Erratum to: A co-design process developing heuristics for practitioners providing end of life care for people with dementia.

Nathan Davies,Kethakie Lamahewa,Jane Wilcock,Rammya Mathew,Elizabeth L Sampson,Steve Iliffe,Jill Manthorpe

doi:10.1186/s12904-016-0148-x

Abstract

The end of life for someone with dementia can present many challenges for practitioners; such as, providing care if there are swallowing difficulties. This study aimed to develop a toolkit of heuristics (rules-of-thumb) to aid practitioners making end-of-life care decisions for people with dementia. An iterative co-design approach was adopted using a literature review and qualitative methods, including; 1) qualitative interviews and focus groups with family carers and 2) focus groups with health and care professionals. Family carers were recruited from a national charity, purposively sampling those with experience of end-of-life care for a person with dementia. Health and care professionals were purposively sampled to include a broad range of expertise including; general practitioners, palliative care specialists, and geriatricians. A co-design group was established consisting of health and social care experts and family carers, to synthesise the findings from the qualitative work and produce a toolkit of heuristics to be tested in practice. Four broad areas were identified as requiring complex decisions at the end of life; 1) eating/swallowing difficulties, 2) agitation/restlessness, 3) ending life-sustaining treatment, and 4) providing “routine care” at the end of life. Each topic became a heuristic consisting of rules arranged into flowcharts. Eating/swallowing difficulties have three rules; ensuring eating/swallowing difficulties do not come as a surprise, considering if the situation is an emergency, and considering ‘comfort feeding’ only versus time-trialled artificial feeding. Agitation/restlessness encourages a holistic approach, considering the environment, physical causes, and the carer’s wellbeing. Ending life-sustaining treatment supports practitioners through a process of considering the benefits of treatment versus quality-of-life and comfort. Finally, a heuristic on providing routine care such as bathing, prompts practitioners to consider adapting the delivery of care, in order to promote comfort and dignity at the end of life. The heuristics are easy to use and remember, offering a novel approach to decision making for dementia end-of-life care. They have the potential to be used alongside existing end-of-life care recommendations, adding more readily available practical assistance. This is the first study to synthesise experience and existing evidence into easy-to-use heuristics for dementia end-of-life care.

Highlights

Erratum Upon publication of the original article [1], the authors noticed that the numbers of figures 3–7 had been assigned to each figure and its label incorrectly
The publishers, apologise for any inconvenience caused by these errors and would like to thank Dr Nathan Davies from University College London for bringing this to our attention
* Correspondence: Nathan.davies.10@ucl.ac.uk 1Research Department of Primary Care & Population Health, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK Full list of author information is available at the end of the article

Summary

Introduction

Erratum Upon publication of the original article [1], the authors noticed that the numbers of figures 3–7 had been assigned to each figure and its label incorrectly. Erratum to: A co-design process developing heuristics for practitioners providing end of life care for people with dementia Nathan Davies1*, Rammya Mathew1, Jane Wilcock1, Jill Manthorpe2, Elizabeth L. In the original article: “Figure 7” should have read “Figure 3” (Overview of co-design process)

Results

Conclusion