ABSTRACT
This chapter describes that during the terminal stages of the common illnesses associated with ageing such as chronic cardiac disease, long-standing emphysema, and Alzheimer's disease, the care provided needs to be informed by sound palliative practice. It argues that the extension of palliative care to these groups will raise distinctive and often novel issues, especially in the case of the frail aged with dementia. The chapter discusses: communication and planning; the nurse's role as story-teller; whose voice will be heard? Problems with communication; and when 'enough is enough'. It discusses that effective, efficient, and timely communication is the keystone of all good nursing care and is also true in the kinds of cases. The pain relief received can be dependent on a particular nurse's interpretation of the language of the patient, especially if that person has dementia. Communication and explanation with family and friends is vital to ensure that the planned approach can be implemented smoothly.
