A significant grant from the National Institutes of Health is supporting an important study at the University of Oklahoma College of Medicine, which aims to examine if dementia patients' end-of-life care is in line with their personal wishes. The focus of the research, spearheaded by Lee Jennings, M.D., a geriatrician and associate professor, delves into the final stages of life for individuals facing an inevitable decline in cognitive functions, plagued by ailments such as swallowing disorders and frequent falls. Given that around 5 million Americans are currently grappling with Alzheimer's and related dementias.
With a $2.3 million funding pool, Dr. Jennings and her team are poring over data from approximately 550 deceased dementia patients, gathered during the D-CARE study. This previous research compared different models of dementia care, and it has provided a treasure trove of information on patient experiences. According to a report by OU College of Medicine, the study will address how well patients' care preferences were documented and followed, especially as they neared death and were unable to voice their wishes. "Care toward the end of life involves listening to patients, documenting their wishes and coordinating their care around those wishes," Jennings said, stressing the dignity in aligning treatment with patients' desires despite the inability to cure their underlying condition.
The scope of Jennings' investigation is systematically segmented into three primary aims. The first inspects the communication chain of care preferences, how well these are documented and upheld – particularly in acute care settings like hospitals. The second aim looks at caregiver perspectives on the quality of end-of-life care, and its correlation with health service utilization. In the third aim, researchers are sifting through Medicare claims data to quantify costs and identify instances of potentially burdensome interventions that run counter to a patient's established preferences.
This study also includes a crucial examination of disparities in care quality across different racial and ethnic groups, acknowledging that minority populations historically have faced subpar care. Jennings highlighted this issue, saying, "Historically, people from minority populations have received poorer quality care." These efforts to align care quality with patients' end-of-life preferences may uncover a significant contrast between the desired peaceful passing at home and the numerous, often urgent hospital visits aimed at extending life, frequently compromising comfort and quality.
