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Watching Advanced Dementia Video Affects Care Decisions

Last Updated: May 29, 2009.

Showing elderly people a video depicting advanced dementia after they hear a verbal description, affects the choices they make about end-of-life care, according to a study published online May 28 in BMJ.

FRIDAY, May 29 (HealthDay News) -- Showing elderly people a video depicting advanced dementia after they hear a verbal description, affects the choices they make about end-of-life care, according to a study published online May 28 in BMJ.

Angelo E. Volandes, M.D., of Massachusetts General Hospital in Boston, and colleagues conducted a study of 200 people aged 65 years and above with a mean age of 75 years, of whom 106 were randomized to receive a verbal narrative description of advanced dementia, while 94 were also shown a two-minute video of someone with advanced dementia. The two groups were asked to choose their preferred goal of care, either life-prolonging, including mechanical ventilation and cardiopulmonary resuscitation; limited care, including hospital treatment and antibiotics, but no cardiopulmonary resuscitation; or comfort care, for symptomatic relief only.

Whereas 68 of the narrative-only group chose comfort care, 81 of the video group chose this option, the researchers found. In addition, 19 percent in the narrative-only group chose limited care, whereas 9 percent in the video group did, and 14 percent in the narrative-only group chose life-prolonging care, while 4 percent in the video group did. College-level education or higher, good health status, greater health literacy, and white race were all associated with the likelihood of choosing comfort care, the investigators discovered.

"To secure the delivery of high quality end of life care, patients must be informed regarding their decision making," the authors write. "Education of patients using video decision support tools can improve their comprehension of disease states such as advanced dementia that are difficult to envision solely with words."

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