Advance care planning and palliative medicine in advanced dementia: a literature review

Abstract

Aims and method To assess the factors that affect the clinical use of advanced care planning and palliative care interventions in patients with dementia. A literature search of Medline, Embase and PsycINFO was performed to identify themes in advanced care planning and palliative care in dementia.Results In total, 64 articles were found, including 12 reviews, and three key areas emerged: barriers to advanced care planning, raising awareness and fostering communication between professionals and patients, and disease-specific interventions.Clinical implications Most of the studies analysed were carried out in the USA or Continental Europe. This narrative review aims to help guide future primary research, systematic reviews and service development in the UK.

A descriptive study of Lewy body dementia with functional imaging support in a Chinese population: a preliminary study

“…27 Given that LBD is an irreversible neurodegenerative disease, advance care planning (ACP) forms a major part of care. 28 Our data for dysphagia, aspiration pneumonia, pressure sores, and mortality can offer useful information during ACP for Chinese LBD patients. Since those patients who have died had a higher presenting CDR score, lower Barthel Index, and greater usage of levodopa (which probably reflects more severe parkinsonism), ACP should be initiated earlier in LBD patients with these features.…”

Improving the use of treatment escalation plans: a quality-improvement study

“…Advanced Care Plans are targeted interventions aiming to promote early decision-making for patients nearing the end of their lives 1. There is increasing evidence that this planning can allow patients greater autonomy as they lose capacity and improve the grieving process for patients’ families after death 2.…”

End‐of‐life care for people dying with dementia in general practice in Belgium, Italy and Spain: A cross‐sectional, retrospective study

“…We know little about the sizeable group of community-dwelling people with dementia and those whose dementia is in the early stages; that is, mild dementia. 9 These previous studies have shown that residents with advanced dementia are at risk of undergoing burdensome interventions at the end of life, potentially avoidable hospitalizations from nursing homes and of dying with great suffering. [10][11][12][13][14] Cross-country comparisons regarding dying with dementia are limited.…”