Highlights
- •What is the primary questions addressed by this study?This review focuses on the care of those with dementia at the end of life, what barriers exist to receiving high quality care, how to address prognostication in advanced dementia, and how to approach symptomatic management in dementia at the end of life.
- •What is the main finding of this study?Data is available to guide our understanding of how to counsel patents and families about the natural illness course of dementia, the prognosis after a dementia diagnosis or near the end of life, and how to ameliorate symptoms and suffering in patients with dementia at the end of life.
- •What is the meaning of the finding?The adoption of a palliative approach to dementia care, especially at the end of life, has the potential to address historical disparities in the quality of dementia care and to reduce distress in suffering for patients and caregivers.
ABSTRACT
With the geriatric population in the United States growing rapidly, the prevalence
of dementia is expected to rise concomitantly. As dementia is an invariably progressive
and terminal illness, planning for and managing end of life care in dementia is an
important part of the overall process of dementia care. Unfortunately, this is often
neglected outside of formal palliative and hospice medicine training programs and
geriatric psychiatrists are left without preparation on how to manage, as well as
counsel patients and families on, this important phase of dementia care. This review
aims to explore the potential contributors to this historic disparity in geriatric
education and care delivery, as well as its impact, while also attempting to shift
the field's focus toward a palliative approach to dementia care. To begin to accomplish
this, this review explores the natural illness history/disease trajectory of the various
dementing illnesses, as well as the topic of prognostication as it pertains to the
end of life for patients with dementia and how this information can be used in advanced
care planning and symptom management.
Key Words
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Article info
Publication history
Published online: November 11, 2022
Accepted:
November 8,
2022
Received in revised form:
November 3,
2022
Received:
July 19,
2022
Footnotes
Previous Presentation: None.
Article Summary: Geriatric psychiatrists are experts in the care of patients with dementia but often have little training in end of life issues and how to approach them. This clinically focused review focuses on this important phase of dementia, how it uniquely impacts patients, caregivers, healthcare providers, and health systems, and how geriatric psychiatrists and other providers can utilize their expertise in improving the quality of life for patients and caregivers during this stage of dementia.
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- Commentary on “Dementia Care at the End of Life: It's Time to Embrace Palliative Care”The American Journal of Geriatric PsychiatryVol. 31Issue 4
