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End-of-life care in older people. A study of advance care planning and end-of-life decision-making in Flanders, Belgium.

Author: Cindy De Gendt

Date: 14-01-2011

Promotors: Prof. dr. Luc Deliens
Co-Promotors: Prof. dr. Johan Bilsen and Prof. dr. Robert Vander Stichele

Summary of the dissertation

With an ageing population, the pattern of disease and dying is changing. Currently, two thirds of all  deaths  in  Flanders  are  non-sudden  deaths  and  are  likely  to  involve  some  type  of  end-of-life care before death. During the last few decades the awareness has grown that  for these patients prolonging life at any cost may not always be the best solution; palliation and improvement of the quality of life may prevail over futile and often burdensome treatments. This  dissertation  is  dedicated  to  end-of-life  care  for  the  increasing  group  of  older  people  in  our society, and the preceding decision-making processes (advance care planning and medical decision-making at the very end of  life).  This age group needs special attention because decision-making at their end of life is often complicated by loss of competence caused by dementia or other final stage diseases, and by lower general condition and comorbidity. The focus is on medical end-of-life decision-making and terminal sedation at the very end of life for this age group in general, and on advance  care  planning  in  institutionalised  care  for  older  people.  In  the  acute  setting  of  geriatric wards, policy and actual practice concerning do-not-resuscitate decision-making is considered. In the long-term care setting of nursing homes, policy and actual practice regarding advance care planning in general (several end-of-life decisions) is considered. End-of-life care in older people – A study of advance care planning and end-of-life decision-making in Flanders, Belgium was written as a PhD-thesis.

pdf filePhDCindyDeGendt (1.02 MB)