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Barriers to excellent end-of-life care for patients with dementia.

Abstract：

:While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excellent end-of-life care for patients with dementia, including dementia not being viewed as a terminal illness; the nature of the course and treatment decisions in advanced dementia; assessment and management of symptoms; the caregiver experience and bereavement; and health systems issues. We suggest approaches for overcoming these barriers in the domains of education, clinical practice, and public policy. As the population ages, general internists increasingly will be called upon to provide primary care for a growing number of patients dying with dementia. There are great opportunities to improve end-of-life care for this vulnerable and underserved population.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Sachs GA,Shega JW,Cox-Hayley D

doi

10.1111/j.1525-1497.2004.30329.x

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

1057-63

issue

10

eissn

0884-8734

issn

1525-1497

pii

JGI30329

journal_volume

19

pub_type

杂志文章,评审

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