A comparative analysis of comprehensive geriatric assessments for nursing home residents receiving palliative care: a systematic review

Kirsten Hermans; Johanna De Almeida Mello; Nele Spruytte; Joachim Cohen; Chantal Van Audenhove; Anja Declercq

doi:10.1016/j.jamda.2014.01.002

A comparative analysis of comprehensive geriatric assessments for nursing home residents receiving palliative care: a systematic review

J Am Med Dir Assoc. 2014 Jul;15(7):467-476. doi: 10.1016/j.jamda.2014.01.002. Epub 2014 Feb 22.

Authors

Kirsten Hermans¹, Johanna De Almeida Mello², Nele Spruytte², Joachim Cohen³, Chantal Van Audenhove², Anja Declercq⁴

Affiliations

¹ LUCAS, Center for Care Research and Consultancy, KU Leuven, Kapucijnenvoer Leuven, Belgium. Electronic address: Kirsten.Hermans@med.kuleuven.be.
² LUCAS, Center for Care Research and Consultancy, KU Leuven, Kapucijnenvoer Leuven, Belgium.
³ End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Laarbeeklaan, Brussels.
⁴ LUCAS, Center for Care Research and Consultancy, KU Leuven, Kapucijnenvoer Leuven, Belgium. Electronic address: Anja.Declercq@med.kuleuven.be.

PMID: 24569081
DOI: 10.1016/j.jamda.2014.01.002

Abstract

Background/objectives: Nursing homes become important locations for palliative care. By means of comprehensive geriatric assessments (CGAs), an evaluation can be made of the different palliative care needs of nursing home residents. This review aims to identify all CGAs that can be used to assess palliative care needs in long-term care settings and that have been validated for nursing home residents receiving palliative care. The CGAs are evaluated in terms of psychometric properties and content comprehensiveness.

Design: A systematic literature search in electronic databases MEDLINE, Web of Science, EMBASE, Cochrane, CINAHL, and PsycInfo was conducted for the years 1990 to 2012.

Setting: Nursing homes.

Participants: Nursing home residents with palliative care needs.

Measurements: Psychometric data on validity and reliability were extracted from the articles. The content comprehensiveness of the identified CGAs was analyzed, using the 13 domains for a palliative approach in residential aged care of the Australian Government Department of Health and Aging.

Results: A total of 1368 articles were identified. Seven studies met our inclusion criteria, describing 5 different CGAs that have been validated for nursing home residents with palliative care needs. All CGAs demonstrate moderate to high psychometric properties. The interRAI Palliative Care instrument (interRAI PC) covers all domains for a palliative approach in residential aged care of the Australian Government Department of Health and Aging. The McMaster Quality of Life Scale covers nine domains. All other CGAs cover seven domains or fewer.

Conclusions: The interRAI PC and the McMaster Quality of Life Scale are considered to be the most comprehensive CGAs to evaluate the needs and preferences of nursing home residents receiving palliative care. Future research should aim to examine the effectiveness of the identified CGAs and to further validate the CGAs for nursing home residents with palliative care needs.

Keywords: Comprehensive geriatric assessments; nursing homes; older adults; palliative care.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Activities of Daily Living
Aged
Aged, 80 and over
Geriatric Assessment*
Humans
Nursing Homes*
Palliative Care*
Quality of Life*
Surveys and Questionnaires