In the earlier stages of dementia, while the person still has mental capacity, it is important to ensure that they and their carers have discussed how they should plan ahead. Considerations might include:
- Advance statements of wishes and feelings they would like to be taken into account in future decisions about their care and affairs
- Advance decisions in which they state what treatments they do not want to have and would not consent to
- Lasting power of attorney in which they state who they want to make decisions for them if they cannot make decisions for themselves
- Preferred place of care plan in which they record their decisions about future care choices, for example where they would like to die
In the last 6 months of life, people with dementia are thought to experience symptoms (including pain) that last for longer and are less likely to be treated, compared with people dying of other conditions. It is important to ensure that palliative care needs are met in accordance with the Department of Health’s End of life strategy, which includes use of appropriate tools and pathways, including:
The End of Life Care Strategy: quality markers and measures for end of life care (Department of Health, 2009) was published to support commissioners and providers in delivering improvements in care. As with the End of Life Care Strategy they accompany, the markers and measures are generic and apply to care across end of life care. The end of life care quality markers provide detailed structure and process markers and measures which will be relevant for end of life care for people with dementia.
Download: End of Life Care Strategy: quality markers and measures for end of life care (Department of Health, 2009)
See also: