title: Palliative fever management in Alzheimer patients. quality plus fiscal responsibility.
abstract: Aggressive medical treatment of infections does not affect the progressive course of dementia of the Alzheimer type (DAT) and has limited effect on the mortality rate. Utilization of health care resources and discomfort during a fever episode were compared in three differing treatment conditions: in 18 patients in a dementia special care unit (DSCU) who received palliative management, 26 patients in a DSCU who were treated aggressively, and 17 DAT patients in traditional long-term care units who were treated aggressively. Both groups of patients in the DSCU had lower discomfort scores, lower utilization of high-cost health care resources, and higher utilization of analgesics and narcotics. A nursing model of care incorporating hospice concepts into the DSCU is suggested.
authors.affiliation: Geriatric Research, Education and Clinical Center; Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA.
authors.forename: A C
authors.initials: AC
authors.lastname: Hurley
authors.forename: B
authors.initials: B
authors.lastname: Volicer
authors.forename: M A
authors.initials: MA
authors.lastname: Mahoney
authors.forename: L
authors.initials: L
authors.lastname: Volicer
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000191:economics / Q000453:epidemiology / Q000451:nursing* / Q000523:psychology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D005334:Fever / Q000191:economics / Q000453:epidemiology / Q000451:nursing* / Q000523:psychology; D006763:Hospitals, Chronic Disease / Q000191:economics / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D009511:New England / Q000453:epidemiology; D010166:Palliative Care / Q000191:economics / Q000523:psychology / Q000592:standards* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011787:Quality of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal