Obtaining informed consent from continuing care residents: issues and recommendations

Étude préliminaire d'une intervention non-pharmacologique pour réduire l'agitation verbale chez les personnes atteintes de démence

Verbally agitated behaviours are among the behavioural symptoms of dementia most commonly encountered in long-term care facilities. These behaviours may be related to unmet needs that cannot be expressed adequately because of cognitive impairment. The objective of this preliminary study is to assess an intervention, based on the needs of social attention, sensory stimulation, and comfort, for managing verbally agitated behaviours in long-term care demented patients. A multiple baseline case study design was used, with two participants.

Advance Directives for Health Care and Research

Patients suffering from Alzheimer disease and other types of dementia gradually lose their decision-making capacity. Advance directives have been widely promoted as a means to maintain some control over one's life in the event of decisional incompetence. This study used data from a recent postal survey conducted in Quebec, Canada to: 1) estimate the prevalence of formal and informal advance directives for health care and research among community-dwelling older adults presumed free of cognitive deficits; and 2) characterize those who have communicated their preferences regarding health care and research participation. Prevalence rates vary from 7.4% (formal advance directives for research) to 42.3% (informal advance directives for health care). Following multivariate logistic regressions, individuals who have communicated their wishes regarding future health care were found to be older, predominantly women, and to more often know someone with cognitive impairment. Those who have expressed their wishes regarding future research involvement were more inclined to participate in research. They were also more likely to have discussed or written advance directives for health care. The finding that only a small proportion of older adults have discussed future research participation with their families points to the need to find effective ways to promote advance directives for research in this population.