At the crossroads of religion and palliative care in patients with dementia

Kieran L Quinn,Daphna L Grossman

doi:10.1186/s13584-020-00401-5

Abstract

The timing of palliative care initiation may be more appropriately directed using a needs-based approach, instead of a prognostically driven one. Jewish Law or Halachah (“the way”) upholds a strong commitment to the sanctity of life and teaches that the duty to prolong life supersedes the duty to end suffering prematurely, unless one is expected to imminently die. This intersection of palliative care and a reliance on prognostic triggers with an individual’s observance of religious traditions complicates matters nearing the end-of-life. A recent pilot study by Sternberg et al. of 20 patients with advanced dementia in Israel found that home hospice care significantly reduced distressing symptoms, caregiver burden and hospitalization and teaches us important lessons about some of the essential elements to providing excellent palliative care at home, including the 24/7 availability of healthcare providers outside of the emergency department. In light of specific religious practices, palliative care should strive to incorporate a patient’s specific religious observance as part of high-quality end-of-life care.

Highlights

The timing of palliative care initiation may be more appropriately directed using a needs-based approach, instead of a prognostically driven one
Palliative care is an approach that focuses on the care of people who are suffering from serious illness with a goal of improving quality of life, reducing suffering and helping with decision making for them and their caregivers [1]
Palliative care should be delivered when someone is suffering with a serious illness and in need of care to relieve that suffering

Summary

Introduction

The timing of palliative care initiation may be more appropriately directed using a needs-based approach, instead of a prognostically driven one. Palliative care is an approach that focuses on the care of people who are suffering from serious illness with a goal of improving quality of life, reducing suffering and helping with decision making for them and their caregivers [1].

Results

Conclusion