An optimal approach to palliative care for people with dementia has been defined by the European Association for Palliative Care with eleven domains including, for example: Applicability of palliative care; Person-centred care, Communication and shared decision making; Setting care goals and advance care planning. Not all people with dementia will require specialist palliative care and all involved in dementia care, should be able to provide palliative care focussing on care and treatment which aims to increase the comfort and quality of life of the individual and supporting their family. There are many complications and symptoms which may arise for someone with dementia including: increased infections, shortness of breath, swallowing difficulties and pain which the individual may not be able to clearly express. These complications can lead to difficult decisions which need to be made by not only practitioners but also family caregivers as proxy. There should be a shared decision making approach to these complications and symptoms, with advance care planning performed where possible. Caring for someone with dementia is one of the most difficult caring roles support for family caregivers as part of a palliative approach is essential. Each person with dementia is different and needs should be assessed on an individual basis, adopting a person centred approach to care.
educational materials on ACP and exclusion of ACP in clinical notes. After multiple interventions over 6 months, mean monthly completed ACP documentation rose from baseline of 5.5% to 28.8%, with highest achievable completion of ACP documentation at 50%. Though the target of completed ACP documentation was not met, there was an increase in the number of ACP discussions and documentation conducted by the department with increase awareness. This promotes a community of practice where ACP is offered readily. Conclusion Changes in work processes and incorporation of ACP as part of clinical service delivery can improve ACP engagement in patients with dementia and their caregivers.
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