End-of-life care experts say radio personalty Casey Kasem, who died of dementia complications after a protracted family battle over his care, had an advance directive. Kaiser Permanente palliative care specialist Dr. Daniel Johnson said family infrastructure is important, so he involves patients and their loved ones, designated surrogates and people who were not chosen as surrogates in discussions about the directive and reasons for the decisions.
The Illinois Legislature sent Gov. Pat Quinn a bill to expand the state's physician orders for life-sustaining treatment order forms to allow people to consider additional end-of-life care options, such as feeding tubes, pain medications and hospice. The bill also would expand which professionals can sign the form, adding physician assistants, advanced practice nurses and others.
A review of a Pittsburgh hospital's palliative care program developed for hematologic cancer and bone marrow transplant patients found that education was needed to overcome views that palliative care was the same as hospice, researchers reported in the Journal of Community and Supportive Oncology. A survey found that oncologists were satisfied with the program and that it led to an increase in hospice referrals for patients who died.
Illinois has started an initiative that tracks drug data from nursing home pharmacies as a way to reduce the inappropriate use of drugs to subdue patients. State officials will look for the use of chemical restraint and deviation from medical standards.
Clinical practice guidelines, treating families as well as patients and avoiding inappropriate care are three important components of dementia care. Dr. Kyle Allen of Riverside Health System in Virginia said interdisciplinary hospital care is not common with dementia patients because of reimbursement issues, but diagnosis and treatment protocols can close gaps in dementia care and help patients and families deal with the diagnosis.