Palliative Care Report

 

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A new report provides examples of how to improve palliative care education in the community and hospitals, and for groups of people, including people with dementia. The report also comments on the dismal performance of palliative care in actually addressing the needs of this vulnerable population.   Understanding the shortcomings of current practices will help caregivers be better advocates for their loved ones.  

The 2011 World Health Organization report draws on statistics and findings in the European region.  The study found that palliative care for older people with dementia is “widely inadequate” and involving “too much intervention with little benefit,” including tube feeding, laboratory testing, use of restraints and IV medications, or “too little” intervention, indicated by poor pain control, dehydration and malnutrition, emotional and social neglect, absence of spiritual care, and absence of support for family caregivers. The progression of dementia is typically a “prolonged dwindling” and because of this slow progression, it is often difficult for caregivers to know when palliative and end-of-life care is appropriate.  Communication with a person with advanced dementia is extremely difficult and caregivers often cannot accurately assess the pain level or other needs of the patient or loved one.  The report recommends that Advance Care Plans  be addressed very early in the disease process so that caregivers can understand and document the wishes of their loved one.  The report calls for urgent improvement in palliative care for persons with dementia, including interventions for agitation, constipation and pain.

If you have a loved one in the early stages of dementia, take the time to make an Advance Care Plan or other type of Advance Directive, such as a Durable Health Care Power of Attorney.

More information on end of life care for persons with Alzheimer’s or dementia can be found here.