Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review.

Abstract:

BACKGROUND:People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interventions addressing their specific needs. AIM:The aim of this study is to describe the components of palliative care interventions for people with dementia in long-term care focusing on shared decision-making and examine their alignment to the European Association for Palliative Care domains of care. DESIGN:Systematic review with narrative synthesis (PROSPERO ID: CRD42018095649). DATA SOURCES:Four databases (MEDLINE, CINAHL, PsycINFO and CENTRAL) were searched (earliest records - July 2019) for peer-reviewed articles and protocols in English, reporting on palliative care interventions for people with dementia in long-term care, addressing European Association for Palliative Care Domains 2 (person-centred) or 3 (setting care goals) and ⩾1 other domain. RESULTS:Fifty-one papers were included, reporting on 32 studies. For each domain (1-10), there were interventions found aiming to address its goal, although no single intervention addressed all domains. Domain 7 (symptom management; n = 19), 6 (avoiding overly aggressive treatment; n = 18) and 10 (education; n = 17) were the most commonly addressed; Domain 5 (prognostication; n = 7) and 4 (continuity of care; n = 2) were the least addressed. CONCLUSION:Almost all domains were addressed across all interventions currently offered for this population to various degrees, but not within a singular intervention. Future research optimally needs to be theory driven when developing dementia-specific interventions at the end of life, with the European Association for Palliative Care domains serving as a foundation to inform the best care for this population.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Kochovska S,Garcia MV,Bunn F,Goodman C,Luckett T,Parker D,Phillips JL,Sampson EL,van der Steen JT,Agar MR

doi

10.1177/0269216319900141

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

454-492

issue

4

eissn

0269-2163

issn

1477-030X

journal_volume

34

pub_type

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