Top Ten Tips Palliative Care Clinicians Should Know About Cognitive Impairment and Institutional Care

J Palliat Med. 2020 Nov;23(11):1525-1531. doi: 10.1089/jpm.2020.0552. Epub 2020 Sep 21.

Abstract

Most long-term care (LTC) residents are of age >65 years and have multiple chronic health conditions affecting their cognitive and physical functioning. Although some individuals in nursing homes return home after receiving therapy services, most will remain in a LTC facility until their deaths. This article seeks to provide guidance on how to assess and effectively select treatment for delirium, behavioral and psychological symptoms for patients with dementia, and address other common challenges such as advanced care planning, decision-making capacity, and artificial hydration at the end of life. To do so, we draw upon a team of physicians with training in various backgrounds such as geriatrics, palliative medicine, neurology, and psychiatry to shed light on those important topics in the following "Top 10" tips.

Keywords: advance care planning; delirium; dementia; palliative care; skilled nursing facility.

MeSH terms

  • Aged
  • Cognitive Dysfunction* / therapy
  • Hospice and Palliative Care Nursing*
  • Humans
  • Long-Term Care
  • Nursing Homes
  • Palliative Care