agreed that the resident "appeared to be at peace" during the dying process. Spearman correlation coefficients gave the correlations between physical and psychological distress (as measured using the Symptom Management at the End of Life with Dementia and Comfort Assessment in Dying at the End of Life with Dementia scales) and dying peacefully (as measured using the Quality of Dying in Long Term Care instrument). Results The sample comprised 92 relatives of deceased residents with dementia. In 54% of cases, relatives indicated that the resident died peacefully. Weak-to-moderate correlations (0.2-0.57) were found between dying peacefully and physical distress in the last week of life. Regarding psychological distress, weak-to-moderate correlations were found for both the last week (0.33-0.44) and last month of life (0.28-0.47). Conclusion Only half of the residents with dementia died peacefully as perceived by their relatives. Relatives' assessment of whether death was peaceful is related to both physical and psychological distress. Further qualitative research is recommended to gain more in-depth insights into the aspects on which relatives base their judgment of dying peacefully.

AB - Context Although dying peacefully is considered an important outcome of high-quality palliative care, large-scale quantitative research on dying peacefully and the factors associated with a peaceful death is lacking. Objectives To gain insight into how many residents with dementia in long-term care facilities die peacefully, according to their relatives, and whether that assessment is correlated with observed physical and psychological distress. Methods This was a retrospective cross-sectional study of deceased nursing home residents in a representative sample of long-term care facilities in Flanders, Belgium (2010). Structured post-mortem questionnaires were completed by relatives of the resident, who were asked to what extent they agreed that the resident "appeared to be at peace" during the dying process. Spearman correlation coefficients gave the correlations between physical and psychological distress (as measured using the Symptom Management at the End of Life with Dementia and Comfort Assessment in Dying at the End of Life with Dementia scales) and dying peacefully (as measured using the Quality of Dying in Long Term Care instrument). Results The sample comprised 92 relatives of deceased residents with dementia. In 54% of cases, relatives indicated that the resident died peacefully. Weak-to-moderate correlations (0.2-0.57) were found between dying peacefully and physical distress in the last week of life. Regarding psychological distress, weak-to-moderate correlations were found for both the last week (0.33-0.44) and last month of life (0.28-0.47). Conclusion Only half of the residents with dementia died peacefully as perceived by their relatives. Relatives' assessment of whether death was peaceful is related to both physical and psychological distress. Further qualitative research is recommended to gain more in-depth insights into the aspects on which relatives base their judgment of dying peacefully.

KW - dementia

KW - long-term care facilities

KW - nursing homes

KW - palliative care

KW - Peaceful death

KW - quality indicators

KW - spirituality

U2 - 10.1016/j.jpainsymman.2015.02.024

DO - 10.1016/j.jpainsymman.2015.02.024

M3 - Journal article

C2 - 25847852

AN - SCOPUS:84937523497

VL - 50

SP - 1

EP - 8

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 1

ER -