Elsevier

Maturitas

Volume 83, January 2016, Pages 1-2
Maturitas

Editorial
Palliative care in dementia: Does it work?

https://doi.org/10.1016/j.maturitas.2015.10.006Get rights and content

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)

  • J.T. Van der Steen 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)
There are more references available in the full text version of this article.

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