EditorialPalliative care in dementia: Does it work?
Section snippets
Conceptual
In relation to dementia, palliative care could cover a huge range from the whole course of dementia from diagnosis onwards to a much narrower focus on end-of-life care. And maybe there are points in between, e.g. as a person passes from ‘living well with dementia’ to the next stage, which might be regarded as that of inexorable decline.
Van der Steen et al. [1] have attempted to create clearer boundaries for what we mean by ‘palliative care’ in dementia. They used a Delphi process to generate a
Empirical
Universal acceptance of palliative care in dementia would be easier if there was good research evidence that it delivers better outcomes than other forms of care. This is more difficult to test than it appears at first sight, for at least two good reasons.
The first of these is that, if we take the view that all dementia care is palliative care, any trial of palliative care might need to be across the whole pathway of dementia. This is unfeasible given the length of time that such a trial would
Conclusion
Applying the term palliative care in dementia has some attractions and this accounts for the expansion of recent interest. However, it is a slippery concept to use as there is no agreement as to when it is best applied to dementia and there is no evidence that any thus-labelled intervention has improved outcomes. Furthermore, this may not even be an empirical question, in which case it is either a moral question (‘how do we wish to end our lives?’) or one of popular taste. So far, the discourse
Contributors
Tom Dening and Karen Harrison Dening jointly conceived of the paper, and shared its writing and editing.
Conflict of interest
The authors declare that they have no conflict of interest.
Funding
No funding has been received for this article.
Provenance and peer review
Commissioned; not externally peer reviewed.
References (3)
- et al.
White paper defining optimal palliative care in older people with dementia: a Delphi study amd recommendations from the European Association of Palliative Care
Palliat. Med.
(2014)
Cited by (3)
A retrospective study examining the properties and characteristics of dementia patients in a palliative care center
2018, Turkish Journal of Medical SciencesDying with dementia—how can we improve the care and support of patients and their families
2017, Annals of Palliative Medicine