End-of-life care and advance care planning in dementia

Abstract

This chapter will describe the principles of end-of-life care in relation to the care and management of people with dementia and highlight why end-of-life care is such an important aspect of care in many nursing homes. It will explain why accurate end-of-life prognostication is difficult in so many cases and look at residents', family members' and healthcare professionals' perspectives on the delivery of endof- life care to those with dementia in nursing homes. The chapter will also address some of the challenges commonly affecting people with dementia at the end of life, the importance of timely assessment and symptom management and some of the tools which can be used to assist carers in the assessment, planning, delivery and evaluation of the care provided in such circumstances. The contribution of specialist palliative and end-of-life care input from the local hospital, hospice or family physician will also be discussed. Finally, the importance of identifying resident's concerns, anxieties and wishes as early as possible will be considered so that care at the end of life can be delivered as far as possible in line with their wishes, and their physical, psychological, emotional, social and spiritual needs are addressed in a timely and appropriate manner as life draws to an end.