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Clinical Trials Update
February 28, 2017

Improving Shared Decision Making in Management of Dementia

Author Affiliations

Copyright 2017 American Medical Association. All Rights Reserved.

JAMA. 2017;317(8):798. doi:10.1001/jama.2017.1135

An intervention designed to help family members prioritize treatment decisions improved end-of-life communication and palliative care treatment plans and reduced hospitalization rates for nursing home residents with advanced dementia. At the same time, the randomized trial published in JAMA Internal Medicine highlighted shortcomings of dementia palliative care.

Participants were family decision makers for 302 residents with advanced dementia in 22 nursing homes. The intervention involved an 18-minute dementia-specific goals of care video decision aid that presented treatment options related to different goals—prolonging life, supporting function, and improving comfort. Family members also had a structured discussion with the nursing home care team, who received a 1-hour training session to prepare them for the discussion. Family members in the control group received an informational video on dementia and a usual care plan meeting with staff.