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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S83
life situations and in geriatric care, their relatives, professional
caregivers and the health care stakeholders is mostly unknown.
Existing research data from a general population is not transferable
for an end-of-life care population. Therefore, an interprofessional
team of nursing scientists, psychologists, health economists and
physicians from different departments of university realize M-
EndoL, which aims to develop a patient- and family-centered
approach for handling MRSA/MRE in end-of-life care, taking into
account the complex situation of hospitalized patients and their
relatives.
Methods:
The study uses a mixed methods approach and
is conducted across two research phases and at two study
centers. In a first phase, patients and relatives are interviewed
using semi-structured questioning to explore information and
communication in clinical setting and the individual consequences
due to complaints, therapy and hygienic measures. Transcripts
are analyzed using principles of Grounded Theory and MAXQDA
software. In the second research phase, results are shared in focus
group discussions.
Results:
We will present first categorizations and hypothesis about
the impact of MRSA/MRE infection and colonization on geriatric
patients and their relatives.
Conclusions:
A synthesis of the research findings will result in a
best practice guide for handling MRSA/MRE in end-of-life care. The
guide will be developed using expert consensus.
The project is funded by Bundesministerium f ¨ur Bildung und
Forschung (BMBF). There are no conflicts of interest to be reported.
P-194
Terminal change in functional decline of nursing home
residents with and without advanced dementia
N. Theill
University of Zurich, Zurich, Switzerland
Background:
Decline in physical functioning has been reported to
indicate impending death of residents in long-term care. However,
the role of dementia remains unclear, as well as time of onset
of terminal decline and the amount of change compared to pre-
terminal decline.
Objectives:
To investigate terminal change in functional decline of
nursing home residents with advanced, mild or no dementia.
Methods:
Mulitphase growth models were applied to retrospective
data of the last 24 months of 44,811 deceased residents (mean age
at death: 87.46
±
7.17, 67.6% women) of 358 Swiss nursing homes
between 1998 and 2014. Physical functioning was assessed with
the activities of daily living (ADL) index of the Resident Assessment
Instrument-Minimum Data Set (RAI-MDS).
Results:
Results revealed an acceleration of functional decline
between two and three months before death in all three groups. For
individuals without dementia, terminal decline was 1.5 points per
month compared to 0.1 points during pre-terminal decline. While
residents with mild dementia only showed slight differences in
end-of-life trajectories compared to the non demented residents,
advanced dementia was related to a lower physical functioning as
well as less severe rate of terminal decline.
Conclusion:
Impending death of nursing home residents is
indicated by terminal change in functional decline between two
to three months before death. Although global level of physical
functioning is lowered in residents with advanced dementia, they
still show a considerable increase in end-of-life functional decline.
P-195
Treatment-related differences in health related quality of life
and disease specific symptoms among colon cancer survivors:
Results from the population-based PROFILES registry
S. Verhaar
1
, P. Vissers
2
, H. Maas
3
, L. van de Poll-Franse
2
, F. Erning
4
,
F. Mols
2
1
AIOS, Tilburg, Netherlands;
2
UVT, Tilburg, Netherlands;
3
Netherlands;
4
IKNL, Utrecht, Netherlands
Objectives:
The goal of this study was to compare health related
quality of life (HRQoL) and disease-specific symptoms between
colon cancer patients treated with surgery only (SU) and surgery
and adjuvant chemotherapy (SU+adjCT). Results were stratified for
those aged
<
70 and ≥70 years. HRQoL of patients was also compared
with an age- and sex-matched normative population.
Methods:
Patients diagnosed with colon cancer and surgically
treated between January 2000 and June 2009, as registered
within the population-based Eindhoven Cancer Registry, received
a questionnaire on HRQoL (EORTC QLQ-C30) and disease-
specific symptoms (EORTC QLQ-CR38) in 2010. EORTC QLC-C30
questionnaire was also completed by the normative population
(n = 685).
Results:
1606 (72%) colon cancer survivors responded to our
questionnaire. 854 colon cancer patients aged ≥70 were included in
this study, treated with SU (n = 643) or SU+adjCT (n = 211), with a
matched normative control group of 98. No statistically significant
differences on the scales of the EORTC QLQ-C30, both functioning
scales as subscales, were observed between colon cancer patients
treated with either SU or SU+adjCT and the normative population.
Conclusion:
No differences in HRQoL were found between colon
cancer patients aged ≥70, 1–10 years after diagnosis, treated with
either SU or SU+adjCT and a normative population aged ≥70. Long-
term HRQoL does not justify withholding adjuvant chemotherapy.
Furthermore, HRQoL-measurements in an elderly population may
be complex and actual HRQoL instruments may lack the ability to
discriminate HRQoL in elderly patients.
P-196
Dementia Village Singapore: visions of the future
X.Y. Yap
1
, M.Y. Yap
2
1
Changi General Hospital, Singapore, Singapore;
2
Changi General
Hospital, Singapore
Introduction:
In place of traditional nursing homes, the
Netherlands has pioneered the first dementia village in the world,
the De Hogeweyk. We imagine how a similar-styled village can be
built in Singapore, and its feasibility.
The Dementia Village:
Land scarce Singapore would be the perfect
setting for a block of condominium-style apartments. It will be
situated within a gated premise with security cameras, replete
with pavements, cycling paths and gardens. Residents will be given
the independence to walk around as they please.
The village will be helmed by a myriad of healthcare staff who will
“live” in the same community. They will patrol the village in their
own clothes and look after the villagers in a discreet manner.
The village will be self-equipped with its own facilities. There will
be a grocery store, hair salon, restaurant, chapel and a GP clinic.
There will also be a town hall, where villagers can mingle and have
classes such as cooking and art therapy.
It is hoped that the village will create a safe environment for
dementia patients to live as normal a life as they could, in a
dignified manner.
Limitations:
The cost of building and maintaining the compounds
will be the main consideration, as well as manpower recruitment
and training. Also criteria have to be put in place to achieve a deft
balance between demand and supply.