Demencia avanzada y cuidados paliativos: características sociodemográficas y clínicas
Resumen
Introducción
Cada vez es más reconocida la necesidad de incorporar los cuidados paliativos en el abordaje de los pacientes con demencia avanzada. El objetivo del estudio fue describir las características socio-demográficas y clínicas que definen al paciente con demencia avanzada, tributario de tratamiento paliativo durante el ingreso en la unidad de psicogeriatría, además de evaluar el malestar emocional y la sobrecarga del cuidador.
Material y métodos
Se recogieron datos socio-demográficos y clínicos de pacientes ingresados en la unidad de psicogeriatría, con diagnóstico de demencia avanzada según criterios del Hospice Enrolment Criteria for End-stage Dementia patients. Los instrumentos de evaluación en los cuidadores fueron la escala de sobrecarga del cuidador de Zarit (ZR), y el cuestionario de salud general de Goldberg (GHQ-28).
Resultados
Se evaluaron a 27 pacientes. El tipo de demencia más prevalente es la demencia tipo Alzheimer (51,9%). Según la valoración del estado funcional, la mayoría de pacientes han perdido la capacidad para sentarse (59,3%), la deambulación (37%) y el vocabulario es ininteligible (25,9%). La comorbilidad asociada a la demencia avanzada: malnutrición (81,5%), úlceras (33,3%), pielonefritis (29,6%), fiebre (22,2%), neumonía (18,5%), septicemia (14,8%) y albúmina inferior a 2,5 g/dl (11,1%). La duración de los cuidados de alta dependencia más frecuente fue de 6-20 meses (25,9%) y 2-3 años (33,3%). El cuidador principal es mujer (68,4%) y la relación de parentesco más frecuente es la de hijo/a (74,1%). La puntuación media en el malestar emocional del cuidador adquiere valores significativos (GHQ-28: 8,58, Sd:5,73), y es elevada el grado de sobrecarga (ZR: 45,64, Sd:10,09).
Conclusiones
La identificación e inclusión de los pacientes con demencia avanzada dentro del programa de cuidados paliativos puede facilitar el control de síntomas al final de la vida y ofrecer soporte emocional a la familia dentro del entorno sanitario.
vía: https://www.sciencedirect.com/
Gema Costa Requena.M.Carmen Espinosa Val.Ramón Cristófo. Jose Cañete
a
Servicio de Psiquiatría, Hospital de Mataró, Consorci Sanitari del Maresme, Barcelona, España
b
Servicio de Geriatría, Antic Hospital St. Jaume i Sta. Magdalena, Consorci Sanitari del Maresme, Barcelona, España
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