Palliative Care And Advanced Dementia: The Croydon Project

Abstract

Advanced dementia is associated with a high symptom burden. However, people with advanced dementia and their carers are less likely to be cared for by specialist palliative care services than people with other conditions such as cancer. The traditional model of specialist palliative care, with its high level of symptom support input in the last weeks/months of life, is not appropriate for people with dementia as the condition is associated with a longer, dwindling trajectory towards death, associated with progressive decline in physical and cognitive functioning. There is also a fear in some quarters that if people with dementia have access to specialist palliative care, services such as hospices will become inundated with referrals. Thus, there is an urgent need to develop models of palliative care services for people with advanced dementia and their carers. This article provides an overview of a 3-year project that was conducted by St Christopher’s Hospice, London, with the aim of studying the problems faced by these patients and their families/carers and developing a feasible model of specialist palliative care for advanced dementia. Conflicts of interest: none