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patients. Skin and heart valves are waiting to be transplanted. In the

Netherlands donation following euthanasia is legalized and has been

performed only14 times. With the increased interest in euthanasia,

the growing organ shortage and the established expert guide in 2015,

we expect more requests for organ donation following euthanasia.


Knowledge of local Electronic Palliative Care Co-ordination

Systems (EPaCCS) within a Multidisciplinary Team at a District

General Hospital

K. Khan-Mahmood


, N. Jaafar


, D. Coates




Colchester General Hospital,

Colchester, United Kingdom


The increasing prevalence of frailty extrapolates to

higher numbers of patients rapidly approaching the end of their life.

Discussions of wishes at the end of life are not always translated

from community to hospital on admission. This can lead to failure of

wishes being respected. There are a number of electronic databases

being created such as EPaCCS, or My Care Choices (MCC). Is there an

awareness of these tools amongst the multi-disciplinary team (MDT)?


We randomly assessed healthcare professionals via ques-

tionnaires. We questioned nurses, foundation year doctors, GP

trainees, core medical trainees, specialist registrars, and consultants.

We surveyed six wards (all 4 elderly care wards, A&E and EAU).


There were 77 respondents (Elderly:Acute = 44:33). In the

wards questioned, staff aware of its existence were 79% (35/44) elderly

vs 24% (8/33) on acute. Of the healthcare workers surveyed, core

medical trainees displayed the lowest awareness (38%) and GP trainees

(83%) the highest. In the emergency department there was no

recognition or knowledge of the MCC register, slight improvement in

EAU, overall the knowledge on elderly care wards was much better.


A&E is the first point of contact in the hospital journey;

our results show this is where knowledge of the MCC is very

poor, impacting on appropriate rates of admission. Knowledge of

this communication tool at the front door will help tailor initial

management thus improving overall outcome and wishes.


The nature of the caregiving experience: a qualitative study

C. Laranjeira.


Piaget Institute, Viseu, Portugal


As ever-increasing numbers of family members take on

the responsibility of providing care at the end of life, there is a

increasing need to assess caregiver learning needs and processes. This

study explicates what family members learn during the process of

providing end-of-life care.


This qualitative study employed semistructured interviews,

and we analyzed data using grounded theory and qualitative methods.

We recruited 14 Portuguese family caregivers from a medical care unit

at an academic medical center.


The mean age of participants was 59 years (SD = 17) and the

majority were women. Thematic and cross-comparative analyses

found three general kinds of learning that were described


about: (a) the illness, (b) how to assist the patient, and (c) how to

access health services. In some cases, participants

reports about

attitudinal learning appeared to reflect an ongoing effort to convince

or remind themselves of something they were struggling to achieve

or accept in order to cope with their situation.


The caregivers exposed themselves to emotional diffi-

culties and an increased need for support and information. Findings

can inform the development of individualized educational programs

and interventions for family caregivers.


Elderly persons in hospice. From palliative care to euthanasia:

ethical considerations

J.C. Leners.

Palliative Care and Hospice, Luxembourg


To find out the details of all elderly persons admitted since

its beginning.


Since 6 years, Luxembourg created a unique fifteen beds

hospice and we produced a statistical analysis of all seniors



Nearly 72% of the population is above 75 years. The admission

rate per year varies between 120 and 140 and the most important

diseases for the elderly people are: 64% have an end-stage tumor; 16%

terminal respiratory problems; 13% terminal heart failure and 7% pure

neurological diseases. Of all senior patients, some 21% have written

living wills, expressing clearly that in case of unbearable pain or

discomfort, they wish a terminal sedation. The data suggest that only

18% of this population made an oral request for this type of sedation.

The mean duration of a sedation is 2,5 days. For the other patients

expressing the wish for euthanasia (as legally allowed), we have

registered some 42 in advance written requests. Most of all these

elderly persons will not ask for euthanasia, but the natural process

of the disease will lead prior to death. Should there be a repeated

oral request for euthanasia, the process will be as follows: ethical

considerations from the whole team in a meeting, where the accuracy

of the demand is debated. Should there be other options considered,


temporarily or terminal sedation; inactivation of an implantable

defibrillator, the stopping of nocturnal respiratory assistance, etc the

physician will discuss these possible alternatives with the patient.


More than half of all requests for euthanasia turn to a

terminal sedation and very few seniors stick to their initial demand.

(less than 5%)



antibiotics for pneumonia and artificial hydration for

insufficient fluid intake in advanced dementia

A. Loizeau


, S. Eicher


, N. Theill


, M. Martin


, F. Riese




University of

Zurich, Center for Gerontology,


University of Zurich, University Research

Priority Program

Dynamics of Healthy Aging



Psychiatric University

Hospital Zurich, Division of Psychiatry Research and Psychogeriatric

Medicine, Zurich, Switzerland


About two-thirds of people with dementia die from

pneumonia and one-third die from dehydration. The DemFACTS study

aims to develop and test decision aids called fact boxes, in order to

support decision-makers, who have to make treatment decisions at

the end-of-life of people with dementia and either pneumonia or

insufficient fluid intake.


The study employs a randomized, controlled, pre-/post-

intervention design. Relatives of people with dementia (n = 100),

professional proxies (n = 100) and physicians (n = 100) will evaluate

the newly developed fact boxes. At pretest, participants will be asked

to make two fictional decisions concerning burdensome medical

interventions in advanced dementia based on case vignettes. Four

weeks later, at posttest, the intervention group will be presented with

two fact boxes in addition to the two case vignettes, whereas the

control group will only be provided with the case vignettes.

Expected results:

The fact boxes

effect on decisional conflicts

(primary outcome), additional decision outcomes, knowledge trans-

fer, and the appropriateness of the fact boxes (secondary outcomes)

will be assessed.


The fact boxes could reduce the decision-makers


sional conflicts and enable them to better understand the treatment

decisions. Improving knowledge transfer in palliative care decision-

making could have a major impact on how decision-making aids in

this field will be shaped in the future.


Follow-up of pressure ulcers according to the feed

E. García Tercero, T. Martínez Maroto, M. Araújo Ordóñez, M.C.

Bejarano Gómez, M. Bravo García, E. Villamora Fernández.


Virgen del Valle


The presence of patients with pressure ulcers (PU) in

old people

s home is not a rare event, requiring a higher consumption

of human, technical and nutritional resources, since it is known the

Poster presentations / European Geriatric Medicine 7S1 (2016) S29