Sonia Hines

The later stages of many incurable diseases are treated with a palliative approach – an approach where treatment focuses on reducing burdensome symptoms without attempting to cure the illness. Such an approach is often lacking for the treatment of dementia despite some research suggesting that this sort of approach would be the most appropriate framework for managing treatment options for people with advanced dementia.

A research team from the DCRC – Carers and Consumers has conducted a systematic review of existing research on palliative approaches to dementia care in order to develop best practice guidelines, based on both the effectiveness and appropriateness of options. The research team analysed a total of 107 articles written between 1997 and 2009.

Based on analysis of these articles the following findings were found to reflect best practice:

  • Palliative care should be individualised to meet the needs of the patient, their family and the clinical context
  • Families often need education to understand the disease trajectory of dementia
  • Healthcare professionals may require education on providing palliative care for people with advanced dementia
  • The most appropriate interventions are those which address quality of life issues
  • Artificial nutrition and hydration appear to be of little or no benefit to people with advanced dementia
  • There is some evidence to suggest that the use of IV antibiotics is of little benefit in end stage dementia
  • Advance health directives are important and may help facilitate an approach to care at the end of life that is consistent with the patient's wishes and values
  • Planning for the end of life should begin as soon as possible after a diagnosis of dementia
  • The most appropriate and effective care is an approach which aims to palliate the unpleasant symptoms of advanced dementia

A copy of the summay report is available via the link below:

The effectiveness and appropriateness of a palliative approach to care for people with advanced dementia: a systematic review