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International Journal of Health Professions

The journal of Verein zur Förderung der Wissenschaft in den Gesundheitsberufen

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Dying with dementia: most frequent symptoms. A review of the literature / Sterben mit Demenz: die häufigsten Symptome. Eine Literaturübersicht

Andrea Koppitz
  • Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Technikumstrasse 71, 8401 Winterthur, SWITZERLAND
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  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Veronika Waldboth
  • Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Technikumstrasse 71, 8401 Winterthur, SWITZERLAND
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jutta Dreizler
  • Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Technikumstrasse 71, 8401 Winterthur, SWITZERLAND
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lorenz Imhof
  • Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Technikumstrasse 71, 8401 Winterthur, SWITZERLAND
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-05-29 | DOI: https://doi.org/10.1515/ijhp-2015-0003

Abstract

Sensing, observing and interpreting the symptoms of persons suffering from dementia is very challenging. The difficulties lie in their restricted capacity to communicate and irregular transitions from a chronic-stable to an acute-critical condition both in the course of their symptoms and in the slow but continuous process of deterioration.

The aim of this integrative literature review was to identify the symptoms dementia patients present in the final twelve months of their lives and to identify instruments for symptom assessment. To this end, a comprehensive literature search within the electronic databases Medline® (PubMed), Cinahl® (EBSCO), PsycINFO® (OVID) and Cochrane Library for systematic reviews® and for clinical trials® in both German and English was performed including publications from January 2000 to July 2012.

Six symptoms were identified as frequent and common in the end-of-life phase of people with dementia: respiratory distress, pain, mood swings, restricted mobility, restricted food and fluid intake and behavioural and psychosocial symptoms. Knowledge of atypical symptom manifestation requires critical reflection about perceptions and observations, interpretation of these observations, development of assumptions and location within the context of everyday life in the meaning of clinical reasoning.

Abstract

Das Wahrnehmen, Beobachten und Interpretieren von Symptomen bei Personen mit Demenz in ihrer letzten Lebensphase ist herausfordernd. Die Schwierigkeiten liegen in der eingeschränkten verbalen Kommunikation, in wechselnden Übergängen von chronisch-stabilen zu akut-kritischen Symptomverläufen und in der langsamen aber stetigen Krankheitsverschlechterung.

Das Ziel dieser integrativen Literaturübersicht war es Symptome demenzerkrankter Personen in ihren letzten zwölf Lebensmonaten zu erfassen. Hierzu wurden die elektronischen Datenbanken Medline® (PubMed), Cinahl® (EBSCO), PsycINFO® (OVID), Cochrane Library für systematischeReviews® und für klinische Studien® von Januar 2000 bis Juli 2012 in Deutsch und Englisch systematisch durchsucht.

Es konnten sechs häufig und gemeinsam vorkommenden Symptome identifiziert werden: Atemnot, Schmerzen, Stimmungsschwankungen, eingeschränkte Mobilität, Ernährungsschwierigkeiten und herausforderndes Verhalten. Das Wissen um eine atypische Symptommanifestation erfordert ein klinisches Urteilsvermögen, das Wahrnehmungen und Beobachtungen kritisch reflektiert und interpretiert, die Entwicklung von Hypothesen und eine Einordnung in den Alltag ermöglicht.

Keywords : Dementia - Symptoms - Assessment - Dying

Keywords : Demenz - Symptome - Assessment - Sterben

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About the article

Received: 2014-04-15

Accepted: 2014-10-08

Published Online: 2015-05-29

Published in Print: 2015-06-01


Citation Information: International Journal of Health Professions, Volume 2, Issue 1, Pages 49–63, ISSN (Online) 2296-990X, DOI: https://doi.org/10.1515/ijhp-2015-0003.

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