Concept of pre-death. Restlessness in dementia

Area of Science:

• Gerontology
• Neurology
• Palliative Care

Background:

• A behavior stabilization unit experienced a significant increase in patient deaths over one year.
• This elevated mortality rate prompted an investigation by unit staff.
• Most deceased patients had a diagnosis of vascular or mixed dementia.

Purpose of the Study:

• To examine the circumstances surrounding an increased number of deaths on a behavior stabilization unit.
• To explore the potential link between patient behaviors and pre-death restlessness in end-stage dementia.
• To inform clinical practice regarding assessment and care for patients with dementia.

Main Methods:

• Retrospective examination of patient deaths on a behavior stabilization unit over a 1-year period.
• Analysis of patient diagnoses, focusing on dementia subtypes.
• Review of patient behaviors and their potential correlation with end-of-life signs.

Main Results:

• Twenty-three patient deaths occurred within the 1-year study period, more than double previous rates.
• Seventeen deaths (74%) occurred within two months of admission.
• Sixteen of the deceased patients (69%) had a diagnosis of vascular or mixed dementia.

Conclusions:

• Patient behaviors on the unit may be indicative of pre-death restlessness, particularly in those with end-stage vascular dementia.
• Recognition of pre-death restlessness can aid in distinguishing dying processes from other behavioral changes.
• Implementing palliative care based on accurate nursing assessment can improve comfort for patients and families.