Palliative Care in Dysphagia and Dementia

Abstract

Purpose The purpose of this clinical focus article is to discuss palliative care for patients with dysphagia who also have a comorbid condition of dementia. It reviews the nature of palliative care as encompassing important aspects of patient/resident choice and comfort, which are important regardless of the cognitive status of the patient or the terminal nature of the diagnosis. It provides a comparison of palliative care, hospice care, and rehabilitative care. It then discusses issues that are specific to dementia and dysphagia for patients who are approaching the end of life. Conclusion The philosophy of palliative care need not be limited to end-of-life cases in dysphagia management as considerations for comfort, and patient's wishes should always be part of care planning. Clinicians working with cognitively impaired patients at the end of life must be particularly sensitive to their communication efforts and be willing to work cooperatively with family members and other stakeholders in developing plans of care using shared decision making.