AIM: This paper considers the challenges of delivering effective palliative care to older people with dementia and the possible strategies to overcome barriers to end-of-life care in these patients. BACKGROUND: In UK alone, approximately 100,000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliative care should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliative care services. METHOD: A review of English language literature published after 1996 to the present day relating to older people with dementia during the terminal phase of their illness. RESULTS: Twenty-nine articles met inclusion criteria for the review. Most originated from North America and UK and were mostly quantitative in nature. Four key themes were identified: difficulties associated with diagnosing the terminal phase of the illness (prognostication); issues relating to communication; medical interventions; and the appropriateness of palliative care intervention. CONCLUSIONS: This review reinforces the importance of providing appropriate palliative care to individuals suffering from end-stage dementia and identifies some of the barriers to extending such specialist palliative care provision. RELEVANCE TO PRACTICE: There is an urgent need to improve palliative care provision for older people with end-stage dementia and, in addition, more research is required on the needs of patients entering the terminal phase of dementia to assist the allocation of appropriate resources and training to ensure quality and equality in the provision of end-of-life care.
AIM: This paper considers the challenges of delivering effective palliative care to older people with dementia and the possible strategies to overcome barriers to end-of-life care in these patients. BACKGROUND: In UK alone, approximately 100,000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliative care should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliative care services. METHOD: A review of English language literature published after 1996 to the present day relating to older people with dementia during the terminal phase of their illness. RESULTS: Twenty-nine articles met inclusion criteria for the review. Most originated from North America and UK and were mostly quantitative in nature. Four key themes were identified: difficulties associated with diagnosing the terminal phase of the illness (prognostication); issues relating to communication; medical interventions; and the appropriateness of palliative care intervention. CONCLUSIONS: This review reinforces the importance of providing appropriate palliative care to individuals suffering from end-stage dementia and identifies some of the barriers to extending such specialist palliative care provision. RELEVANCE TO PRACTICE: There is an urgent need to improve palliative care provision for older people with end-stage dementia and, in addition, more research is required on the needs of patients entering the terminal phase of dementia to assist the allocation of appropriate resources and training to ensure quality and equality in the provision of end-of-life care.
Authors: Seth F Einterz; Robin Gilliam; Feng Chang Lin; J Marvin McBride; Laura C Hanson Journal: J Am Med Dir Assoc Date: 2014-02-06 Impact factor: 4.669
Authors: Alexia M Torke; Laura R Holtz; Siu Hui; Peter Castelluccio; Stephen Connor; Matthew A Eaton; Greg A Sachs Journal: J Am Geriatr Soc Date: 2010-11 Impact factor: 5.562
Authors: Laura C Hanson; Timothy S Carey; Anthony J Caprio; Tae Joon Lee; Mary Ersek; Joanne Garrett; Anne Jackman; Robin Gilliam; Kathryn Wessell; Susan L Mitchell Journal: J Am Geriatr Soc Date: 2011-09-15 Impact factor: 5.562
Authors: Luis Carlos Escobar Pinzon; Matthias Claus; Klaus Maria Perrar; Kirsten Isabel Zepf; Stephan Letzel; Martin Weber Journal: Dtsch Arztebl Int Date: 2013-03-22 Impact factor: 5.594
Authors: Mirjam C van Soest-Poortvliet; Jenny T van der Steen; Henrica C W de Vet; Cees M P M Hertogh; Bregje D Onwuteaka-Philipsen; Luc H J Deliens Journal: J Palliat Med Date: 2014-12 Impact factor: 2.947