Rapport final
Palliative care for people with dementia - Miranda Rose
I performed three studies on palliative care for older people with dementia.
First, between 2010 and 2015, there was a higher prevalence of residents with dementia in nursing homes in Flanders, Belgium, who persistently had complex care needs and had no change in their total comfort at the end of life. This study highlights the increasing complexity of challenges faced by the nursing home sector, which underscores an urgent need to better support nursing homes in improving their capacities to provide timely, high-quality and comprehensive palliative care to more residents living and dying with dementia.
Second, while PACE Steps to Success did not improve comfort in all dying residents, it appeared to equally improve quality of care and dying in the last month of life for residents with dementia (regardless of the stage) and those without dementia. This study suggests that a non-disease-specific palliative care program, such as PACE Steps to Success, is a useful starting point for future improvement of palliative care in nursing homes, but it needs further development to effectively improve residents’ comfort.
Third, of all older people living at home who died with dementia between 2010 and 2015 in Belgium, only one in four of them had access to palliative home care support within two years before death. Their palliative home care support use is associated with improved quality and reduced costs of end-of-life care. Considering these clear benefits of palliative home care support, the low uptake underscores a need to improve its timely access in dementia.