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

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


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).


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


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).


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 care included cardiopulmonary resuscitation (CPR) and mechanical …

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  • Sources of funding The Foundation for Informed Medical Decision Making, the Alzheimer's Association and the Hartford Foundation.


  • Competing interests None

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