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Background: The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes. Methods: A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery. The Intensity of Interprofessional Collaboration Scale included two subscales: care sharing activities, and interprofessional coordination. In total, 697 LTC staff were given surveys, including personal support workers, support staff (housekeeping, kitchen, recreation, laundry, dietician aids, office staff), and registered staff (licensed nurses, physiotherapists, social workers, pharmacists, physicians). Results: A total of 317 participants completed the survey (126 personal support workers, 109 support staff, 82 registered staff) for a response rate of 45%. Significant differences emerged among occupational groups across all scales and subscales. Specifically, support staff rated their comfort of working with dying patients significantly lower than both nurses and PSWs. Support staff also reported significantly lower ratings of care sharing activities and interprofessional coordination compared to both registered staff and personal support workers. Conclusions: These study findings suggest there are differing educational needs and sense of interprofessional collaboration among LTC staff, specific to discipline group. Both the personal support workers and support staff groups appeared to have higher needs for education; support staff also reported higher needs related to integration on the interdisciplinary team. Efforts to build capacity within support staff related to working with dying residents and their families are needed. Optimal palliative care may require resources to increase the availability of support for all staff involved in the care of patients. [ABSTRACT FROM AUTHOR]

SUMMARY A male aged 54 developed recurrent carcinoma of urinary bladder. No bone formed in the stroma of the bladder growths at any time, but well-formed bone was present in the stroma of a metastasis in the abdominal wall. The literature of osseous metaplasia in such tumours is reviewed and its pathogenesis discussed. [ABSTRACT FROM AUTHOR]

Chemoradiation and radiation alone are a standard of care for a significant proportion of oropharyngeal squamous cell carcinoma (SCC). Pharyngeal ulceration is a complication which may occur following treatment even when not associated with recurrence. We evaluate the incidence and factors associated with non-malignant pharyngeal ulceration (nm-ulcer) and its treatment and resolution. From an IRB approved registry of head and neck cancer patients treated at a tertiary care center we identified non metastatic oropharyngeal squamous cell carcinoma patients undergoing definitive treatment with radiation or chemoradiation between 2010 and 2020. Patient postoperative physical examination, laryngoscope and PET and CT scans were reviewed to identify patients with a pharyngeal ulceration after completion of treatment. Treatment and outcomes of ulcers not associated with recurrence were reviewed. Cumulative incidence of development of nm-ulcer was analyzed as a competing risk against the risk of local recurrence. Predictors of development of these ulcers were analyzed on univariate and multivariable models. A cohort of 719 definitive oropharyngeal SCC were identified with a median age of 60 years and a median follow up of 40.4 months. Forty patients (5.6%) developed nm-ulcer and 40 developed local recurrence. The 12- and 36-month rates of nm-ulcer was 5.6% at both timepoints and the rate of local recurrence was 4.1% and 5.0% at the two timepoints respectively. No significant differences in use of chemotherapy, radiation dose or use of adaptive replanning were noted between nm-ulcer patients and other patients. Among NM ulcer patients, three had associated bone exposure, none had a prior debridement or biopsy and only a single patient was also found to be hypothyroid. Treatment of ulcers included oral antibiotics in 23 (57.5%), narcotics in 29 (72.5%), long-acting narcotics in 28 (70%), feeding tube for pharyngeal rest 7 (17.5%), and surgery 4 (10%). Nm-ulcer was ultimately successfully resolved in 33 (82.5%) at a median time of 3.7 months. On univariate analysis, T3-4 tumor (HR 3.1, 95% CI = 1.6-5.8 p = 0.0005) and smoking (HR 2.2 95%, CI = 1.05-4.5 p = 0.037) were associated with an increased risk of nm-ulcer. On multivariable analysis only T3-4 tumor remained statistically significant (HR 2.95 95%, CI = 1.57-5.54 p = 0.0008) In a modern series of oropharyngeal SCC patients treated with radiation/chemoradiation the rates of non-malignant pharyngeal ulceration following treatment are low but similar to the incidence of local recurrence. Such ulcers commonly require a protracted period of narcotics and may require feeding tube for pharyngeal rest and rarely surgical correction. Larger tumor and current smoking may increase risk. [ABSTRACT FROM AUTHOR]

Patients with head and neck locoregional only nonmelanoma skin cancer (NMSC) who are not candidates for surgery or immunotherapy, or progress after prior treatment, have limited options. SBRT offers a noninvasive, short, definitive treatment with the potential for durable control. An IRB approved registry of head and neck cancer patients was queried for NMSC treated with 5 fraction SBRT (minimum 35 Gy) from 2014 to present. Acute toxicity (<90 days from SBRT) graded per CTCAE v4.0 was evaluated. Crude rates of locoregional control (LRC) and distant metastasis (DM) were calculated. Head and neck SBRT was used in 13 patients with NMSC. The median follow up was 9.8 months (range 3.8-57.6) and median age was 73.4 years (range 60.7-91.5). Histologies included squamous cell carcinoma (77%), basal cell carcinoma (15%), porocarcinoma (8%). 15% were immunosuppressed, 31% had prior parotidectomy, and 77% had prior overlapping radiation. Median time from prior radiation to SBRT was 12 months (range 4.1-17.4). Treatment site was neck/parotid in 77%, base of skull 23%. Concurrent and adjuvant cetuximab and immunotherapy was given in 23% and 15%, respectively. SBRT dose was 45 Gy (7.5%), 40 Gy (69%), 37.5 Gy (7.5%), 35 Gy (15%). Secondary elective volume of 25-35 Gy was used in 38.5%. Median high dose and elective PTV volumes were 79 cc (range 7-165) and 276 cc (range 158-631), respectively. Bolus was used in 38.5%. LRC was 100% for patients without prior RT (N = 3) and 60% for re-irradiation (N = 6/10), with all failures within the high dose region. DM developed in 38.5% (N = 5), 2 with synchronous locoregional failure. Acute grade 3+ toxicity was seen in 15% of patients (N = 2), which included grade 3 dermatitis (N = 1) and grade 3 meningitis (N = 1; exposed calvarium present at baseline). SBRT in the primary or re-irradiation setting offers a short and effective treatment option for patients with NMSC that are not candidates for, or refuse, standard therapy. Longer follow up is needed to assess the incidence of late effects, however this is a promising treatment approach for select patients. [ABSTRACT FROM AUTHOR]

The optimal treatment of stage 1 single node HPV+ oropharyngeal squamous cell carcinoma (OPC) is unclear. For non-operative treatment, the benefit of concurrent chemotherapy with standard radiation (70 Gy) has not been clearly established, as evidence supporting chemotherapy is based on pre-HPV data and best for AJCC7 N2a. We sought to describe practice patterns and outcomes of stage 1 single node HPV+ OPC and compare outcomes with multi-node N1 disease. An IRB approved database was queried for patients with AJCC 8 cT1-2N1 HPV+ OPC treated definitively from 2012-2022 with at least 2-yrs follow up. Categorial variables were evaluated with Fisher's Exact Test. Locoregional failure (LRF) and distant metastasis (DM) rates were estimated using Cumulative Incidence and predictors were assessed with Gray's test and competing risk regression. Disease free survival (DFS) was performed using Kaplan-Meier, and predictors were assessed with Cox proportional hazards regression. Of 304 cT1-2N1 patients, 73 had single node disease (AJCC 7 N1 50.7% and N2a 49.3%). Median follow up was 4.6 years and age 60 years (42-88). Most were male (75.3%), white (90.4%) and never smokers (54.8%). All received radiation, 46 (60.0%) with concurrent chemotherapy (91.3% cisplatin), and 15 (20.5%) included oncologic surgical management. Concurrent chemotherapy was given in 51.4% and 75.0% of AJCC7 N1 and N2a patients, respectively. Median LN size in longest dimension was 2.97 cm (IQR 2.44 – 3.64). The craniocaudal (CC) dimension was most commonly largest (87.7%) and alone upstaged to AJCC 7 N2a in 34.2%. Smoking, T-stage, and cell differentiation were not associated with use of chemotherapy (p>0.05); AJCC7 N2a was associated with use of chemotherapy (p = 0.023) when excluding excisional biopsy patients. LRF for single node patients was 4.1% at 2- and 5-yr, and the receipt of chemotherapy was associated with decreased LRF (0% vs 12%, p = 0.02). Node volume was associated with LRF, but on multivariate analysis, use of chemotherapy only persisted (p<0.001). When comparing single versus multi node cT1-2N1 patients 5-yr LRF was 4.1% vs 2.7% (p = 0.64), DM 2.7% vs 6.8% (p = 0.18), and DFS 93.2% vs 90% (p = 0.35). In this series, patients with stage 1 HPV+ OPC with single lymph node metastasis have a LRF benefit of concurrent chemotherapy, regardless of AJCC7 N1 vs N2a and smoking status. Outcomes are similar between single and multi-node patients, consistent with new grouped N1 AJCC 8 staging. [ABSTRACT FROM AUTHOR]

The prognosis of patients with early progressive disease following surgical resection for oral cavity carcinoma is not well established. In this study, we evaluate patient, treatment, and outcome characteristics of patients with gross disease found in within 3 months of surgical resection. We queried an IRB-approved registry of head and neck cancer patients at a tertiary care center to identify patients with non-metastatic oral cavity carcinoma undergoing primary surgical resection between 2010 and 2020. Patients with gross disease in the head and neck following surgery, either during radiation planning or within 3 months postoperatively if RT was not employed, were included. Patients were stratified by locoregional only or metastatic disease. Pre- and post-op imaging was reviewed to determine if, after direct comparison with imaging at the time of disease identification, gross disease was present before surgery but not radiologically recognized at the time (persistence) versus those with a rapid progression. One-way ANOVA and Chi-square were used for univariate analysis of normal continuous and categorical variables, respectively, while Kruskal-Wallis was used for non-normal continuous variables. Cox-proportional hazards model was used to analyze time-to-event data and Kaplan Meier for actuarial survival estimates. Of 528 oral cavity carcinoma patients, 43 (8.1%) were identified to have persistent (n = 10) or progressive (n = 27) disease. Imaging was not adequate to classify the status of 6 patients. 42 patients had squamous cell histology, of which two were sarcomatoid, and 1 adenocarcinoma. The progressive group had a slightly higher prevalence of pT3-4 patients than the persistent group (63% vs 40% p = 0.29). 8 patients had synchronous distant metastatic disease, and survival outcomes were poorer for this group (12-month actuarial survival of 79% (95% CI = 66%, 94%) vs 33% (95% CI = 13%, 84%)). Among patients with locoregional only disease, radiation dose was escalated to higher than 66Gy in 24 (83%), one patient received additional surgery (3.4%), one received immunotherapy (3.4%) in addition to other treatments, and concurrent chemotherapy was added for 11 (38%) of cases in which it would not have been otherwise indicated. 12 and 24-month actuarial survival among non-metastatic persistent and progressive disease patients was 75% (61%, 93%) and 52% (36%, 75%). A small number of patients will have gross disease in the first 3 months after surgery for oral cavity cancer, and close attention is needed at time of radiation planning. Patients with locoregional only disease can have reasonable disease control, often requiring escalation of adjuvant treatment. Those with synchronous metastatic disease have a limited life expectancy. [ABSTRACT FROM AUTHOR]

Plasma high-risk Human Papillomavirus (HPV) DNA is a biomarker for oropharyngeal carcinoma. Existing molecular diagnostics utilizing single-target real-time PCR (qPCR), multiplex digital PCR (dPCR), or hybrid-capture next-generation sequencing (NGS) may be limited by inadequate sensitivity, low genomic coverage, specialized instrumentation, or impractical cost/complexity for longitudinal monitoring and minimal residual disease assessment. We hypothesized that sensitive and specific plasma HPV16 DNA detection may be achieved via a highly-multiplex qPCR method. We designed and validated a highly-multiplex single-tube one-step genotype-specific qPCR assay for detection of cell-free HPV16 DNA in human plasma. Recurrently-mutated or conserved regions within and across HPV genotypes were identified using more than 7,000 whole genome sequences spanning 18 genotypes. Amplicons were optimized for cell-free HPV16 DNA fragment size, genotype specificity, and maximal genomic coverage. Synthetic whole-genome HPV16 DNA served as a positive control for analytical validation. A human gene served as an endogenous internal control for extraction and amplification. Pre-treatment plasma specimens from patients with oropharyngeal carcinomas with HPV status confirmed by tissue/cytology served as clinical controls. The multiplex qPCR assay covered 16% of the HPV16 genome with median amplicon size 99 (range = 81-124). Oligonucleotides were conserved in a median of 99.0% (range = 95.2-99.7%) of 4,000 HPV16 genomes in silico. The 95% lower limit of detection was 0.35 HPV16 genome copies/reaction (95% CI 0.22-0.48) and the limit of blank was 0. In a cohort of 33 patients (18 HPV-positive, 15 HPV-negative), there was 100% concordance with tissue/cytology HPV status. The assay detected plasma HPV16 DNA below 0.5 genome copies/reaction in clinical samples. A highly-multiplex qPCR assay was specific for detection of plasma HPV16 DNA among subjects with oropharyngeal carcinoma. Sub-genomic analytical sensitivity was achieved via increased genomic coverage relative to single- or dual-target assays. The one-step single-reaction qPCR format might be more accessible than dPCR or NGS due to low cost/complexity, rapid turnaround time, and widespread availability of qPCR instrumentation and trained personnel. Future studies are warranted to directly compare the performance of existing assays for minimal residual disease detection. [ABSTRACT FROM AUTHOR]

The purpose of the study was to define whether circulating tumor DNA (ctDNA) can be used as a measure to detect minimal residual disease (MRD) following surgical intervention in high-risk positive patients for head and neck squamous cell carcinoma (HNSCC). IRB approval was obtained through our institution. Patients with HNSCC with surgical resection of their tumor were enrolled. Of these, 28 patients had ctDNA levels determined post-operatively (n = 28) using the Signatera test. Data were extracted from electronic medical records by trained abstractors. The patient cohort (20 male and 8 female) had an average age of 67.0 ± 9.82 years at the time of surgery. Patients were assessed using The Eastern Cooperative Oncology Group (ECOG) functional scores, with 17.9% scoring 0, 75.0% scoring ECOG 1, and 7.14% of patients with ECOG 2 or 3. All patients had primary laryngeal or oral cavity cancer, including gingival, tongue, and mandibular. The study had two patients with pathologic Stage I cancer, three with Stage II, five with Stage III, eleven with Stage IVA, and seven with Stage IVB. One patient received neoadjuvant chemotherapy prior to surgery. There were 19 high-risk positive cancers, defined as positive extranodal extension or positive margins during surgery. 15 of these 19 patients patients received adjuvant chemotherapy and radiation, with or without a platinum agent, depending on their chemotherapy eligibility. In these high-risk patients, 18 had data in the post-operative period, prior to adjuvant therapy, for which 61.1% had positive ctDNA. Conversely, there were 9 patients without high-risk features, of whom only two had positive MRD post-operatively, and two with disease recurrence. There was a significantly lower tumor recurrence in the patients without high-risk features compared to those with high-risk features (22.9% vs. 54.5%, respectively) which correlated with ctDNA. At the time of data collection, 7 patients had disease recurrence for which 5 were post-operative ctDNA positive. Two patients were ongoing adjuvant treatment and follow-up without recurrence data. ctDNA was detected frequently in the HNSCC patients with high-risk features post-operatively. Although we have a small number of the patients, the patients with recurrence following adjuvant treatment had high rates of positive ctDNA after the surgery. Therefore post-operative ctDNA for high-risk patients may be prognostic and considered in clinical trials designed for treatment intensification. [ABSTRACT FROM AUTHOR]

Background and Objectives: Older homeless persons can experience relief when accessing housing. However, becoming housed can also elicit the (re)emergence of loss and grief. Building on the notion of disenfranchised grief, this study sought to better understand how grief works together with relief to shape older persons' experiences living in long-term transitional housing., Research Design and Methods: Eleven older persons with experience of homelessness participated in up to three photovoice interviews in Montreal, Canada. Informed by the principles of interpretative phenomenology, their accounts and photos were analyzed to capture the nuances and depth of their lived experiences., Results: Analysis showed that relocation to long-term transitional housing allows for the re-emergence of grief associated with past losses, while also provoking new forms of grief related to housing conditions and anticipated losses. Analysis further revealed that a failure to recognize these losses, alongside a lack of resources to support the grieving process, can result in an accumulation of losses that widens the gap between older homeless persons' experiences and the world around them., Discussion and Implications: If left unattended, grief and loss can threaten older homeless persons' reaffiliation when relocating to transitional housing. Adopting a humanistic-existential grief perspective could go a long way in supporting the development of housing policies, programs and practices that nurture the time and space required to attend to grief and truly address precarity in the final stages of life., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Gerontological Society of America.)

Introduction: Supporting persons living with advanced dementia in long-term care (LTC) homes requires strong collaborative partnerships between staff, family members, and residents. Yet, relational tensions-such as differing expectations around care decisions-can inhibit the implementation of collaborative partnerships at this critical point in the trajectory of care., Objective: This study aims to explore the emotional experiences of families and staff during shared decision-making processes for individuals with advanced dementia in LTC., Method: Guided by interpretative description, this qualitative study investigated the experiences of staff ( n  = 12) and families ( n  = 16) collaborating in two Canadian LTC homes. Data was collected through semistructured interviews lasting 45-60 min, which facilitated a detailed exploration of participants' narratives. The interviews were audio-recorded, transcribed, and analyzed using reflexive thematic analysis facilitated by a combination of inductive and deductive approaches., Results: Our analysis revealed a complex parallel process of trauma and grief including accumulated distress, isolation, and feelings of devalue that worked together to create distance between staff and families at a time when connection was critical. Our findings further suggested that a lack of time and space for reflection and validation for staff and family, resulted in a cycle whereby staff and families engaged in a push and pull dynamic with each viewing the other as adversaries rather than allies., Conclusion: Our findings highlight the critical need for reflexive opportunities in LTC homes to overcome and attend to the emotional barriers that interfere with true collaboration between staff and families. We hope that the proposed cycle serves as a preliminary framework to support staff in navigating difficult conversations and emotions, and fosters reflexive care that enhances, rather than obstructs, connections., Competing Interests: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background and Objectives: Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on 6 groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual, and transgender) community, and individuals living in a rural area., Research Design and Methods: A 5-stage scoping review methodology was followed, and 53 articles (published between 2000 and 2022) from 5 social science databases were analyzed., Results: The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analyzed in 1 specific policy area or within a clinical setting along the lines of facilitating care coordination., Discussion and Implications: This scoping review reveals a mutual neglect on the part of public administration and policy scholars toward marginalized older adults and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Background and Objectives: Comprehensive definitions of social issues and populations can set the stage for the development of responsive policies and practices. Yet despite the rise of late-life homelessness, the phenomenon remains narrowly understood and ill-defined., Research Design and Methods: This article and the definition that ensued are based on the reconceptualization of interview data derived from a critical ethnography conducted in Montreal, Canada, with older homeless persons (N = 40) and service providers (N = 20)., Results: Our analysis suggests that definitions of late-life homelessness must include 4 intersecting components: (1) age, eligibility, and access to services; (2) disadvantage over the life course and across time; (3) social and spatial processes of exclusion that necessitate aging in "undesirable" places; and (4) unmet needs that result from policy inaction and nonresponse., Discussion and Implications: The new definition derived from these structural and relational components captures how the service gaps and complex needs identified in earlier works are shaped by delivery systems and practices whose effect is compounded over time. It provides an empirically grounded and conceptually solid foundation for the development of better responses to address homelessness in late life., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Aim: This systematic review aims to identify methodological and ethical challenges in designing and conducting research at the end of life from the perspective of researchers and provide a set of recommendations., Background: Conducting research with patients and family carers facing end-of-life issues is ethically and methodologically complex., Design: A systematic review was conducted., Data Sources: Four databases (MEDLINE, EMBASE, CINAHL, PsycInfo) were searched from inception until the end of 2021 in February 2022., Review Methods: The Preferred Reporting Items for Systematic Reviews was followed, and the JBI Approach to qualitative synthesis was used for analysis., Results: Seventeen of 1983 studies met inclusion criteria. Data were distilled to six main themes. These included (1) the need for flexibility at all stages of the research process; (2) careful attention to timing; (3) sensitivity in approach; (4) the importance of stakeholder collaboration; (5) the need for unique researcher skills; and (6) the need to deal with the issue of missing data., Conclusion: The findings illuminate several considerations that can inform training programmes, ethical review processes and research designs when embarking on research in this field., (© 2023 John Wiley & Sons Australia, Ltd.)

Background: A Strategic Guiding Council (SGC) was created within a Family Carer Decisions Support study, to engage family carers of persons with advanced dementia as advisors to inform the design and implementation of the study. The SGC consists of an international group of family advisors from Canada, the Republic of Ireland, the United Kingdom, the Netherlands, and the Czech Republic. There are limited studies that have explored the integration of Patient and Public Involvement (PPI) in dementia research, end-of-life care and long-term care. Therefore, this study explores PPI engagement in health research with family carers to understand further their interest in being involved in the SCG within the FCDS intervention which is focused on supporting caregivers to make decisions about end-of-life care for residents with advanced dementia., Methods: This study utilized an interpretive descriptive design and explored the motivations of ten family advisors from Canada, the Republic of Ireland, the United Kingdom, and the Netherlands in being part of the SGC. Semi-structured interviews were conducted by phone or videoconferencing and were recorded, transcribed, and analyzed using thematic analysis., Results: Three themes generated from the findings of the study were (1) engaging in reciprocal learning; (2) using lived experience to support other family carers; and (3) creating a collective momentum for advocacy and change., Conclusions: Family carers motivations to being part of the SCG was driven by their intent to help carers navigate the health system and to create a psychosocial support system for other carers experiencing end-of-life with their loved ones. Being part of the SCG provided a benefit to family carers which provided a venue for them to contribute meaningful information from their experience, learn from other health professionals, research and other advisors and an avenue for advocacy work to improve access to end-of-life care supports through education. To our knowledge, this is the first study that explores the motivations of an international group of family advisors' engagement in health research to promote integration of a palliative approach to dementia care in long-term care homes. This study further contributes to the literature from an international perspective the importance of PPI in research. Further research is warranted that explores PPI in research to improve access to end-of-life supports., (© 2024. The Author(s).)

Introduction: The United Nations Convention on the Rights of Persons with Disabilities asserts that all persons with disabilities have the right to receive the support they require to participate in decisions that affect them. Yet, persons with dementia continue to be excluded from decisions on issues that matter to them. Our planned scoping review seeks to address this gap by documenting the current knowledge on supported decision-making for persons with dementia and informing the next steps for research and practice., Methods and Analysis: We will use Arksey and O'Malley's (2005) six-stage framework to guide our review of the English scientific literature (2005 onwards), searching the following databases: MEDLINE, PsycINFO, CINAHL, AgeLine and the Social Science Abstracts. Our review will focus on primary studies examining supported decision-making for persons with dementia, including the voices of those with dementia. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we will identify (1) domains of supported decision-making discussed in the empirical literature and (2) practices/factors that facilitate or inhibit supported decision-making. Consultations with persons with dementia and their care partners will provide insights into lived experiences, helping identify gaps between research literature and lived realities. The preliminary title and abstract search for eligible articles were conducted between August and October 2023 and updated in June 2024, yielding 56 eligible articles for review., Ethics and Dissemination: This scoping review will be conducted following the standards of the Tri-Council Policy Statement for Ethical Conduct for Research Involving Humans (1998 with 2000, 2002 and 2005 amendments). The procedures for eliciting feedback from persons with dementia and their care partners were approved by the Office of Research Ethics Board at McGill University (Reference # 23-08-048). Dissemination of review findings to persons with dementia and care partners will occur during ongoing community consultations. Visual aids and brief lay summaries will be used to facilitate input and dialogue. Dissemination to the broader practice and research communities will include workshops conducted in collaboration with study partners and presentations and publications in peer-reviewed forums., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Namaste Care offers practical skills for healthcare providers, volunteers, and families to meaningfully engage individuals with dementia in activities (e.g., music, massage, reminiscing, socialization, aromatherapy, snacks). A hospital-based specialized dementia care unit for patients with mid- to late-stage dementia offered an adapted version of the Namaste Care program, which was called Meaningful Moments. The aim of this study was to assess the acceptability and preliminary effects of this novel approach using trained volunteers for older adults with mid- to late-stage dementia., Methods: A mixed methods multiphase design was used. Qualitative description was used to explore acceptability of the Meaningful Moments program delivered over 6 months through focus groups (e.g., charge nurses, therapeutic recreationists, nurses, social workers) and individual interviews with one volunteer and two family members. A prospective pre-post-test study design was used to evaluate the preliminary effects of the program for patients with dementia and family members. Outcomes included quality of life, neuropsychiatric symptoms, and pain for patients with dementia and family carer role stress and the quality of visits for families. Data were collected from June 2018 to April 2019. Descriptive analyses of participants' characteristics were expressed as a mean (standard deviation [SD]) for continuous variables and count (percent) for categorical variables. Focus group and individual interview data were analyzed using thematic analysis. The generalized estimating equations (GEE) method was used to assess change in the repeated measures outcome data., Results: A total of 15 patients received the Meaningful Moments interventions. Families, staff, and volunteers perceived that patients experienced benefits from Meaningful Moments. Staff, volunteers, and families felt fulfilled in their role of engaging patients in the Meaningful Moments program. Individualized activities provided by volunteers were perceived as necessary for the patient population. There were no statistically significant improvements in patient outcomes. There was a statistically significant decline in family carer role stress., Conclusions: Using a one-on-one approach by volunteers, patients experienced perceived benefits such as improved mood and opportunities for social interactions. There is a need for tailored activities for older adults with advanced dementia through practical strategies that can offer benefit to patients., (© 2024. The Author(s).)