Quality until we die: quality of life and quality of dying in nursing home residents with dementia

Klapwijk, M.S. (2022)

Doctoral Thesis

The aim of this thesis was to investigate different aspects of quality of life and quality of death for people with dementia in nursing homes.
Quality of life was measured with the QUALIDEM, an observation instrument. As an intervention, half of the care teams implemented a step-by-step method in addition to training about behavior and pain. The research showed that underlying conditions such as lung and psychiatric diseases, pain and behavioral problems have a negative influence on quality of life. In addition, after 3 months, the residents were less restless and tense. Between 3 and 6 months this was no longer the case, but the social isolation did decrease.
Quality of dying is often determined by the presence or absence of symptoms such as pain. Respondents were satisfied with the implementation of the Liverpool Care Pathway, but it was felt that recognizing the dying phase can be very difficult, especially in people with dementia. In the case of an expected death with extra attention to symptom burden, the dying phase proceeded with fewer symptoms. In recent years, relatives' satisfaction with care in the last period until death has increased, although the symptom burden has not decreased.

• Quality of life
• Palliative care in dementia
• Dying
• Nursing home

• All authors: Klapwijk, M.S.
• Supervisor: Achterberg, W.P.
• Co-supervisor: Steen, J.T. van der; Caljouw, M.A.A.
• Committee: Gussekloo, J.; Linden, Y.M. van der; Koopmans, R.T.C.M.; Van den Block, L.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2022-01-20
• ISBN (print): 9789090354811
• Sponsorship: Alzheimer Nederland