Laura C. Hanson|Timothy S. Carey|Anthony J. Caprio|Tae Joon Lee|Mary Ersek|Joanne M. Garrett|Anne Jackman|Robin Gilliam|Kathryn Wessell|Susan L. Mitchell
Improving Decision-Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|East Carolina University|University of Pennsylvania|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|Hebrew SeniorLife
objectives test whether decision aid improves quality decisionmaking feeding options advanced dementia design cluster randomized controlled trial setting twentyfour nursing homes north carolina participants residents advanced dementia feeding problems surrogates intervention intervention surrogates received audio print decision aid feeding options advanced dementia controls received usual care measurements primary outcome decisional conflict scale range 15 measured 3 months main outcomes surrogate knowledge frequency communication providers feeding treatment use results two hundred fiftysix residents surrogate decisionmakers recruited residents average age 85 67 caucasian 79 women surrogates average age 59 67 caucasian 70 residents children intervention improved knowledge scores 168 vs 151 p 001 3 months intervention surrogates lower decisional conflict scale scores controls 165 vs 190 p 001 often discussed feeding options healthcare provider 46 vs 33 p 04 residents intervention group likely receive dysphagia diet 89 vs 76 p 04 showed trend toward greater staff eating assistance 20 vs 10 p 08 tube feeding rare groups even 9 months 1 intervention vs 3 control p 34 conclusion decision aid feeding options advanced dementia reduced decisional conflict surrogates increased knowledge communication feeding options providers