Delivering Palliative Care in Ageing Populations: Comprehensive Interventions and Clinical Models: What are the Components of an Effective Model of Palliative Care for Dementia?

Aims: Palliative care has been identified as a priority in dementia care, and research into “effective models” of palliative care for people with dementia has been recommended by several European agencies. The Model for Dementia Palliative Care Project is currently underway in Ireland, aiming to develop an acceptable, evidence- and practice based model for palliative care for people with dementia in the community.
Methods: Project Phases I-II are complete. Phase I involved a scoping review of the evidence for various components of a dementia palliative care model. In Phase II, a web-based survey was designed to i) explore key stakeholders’ preferences for a model, and ii) identify existing services in the Republic of Ireland, Northern Ireland, England, Wales, and Scotland. Preliminary results of Phase III, evaluations of existing services, are available.
Results: There is limited published research supporting components of dementia palliative care models in the community. However, the scoping review suggests that the core areas of an effective community model include: advance care planning, education on the disease process, 24-hour nurse phone support, improved care co-ordination and family support.
Survey respondents rated the three most essential aspects of a model as: “Care for People at all Stages of Illness” (77% considered ‘essential’), “Information Continuity” (75% ‘essential’) and “Defined Pathways for Specialist Service Input” (58% ‘essential’). In addition, good communication between palliative care and dementia care teams was perceived to be core to a successful model, with a key worker needed to facilitate this
communication, and to support families e.g. around care transitions.
Conclusion: Consistent aspects of an effective model were identified. This work builds on existing theory and research to ensure that future models of care in Ireland will be effective, evidence-based, feasible to adopt and acceptable to healthcare workers and potential users.