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Video decision support affects patients’ care choices in dementia care planning

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Question

Question:

Does a video decision support tool affect care preferences in older people who may develop advanced dementia?

Patients:

200 community dwelling older people (aged 65 or over; average age 75 years; 58% female). Exclusion criteria: unable to communicate in English; unable to provide informed consent; moderate to severe cognitive impairment (short portable mental status questionnaire score <7).

Setting:

Four primary care clinics associated with three academic medical centres, USA; recruitment September 2007-May 2008.

Intervention:

Video decision support tool plus a verbal description or verbal description only. The verbal narrative described the effects of advanced dementia. The 2 min video showed an 80-year-old woman with advanced dementia in a nursing home setting and her daughters, to illustrate the effects described in the verbal narrative (inability to communicate, walk and feed oneself).

Outcomes:

Preferred type of care in the case of advanced dementia (life prolonging care, limited care or comfort care). Preference was assessed before and after the intervention, and 6 weeks later. Life prolonging …

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