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End of life care for community dwelling older people with dementia : an integrated review.

Research output: Contribution to journalJournal article

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  • Claire Goodman
  • Catherine Evans
  • Jane Wilcock
  • Katherine Froggatt
  • Vari Drennan
  • Elizabeth Sampson
  • Martin Blanchard
  • Maggie Bissett
  • Steve Iliffe
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<mark>Journal publication date</mark>04/2010
<mark>Journal</mark>International Journal of Geriatric Psychiatry
Issue number4
Volume25
Number of pages9
Pages (from-to)329-337
StatePublished
Original languageEnglish

Abstract

Objective To review the evidence for end-of-life care for community dwelling older people with dementia (including those resident in care homes). Design An integrated review synthesised the qualitative and quantitative evidence on end-of-life care for community dwelling older people with dementia. English language studies that focused on prognostic indicators for end-of-life care, assessment, support/relief, respite and educational interventions for community dwelling older people with dementia were included. A user representative group informed decisions on the breadth of literature used. Each study selected was screened independently by two reviewers using a standardised check list. Results Sixty eight papers were included. Only 17% (12) exclusively concerned living and dying with dementia at home. Six studies included direct evidence from people with dementia. The studies grouped into four broad categories: Dementia care towards the end of life, palliative symptom management for people with dementia, predicting the approach of death for people with dementia and decision-making. The majority of studies were descriptive. The few studies that developed dementia specific tools to guide end of life care and outcome measures specific to improve comfort and communication, demonstrated what could be achieved, and how much more needs to be done. Conclusions Research on end-of-life care for people with dementia has yet to develop interventions that address the particular challenges that dying with dementia poses. There is a need for investigation of interventions and outcome measures for providing end-of-life care in the settings where the majority of this population live and die.