International Reflections on Caring for People with Advanced Dementia: Dementia care in two countries

Dementia is causing global concern with its massive impacts upon affected individuals, families, society and national economies. As the disease progresses, patients’ needs increase in number, depth, and breadth, covering physical, psychological, social, and spiritual domains. Care varies from place to place, from country to country and from East to West. To learn from some of these variations, we explored advanced dementia care in UK and Japan. Informed by an
overview of literature on care of people with advanced dementia, we reflected upon direct nonparticipant observations of care in urban areas of Northern Ireland and Japan. Whilst we identified a common purpose: to address the complex needs of people living with dementia, there were differences in the approach to care. Broadly, dementia care in UK tends towards person centred
care with a strong interest in Advance Care Planning as part of a palliative care
approach. In Japan, we found less evidence of early stage palliative care and more of family based decision making to inform care of older people. In both countries, dementia care varies regionally, being more available in some areas than others. International knowledge exchange and further comparative studies will help to improve care for people with advanced dementia, everywhere.