char = D;code = 68 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = n;code = 110 char = u;code = 117 char = r;code = 114 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = h;code = 104 char = o;code = 111 char = m;code = 109 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = o;code = 111 char = m;code = 109 char = ;code = 32 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = f;code = 102 char = i;code = 105 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = n;code = 110 char = u;code = 117 char = t;code = 116 char = r;code = 114 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = d;code = 100 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = g;code = 103 char = o;code = 111 char = n;code = 110 char = e;code = 101 char = .;code = 46 result sql = Discomfort in nursing home patients with severe dementia in whom artificial nutrition and hydration is forgone.
Discomfort in nursing home patients with severe dementia in whom artificial nutrition and hydration is forgone.char = <;code = 60 char = b;code = 98 char = >;code = 62 char = B;code = 66 char = A;code = 65 char = C;code = 67 char = K;code = 75 char = G;code = 71 char = R;code = 82 char = O;code = 79 char = U;code = 85 char = N;code = 78 char = D;code = 68 char = ;code = 32 char = :;code = 58 char = ;code = 32 char = <;code = 60 char = /;code = 47 char = b;code = 98 char = >;code = 62 char = W;code = 87 char = h;code = 104 char = i;code = 105 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = b;code = 98 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = b;code = 98 char = o;code = 111 char = u;code = 117 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = e;code = 101 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = i;code = 105 char = t;code = 116 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = y;code = 121 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = t;code = 116 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = g;code = 103 char = o;code = 111 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = f;code = 102 char = i;code = 105 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = n;code = 110 char = u;code = 117 char = t;code = 116 char = r;code = 114 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = d;code = 100 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = (;code = 40 char = A;code = 65 char = N;code = 78 char = H;code = 72 char = );code = 41 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = n;code = 110 char = u;code = 117 char = r;code = 114 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = h;code = 104 char = o;code = 111 char = m;code = 109 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = ,;code = 44 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = e;code = 101 char = q;code = 113 char = u;code = 117 char = e;code = 101 char = n;code = 110 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = g;code = 103 char = o;code = 111 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = A;code = 65 char = N;code = 78 char = H;code = 72 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = u;code = 117 char = l;code = 108 char = a;code = 97 char = r;code = 114 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = i;code = 105 char = r;code = 114 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ,;code = 44 char = ;code = 32 char = h;code = 104 char = a;code = 97 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = n;code = 110 char = o;code = 111 char = t;code = 116 char = ;code = 32 char = y;code = 121 char = e;code = 101 char = t;code = 116 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = e;code = 101 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = v;code = 118 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = g;code = 103 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = >;code = 62 char = M;code = 77 char = E;code = 69 char = T;code = 84 char = H;code = 72 char = O;code = 79 char = D;code = 68 char = S;code = 83 char = ;code = 32 char = :;code = 58 char = ;code = 32 char = <;code = 60 char = /;code = 47 char = b;code = 98 char = >;code = 62 char = I;code = 73 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = s;code = 115 char = p;code = 112 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = l;code = 108 char = o;code = 111 char = n;code = 110 char = g;code = 103 char = i;code = 105 char = t;code = 116 char = u;code = 117 char = d;code = 100 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ,;code = 44 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = u;code = 117 char = d;code = 100 char = y;code = 121 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = 1;code = 49 char = 7;code = 55 char = 8;code = 56 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = D;code = 68 char = u;code = 117 char = t;code = 116 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = n;code = 110 char = u;code = 117 char = r;code = 114 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = h;code = 104 char = o;code = 111 char = m;code = 109 char = e;code = 101 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = m;code = 109 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = l;code = 108 char = l;code = 108 char = ;code = 32 char = m;code = 109 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = c;code = 99 char = c;code = 99 char = o;code = 111 char = r;code = 114 char = d;code = 100 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = D;code = 68 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = S;code = 83 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = e;code = 101 char = -;code = 45 char = D;code = 68 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = A;code = 65 char = l;code = 108 char = z;code = 122 char = h;code = 104 char = e;code = 101 char = i;code = 105 char = m;code = 109 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = T;code = 84 char = y;code = 121 char = p;code = 112 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = F;code = 70 char = u;code = 117 char = r;code = 114 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = m;code = 109 char = o;code = 111 char = r;code = 114 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = l;code = 108 char = l;code = 108 char = ;code = 32 char = m;code = 109 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = e;code = 101 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = u;code = 117 char = s;code = 115 char = i;code = 105 char = b;code = 98 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = m;code = 109 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = g;code = 103 char = i;code = 105 char = s;code = 115 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = d;code = 100 char = .;code = 46 char = ;code = 32 char = D;code = 68 char = a;code = 97 char = t;code = 116 char = a;code = 97 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = y;code = 121 char = z;code = 122 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = t;code = 116 char = e;code = 101 char = c;code = 99 char = h;code = 104 char = n;code = 110 char = i;code = 105 char = q;code = 113 char = u;code = 117 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = g;code = 103 char = e;code = 101 char = n;code = 110 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = i;code = 105 char = z;code = 122 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = e;code = 101 char = q;code = 113 char = u;code = 117 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = >;code = 62 char = R;code = 82 char = E;code = 69 char = S;code = 83 char = U;code = 85 char = L;code = 76 char = T;code = 84 char = S;code = 83 char = ;code = 32 char = :;code = 58 char = ;code = 32 char = <;code = 60 char = /;code = 47 char = b;code = 98 char = >;code = 62 char = D;code = 68 char = e;code = 101 char = c;code = 99 char = i;code = 105 char = s;code = 115 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = g;code = 103 char = o;code = 111 char = ;code = 32 char = A;code = 65 char = N;code = 78 char = H;code = 72 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = d;code = 100 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = o;code = 111 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ,;code = 44 char = ;code = 32 char = f;code = 102 char = e;code = 101 char = m;code = 109 char = a;code = 97 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = c;code = 99 char = u;code = 117 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = l;code = 108 char = l;code = 108 char = n;code = 110 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = o;code = 111 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = i;code = 105 char = m;code = 109 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = a;code = 97 char = g;code = 103 char = n;code = 110 char = o;code = 111 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = e;code = 101 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = i;code = 105 char = m;code = 109 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = c;code = 99 char = i;code = 105 char = s;code = 115 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = c;code = 99 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = a;code = 97 char = y;code = 121 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = u;code = 117 char = b;code = 98 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = f;code = 102 char = f;code = 102 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = n;code = 110 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = t;code = 116 char = w;code = 119 char = e;code = 101 char = e;code = 101 char = n;code = 110 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = .;code = 46 char = ;code = 32 char = D;code = 68 char = y;code = 121 char = s;code = 115 char = p;code = 112 char = n;code = 110 char = e;code = 101 char = a;code = 97 char = ,;code = 44 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = t;code = 116 char = l;code = 108 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = n;code = 110 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = p;code = 112 char = h;code = 104 char = y;code = 121 char = s;code = 115 char = i;code = 105 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = ';code = 39 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = h;code = 104 char = y;code = 121 char = d;code = 100 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = s;code = 115 char = s;code = 115 char = o;code = 111 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = .;code = 46 char = ;code = 32 char = F;code = 70 char = u;code = 117 char = r;code = 114 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = m;code = 109 char = o;code = 111 char = r;code = 114 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = o;code = 111 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = w;code = 119 char = a;code = 97 char = k;code = 107 char = e;code = 101 char = ;code = 32 char = h;code = 104 char = a;code = 97 char = d;code = 100 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = o;code = 111 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = s;code = 115 char = l;code = 108 char = e;code = 101 char = e;code = 101 char = p;code = 112 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 char = <;code = 60 char = b;code = 98 char = >;code = 62 char = C;code = 67 char = O;code = 79 char = N;code = 78 char = C;code = 67 char = L;code = 76 char = U;code = 85 char = S;code = 83 char = I;code = 73 char = O;code = 79 char = N;code = 78 char = S;code = 83 char = ;code = 32 char = :;code = 58 char = ;code = 32 char = <;code = 60 char = /;code = 47 char = b;code = 98 char = >;code = 62 char = F;code = 70 char = o;code = 111 char = r;code = 114 char = g;code = 103 char = o;code = 111 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = A;code = 65 char = N;code = 78 char = H;code = 72 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = o;code = 111 char = ;code = 32 char = s;code = 115 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = c;code = 99 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = n;code = 110 char = o;code = 111 char = ;code = 32 char = l;code = 108 char = o;code = 111 char = n;code = 110 char = g;code = 103 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = d;code = 100 char = r;code = 114 char = i;code = 105 char = n;code = 110 char = k;code = 107 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = e;code = 101 char = m;code = 109 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = g;code = 103 char = e;code = 101 char = n;code = 110 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ,;code = 44 char = ;code = 32 char = n;code = 110 char = o;code = 111 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = s;code = 115 char = s;code = 115 char = o;code = 111 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = d;code = 100 char = i;code = 105 char = v;code = 118 char = i;code = 105 char = d;code = 100 char = u;code = 117 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = f;code = 102 char = f;code = 102 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = n;code = 110 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = e;code = 101 char = m;code = 109 char = p;code = 112 char = h;code = 104 char = a;code = 97 char = s;code = 115 char = i;code = 105 char = z;code = 122 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = n;code = 110 char = e;code = 101 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = t;code = 116 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = s;code = 115 char = i;code = 105 char = b;code = 98 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = .;code = 46 result sql = BACKGROUND : While there is debate about whether it may be better to forgo than to initiate artificial nutrition and hydration (ANH) in nursing home patients with severe dementia, the consequences of forgoing ANH in these patients, in particular their discomfort, have not yet been investigated.METHODS : In this prospective, longitudinal, observational study of 178 patients in Dutch nursing homes, discomfort was measured at all measurement times according to the observational Discomfort Scale-Dementia of Alzheimer Type. Furthermore, at all measurement times, plausible determinants of discomfort were registered. Data were analyzed with the statistical technique of generalized estimated equations.RESULTS : Decisions to forgo ANH were made most often in severely demented, female patients with an acute illness as the most important diagnosis at that time. The mean level of discomfort was highest at the time of the decision and decreased in the days thereafter. There were substantial differences in level of discomfort between patients. Dyspnea, restlessness, and physicians' observations of pain and dehydration were associated with higher levels of discomfort. Furthermore, patients who were awake had higher levels of observed discomfort than patients who were asleep.CONCLUSIONS : Forgoing ANH in patients with severe dementia who scarcely or no longer eat or drink seems, in general, not to be associated with high levels of discomfort. The individual differences emphasize the need for constant attention for possible discomfort.
Publication: Arch. Intern. Med. 2005 Aug 8-22 ;165(15)::1729-35.
Publication Date: 2005 Aug 8-22
Study Author(s): Pasman, H Roeline W;Onwuteaka-Philipsen, Bregje D;Kriegsman, Didi M W;Ooms, Marcel E;Ribbe, Miel W;van der Wal, Gerrit;
Institution: Department of Public Health, VU University Medical Center, and Nursing Home Slotervaart, Amsterdam, the Netherlands.
[email protected]
Shortcut link to this study:
BACKGROUND : While there is debate about whether it may be better to forgo than to initiate artificial nutrition and hydration (ANH) in nursing home patients with severe dementia, the consequences of forgoing ANH in these patients, in particular their discomfort, have not yet been investigated.METHODS : In this prospective, longitudinal, observational study of 178 patients in Dutch nursing homes, discomfort was measured at all measurement times according to the observational Discomfort Scale-Dementia of Alzheimer Type. Furthermore, at all measurement times, plausible determinants of discomfort were registered. Data were analyzed with the statistical technique of generalized estimated equations.RESULTS : Decisions to forgo ANH were made most often in severely demented, female patients with an acute illness as the most important diagnosis at that time. The mean level of discomfort was highest at the time of the decision and decreased in the days thereafter. There were substantial differences in level of discomfort between patients. Dyspnea, restlessness, and physicians' observations of pain and dehydration were associated with higher levels of discomfort. Furthermore, patients who were awake had higher levels of observed discomfort than patients who were asleep.CONCLUSIONS : Forgoing ANH in patients with severe dementia who scarcely or no longer eat or drink seems, in general, not to be associated with high levels of discomfort. The individual differences emphasize the need for constant attention for possible discomfort.
PMID: 16087820