ABSTRACT
Dementia is now recognised as a terminal disease, yet palliative approaches have only recently been applied to dementia and access to hospice services are the exception rather than the rule. The European Association for Palliative Care proposes a new framework, recognising that the traditional model of palliative care may fail to addresses the unique features of end-of-life care for people living with dementia. The framework advocates for a partnership between palliative care and dementia care specialists to ensure optimum end-of-life care for people living with dementia. Through collaborative working with dementia specialists UK hospices are developing hospice-enabled approaches to promote excellence in end-of-life care.
Palliative approaches applied to dementia have much in common with person-centred dementia care. Both recognise the multiplicity of influences on quality of life and the range of domains affected at end of life – physical, medical, psychological, emotional, spiritual and social. In this chapter, we provide an overview of evidence-based, clinically informed, palliative approaches to ensuring person-centred end-of-life care for a diverse range of people with dementia and their families. We illustrate these approaches with case studies and vignettes of best practice in the field. The chapter concludes with implications for practice development and research.
