A palliative approach to care of residents with dementia

Abstract

Dementia is a progressive, life-limiting illness. People with the condition who move into a care home deserve palliative care. This article discusses an interprofessional pilot workshop for direct care providers held in a care home in British Columbia, Canada. The workshop aimed to incorporate a palliative approach into dementia care for residents. Workshop development, teaching strategies, evaluation and outcomes are shared. The four-hour workshop was structured to promote critical reflection and challenge participants to consider that people with dementia and their families need palliative care much earlier than during the last days of life. Commitment to change statements gathered as part of the workshop indicated that participation increased knowledge, skill and confidence to incorporate a palliative approach into care for people with advanced dementia and their families.

What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

“…All six of the studies exploring sense of confidence as an outcome measure targeted staff understanding of dementia and BPSD as part of the intervention. Two papers found a significant increase in confidence following the intervention, one found no significant difference in confidence levels, one saw a decrease in confidence, and two did not statistically analyze their data …”

“…Both of the studies that did not statistically analyze their data found that staff reported their confidence to be higher following training . One study that focused on BPSD using a person‐centred approach also found improvements in communication and knowledge and understanding of dementia .…”

“…While some studies did not statistically analyze their data, they also reported that an improvement in levels of confidence led to a better understanding of dementia and palliative care, as well as feedback from staff suggesting that they were committed to changing their care practices, which could improve the care environment and the effective management of BPSD.…”

End‐of‐Life Decisions in Individuals Dying with Dementia in Belgium

“…Therefore, one must take into account the possibility of undertreatment of pain and other symptoms in dementia . Even recognizing that an individual with dementia is in the dying phase has been shown to be difficult, leading to overly aggressive treatment instead of focusing on comfort . Specialized palliative care services have traditionally been devoted to individuals with cancer, and expanding these services to dementia and other diseases is now widely advocated because it is believed that these individuals also will benefit tremendously from it in terms of symptom management .…”

“…[32][33][34] Even recognizing that an individual with dementia is in the dying phase has been shown to be difficult, leading to overly aggressive treatment instead of focusing on comfort. 21,[34][35][36] Specialized palliative care services have traditionally been devoted to individuals with cancer, and expanding these services to dementia and other diseases is now widely advocated because it is believed that these individuals also will benefit tremendously from it in terms of symptom management. 8,21,30,31,34,35,37 Palliative care is not optimally developed for individuals with dementia, especially in care homes, which is where most individuals with dementia die.…”