Palliative care for older people with dementia — we need a paradigm shift in our approach

Suzanne Timmons, Siobhan Fox, Johnathan Drennan, Suzanne Guerin, W.George Kernohan

Research output: Contribution to journalEditorialpeer-review

3 Downloads (Pure)

Abstract

Older people with dementia have multiple palliative care needs, with pain, agitation, dyspnoea, aspiration and pressure ulcers being common and persistent in advanced dementia. Anticipating the person’s possible symptoms requires knowledge of the whole person, including the type of dementia, which is problematic when the dementia type is often not documented.

A palliative care approach to dementia should look at symptoms across the four pillars of palliative care, but in reality, we tend to over-focus on physical and psychological symptoms, while spiritual and emotional needs can be overlooked, especially around the time of diagnosis, where such needs may be significant.

Advance care planning (ACP) is a central tenet of good dementia palliative care, as the person may lose their ability to communicate and make complex decisions over time. Despite this, care planning is often approached too late, and with the person’s family rather than with the person; much of the literature on ACP in dementia is based on proxy decision-making for people in residential care.

Thus, we need a paradigm shift in how we approach dementia, beginning with timely diagnosis that includes the dementia type, and with services able to assess and meet emotional and spiritual needs especially around the time of diagnosis, and with timely ACP as an integral part of our overall approach.
Original languageEnglish
Article numberafac066
Pages (from-to)1-4
Number of pages4
JournalAge and Ageing
Volume51
Issue number3
DOIs
Publication statusPublished - 25 Mar 2022

Bibliographical note

Declaration of Sources of Funding: Based upon findings
of research supported by Health Research Board funding
(#ILP-HSR-2017-020).

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Funding Information:
Based upon findings of research supported by Health Research Board funding (#ILP-HSR-2017-020)

Publisher Copyright:
© 2022 The Author(s).

Keywords

  • dementia
  • palliative care
  • advance care planning
  • Prognostic factors
  • Grief
  • older people
  • prognostication
  • grief

Fingerprint

Dive into the research topics of 'Palliative care for older people with dementia — we need a paradigm shift in our approach'. Together they form a unique fingerprint.

Cite this