It has long been recognised that people with dementia and their family carers have palliative care needs equal to those of patients with cancer. However, a palliative approach to dementia care requires both the dementia and palliative care workforces to fully understand the needs of people with dementia and their families towards the end of life. This article describes the development of a ‘community of practice’ where healthcare professionals from dementia and palliative care services shared their practice and learned from each other in a safe and supportive environment.
To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Half of nursing home residents (NHR) suffer from dementia. End-of-life hospitalizations are often burdensome in residents with dementia. A systematic review was conducted to study the occurrence of hospitalizations at the end of life in NHR with dementia and to compare these figures to NHR without dementia. Open Access Article
In their clinical review, Fetherston, Rowley and Allen (2018) summarised the literature on diagnosis, assessment and management of dementia, communication and ethical issues in dementia that should guide the provision of end-of-life palliative care. They also touch on topics, such as goals of care and care homes.
Open access. Dying in one’s preferred place is a quality marker for end-of-life care. Little is known about preferred place of death, or the factors associated with achieving this, for people with dementia.
Nutritional problems often manifest during late-stage dementia, and some families may request to instigate artificial nutrition and hydration (ANH) therapies. In the US, an estimated one-third of nursing home patients with a severe cognitive impairment have artificial feeding tubes inserted. Fear that a relative could experience extreme hunger or thirst if they are not mechanically fed tends to be the main driver behind family's requests to implement artificial or enteral feeding methods. In contrast, artificial hydration is rarely given to older people with dementia in the UK and this practice of non-intervention tends to apply across all healthcare and hospice type environments. To read the full article, log in using your MPFT NHS OpenAthens details.
How do you use information for your work and CPD? What do you think of MPFT library services? Tell us here and you could win £25 vouchers: https://www.surveymonkey.co.uk/r/B2JVNPR
Although Alzheimer disease and other dementias are life limiting, only a minority of these patients or their proxy decision makers participate in advance care planning. We describe end‐of‐life care preferences and acute care and hospice use in the last 6 months of life for persons enrolled in a comprehensive dementia care management program.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Most deaths occur in people over the age of 65 years, yet there is widespread evidence that older people have inequitable access to good palliative and end-of-life care. For people with dementia, there are further barriers to receiving palliative care. Identifying when older people with dementia are reaching the end of their lives is not straightforward. A palliative approach to care has been recognised as key in UK practice guidance; the National Institute of Health and Care Excellence recommends that, from diagnosis, people living with dementia should be offered flexible, needs-based palliative care that takes into account how unpredictable dementia progression can be. However there are still wide gaps in care in the dementia pathway, largely because commissioning is fragmented. To read the full article, log in using your MPFT NHS OpenAthens details.
We've added 10 new Be Aware updates following your suggestions:
Musculoskeletal ; Osteoporosis ; Nutrition and obesity ; Falls ; HR ; Research Methods ; Information Governance ; Bladder, bowel and pelvic healthcare ; Rheumatology ; Medicines and healthcare products regulatory agency (circulated email)
We'd like to hear your suggestions for new book alert topics. Simply reply to this email with 'Book Alert Topic' and your suggestions. You can also view and sign-up to our current new book alerts here: http://library.sssft.nhs.uk/librarykeepuptodate
In this overview we discuss the palliative psychiatric care of older people towards the end of life. We briefly consider ethics, dementia care, delirium, depression, anxiety, grief and physician-assisted suicide. We also discuss hope, dignity, spirituality and existentialism. We hope that this article will encourage clinicians to reflect on the effects of terminal illnesses on the mental health of dying people and the current provision of palliative psychiatric care. . To read the full article, log in using your MPFT NHS OpenAthens details.
The aim of this study was to enhance understanding about homecare workers providing care to people with dementia at end of life by exploring homecare workers' perceptions of challenges and the support they needed and sometimes received.. To read the full article, log in using your MPFT NHS OpenAthens details.
To explore current practice and the role taken by UK memory services in helping carers of people with dementia prepare for the end of life.. To read the full article, log in using your MPFT NHS OpenAthens details.
The service was created as a partnership between the palliative care team and older people’s mental health services, to make sure appropriate support is provided. It’s the only one of its kind in the North West.
Open access. Most persons with dementia die in long term care (LTC) homes, where palliative approaches are appropriate. However, palliative approaches have not been widely implemented and there is limited understanding of staff and family experiences of dying and bereavement in this context.
- Quick access to the Royal Marsden online via the library website homepage: library.sssft.nhs.uk
- Sign-in using your Open Athens username and password (if you don't yet have an Open Athens account, register at: openathens.nice.org.uk)
- Do a quick keyword search of all procedures
- Browse all chapters, clinical procedures and illustrations
- View custom MPFT procedures including: infection control skin preparation, medicines management.
From the August/September 2018 issue of Dementia together magazine, the Alzhiemer's Society report on the collaboration between Humber Teaching NHS Foundation Trust and Dove House Hospice that's improving end of life care for people with dementia.
We're expanding our Be Aware updates and want to know what physical health topics you'd like to keep updated on. Let us know your ideas by replying to this email with 'physical health topics' followed by your suggestions
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild–moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals’ prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection.. To read the full article, log in using your NHS OpenAthens details.
Observational pain tools (OPTs) are widely recommended in health care policies, clinical guidelines, and recommendations for pain assessment and management. However, it is unclear whether and how these tools are used for patients with advanced dementia approaching the end of life.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.