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Which has more influence on a family's assessment of the quality of dying of their long-term care resident with dementia: Frequency of symptoms or quality of communication with healthcare team?

Published online by Cambridge University Press:  29 March 2022

Olivia Charest-Drapeau ,
Véronique Provencher Open the ORCID record for Véronique Provencher [Opens in a new window] ,
Lise Trottier ,
Guillaume Léonard ,
Machelle Wilchesky  and
Gina Bravo
Olivia Charest-Drapeau
Affiliation:
Research Centre on Aging, CIUSSS de l'Estrie – CHUS, Sherbrooke, QC, Canada
Véronique Provencher*
Affiliation:
Research Centre on Aging, CIUSSS de l'Estrie – CHUS, Sherbrooke, QC, Canada School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
Lise Trottier
Affiliation:
Research Centre on Aging, CIUSSS de l'Estrie – CHUS, Sherbrooke, QC, Canada
Guillaume Léonard
Affiliation:
Research Centre on Aging, CIUSSS de l'Estrie – CHUS, Sherbrooke, QC, Canada School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
Machelle Wilchesky
Affiliation:
Department of Family Medicine and Division of Geriatric Medicine, McGill University, Montreal, QC, Canada Donald Berman Maimonides Centre for Research in Aging, Montreal, QC, Canada
Gina Bravo
Affiliation:
Research Centre on Aging, CIUSSS de l'Estrie – CHUS, Sherbrooke, QC, Canada Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
*
Author for correspondence: Véronique Provencher, School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, Canada J1H 5N4. E-mail: veronique.provencher@usherbrooke.ca
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Abstract

Objective

Symptoms present at the end of life and the quality of communication with the healthcare team have both been shown to impact family assessments of the quality of dying of their loved one with dementia. However, the relative contributions of these two factors to family assessments have not yet been investigated. To address this knowledge gap, we explored which of these two factors has more influence on family assessments of the quality of dying of long-term care (LTC) residents with dementia.

Method

This is a secondary analysis of a mortality follow-back study. Ninety-four family members of LTC residents who had died with dementia assessed the quality of dying (very good or not very good), the frequency of symptoms, and the quality of communication with the healthcare team using a self-administered questionnaire mailed 1 month after the resident's death. Logistic regression analyses were performed to determine the relative contributions of the two independent variables of primary interest (frequency of symptoms and quality of communication) to the families’ assessments of the quality of dying.

Results

Multivariate analyses revealed that the quality of communication with the healthcare team was closely linked to the quality of dying (p = 0.009, OR = 1.34, 95% CI = 1.09–1.65), whereas the frequency of symptoms was not (p = 0.142, OR = 1.05, 95% CI = 0.98–1.11) after controlling for potential confounders.

Significance of results

Our findings show that healthcare providers’ ability to engage in the end-of-life conversations with families outweighs the frequency of symptoms in family assessments of the quality of dying of their relative with dementia. Enhancing healthcare providers’ ability to communicate with families about the end-of-life care could improve families’ perceptions of the quality of dying of their relative with dementia and, consequently, ease their grieving process.

Keywords

Alzheimer's disease and other dementiasEnd-of-life careFamily caregiversLong-term careQuality of dying
Type
Original Article
Information
Palliative & Supportive Care , Volume 21 , Issue 3 , June 2023 , pp. 438 - 444
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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