Pneumonia: the demented patient's best friend? Discomfort after starting or withholding antibiotic treatment.

Objectives: To assess suffering in demented nursing home patients with pneumonia treated with antibiotics or without antibiotics. This study should provide the first empirical data on whether pneumonia is a "friend" or an "enemy" of demented patients and promote a debate on appropriate palliative care.

Design: Prospective cohort study.

Withholding antibiotic treatment in pneumonia patients with dementia: a quantitative observational study.

Background: Pneumonia is a life-threatening disease in nursing home patients with dementia. Physicians and families face choices about whether to withhold antibiotics when patients are expected to die soon or when treatment may be burdensome. However, little information exists on what factors influence this complex decision-making process.

Severe dementia and adverse outcomes of nursing home-acquired pneumonia: evidence for mediation by functional and pathophysiological decline.

Objectives: To assess whether the severity of dementia is related to unfavorable outcomes of nursing home-acquired pneumonia and how this relationship is mediated.

Design: Prospective cohort study.

Setting: Psychogeriatric wards of 61 nursing homes in the Netherlands.