Effects of facilitated family case conferencing for advanced dementia: A cluster randomised clinical trial

• DOI: 10.1371/journal.pone.0181020
• Publication Date: 2017-08-07T13:31:53Z
• Authors: Meera Agar; Tim Luckett; Georgina Luscombe; Jane Phillips; Elizabeth Beattie; Dimity Pond; Geoffrey Mitchell; Patricia M. Davidson; Janet Cook; Deborah Brooks; Jennifer Houltram; Stephen Goodall; Lynnette Chenoweth
• Keywords: Family Caregivers; Severe dementia

Background Palliative care planning for nursing home residents with advanced dementia is often suboptimal. This study compared effects of facilitated case conferencing (FCC) usual (UC) on end-of-life care. Methods A two arm parallel cluster randomised controlled trial was conducted. The sample included people from 20 Australian homes and their families professional caregivers. In each intervention (n = 10), Care Planning Coordinators (PCPCs) family conferences trained staff in person-centred palliative 16 hours per week over 18 months. primary outcome family-rated quality (End-of-Life Dementia [EOLD] Scales). Secondary outcomes nurse-rated EOLD scales, resident life (Quality Life Late-stage [QUALID]) the last month (pharmacological/non-pharmacological strategies, hospitalization or inappropriate interventions). Results Two-hundred-eighty-six took part but only 131 died (64 UC 67 FCC which fewer than anticipated), rendering analysis under-powered no group effect seen scales. Significant differences pharmacological (P < 0.01) non-pharmacological 0.05) management were seen. Intercurrent illness associated lower Satisfaction (coefficient 2.97, P staff-rated Comfort Assessment Dying 4.37, 0.01). Per protocol analyses showed positive relationships between to bed ratios, proportion attitudes. Conclusion facilitates a approach Future trials should consider processes regarding decision making anticipated events acute illness. Trial registration New Zealand Clinical Registry ACTRN12612001164886