Palliative care for community patients diagnosed with dementia: a systematic review

Dementia is one of the primary causes of ill health worldwide (Public Health England (PHE), 2017). Because of the intricate array of behavioural and cognitive symptoms manifested in those with dementia, the care needs of this population differ widely from those of others. At present, the focus of research and consultations is identifying a cure for dementia, but it is necessary to be practical, and equal importance must be placed on the care provided to those with dementia and the support given to their families and carers.

Due to the symptoms experienced by people living with dementia, most with this condition will require palliative care (World Health Organization (WHO), 2017). Unlike the steady decline and predictability of end-of-life (EoL) symptoms associated with cancer or other disorders such as respiratory disease, the end-of-life symptoms associated with dementia, such as changes in behaviour, disorientation, weight loss and swallowing problems, follow a less predictable trajectory. The fact that people are living longer implies that the prevalence of dementia will no doubt rise. This will impose challenges in dementia care and in turn warrant a change in the demands of the role of community nurses, who provide this care. It is, therefore, essential that the workforce is trained, and that health professionals are able to engage in evidence-based practice in order to provide optimum care. There is, however, a gap in the management of EoL care for patients living with dementia, with substantial evidence showing that these patients have problems accessing palliative care services (National Council for Palliative Care (NCPC), 2007; PHE, 2015; Department of Health and Social Care (DHSC), 2016).