A Prospective Longitudinal Study of Caregivers of Community Dwelling Persons with Severe Dementia (PISCES): Study Protocol
Chetna Malhotra, Padmini Vishwanath, Jing Rong Yong, Truls Østbye, Dennis Seow, Phillip Yap, Lay Ling Tan, Weng Yew Tham, Janhavi Ajit Vaingankar, Jason Foo, Boon Yeow Tan, Kamun Tong, Wai Chong Ng, John Carson Allen, Rahul Malhotra, Weng Mooi Tan, Shiou Liang Wee, Li Ling Ng, Richard Goveas, Vanessa Wai Ling Mok, Alisson Sim, Wei Fern Ng, Hon Khuan Wong, Bharathi Balasundaram, Rui Qi Tan, Pui Sim Ong, Chin Yee Cheong, Alethea Yee Chung Pheng, Christina Tiong, Allyn Hum, Ángel Lee, Eric Finkelstein
Abstract
Although many persons with severe dementia (PWSDs) are cared for at home by their family caregivers, few studies have assessed end of life (EOL) care experiences of PWSDs. We present the protocol for the PISCES study (Panel study Investigating Status of Cognitively impaired Elderly in Singapore) which aims to describe the clinical course, health care utilization, and expenditures for community-dwelling PWSDs; and perceived burden, coping, resilience, anticipatory and prolonged grief among their caregivers. This ongoing multi-center prospective longitudinal study is recruiting primary informal caregivers of 250 PWSDs from major restructured public hospitals, community hospitals, home care foundations, and hospices in Singapore. Caregivers are surveyed every four months for two years or until the PWSD passes away and then at eight weeks and six months post-death to assess the bereavement of the caregiver. Survey questionnaires included validated tools to assess PWSDs' quality of life, suffering, behaviors, functional status, resource utilization; and caregiver's satisfaction with care, awareness of prognosis, care preferences, resilience, coping, perceived burden, distress, positive aspects of caregiving, anticipatory grief, and bereavement adjustment. We also conduct qualitative in-depth interviews with a sub-sample of caregivers. The survey data is being linked with medical and billing records of PWSDs. The study has been approved by an ethics board. Results from the study will be disseminated through publications and presentations targeting researchers, policy makers and clinicians interested in understanding and improving EOL care for PWSDs and their caregivers.