Palliative Care in Dementia: A European View of the Models of Palliative Care

Palliative Care in Dementia: A European View of the Models of Palliative Care www.phwiki.com

Palliative Care in Dementia: A European View of the Models of Palliative Care

Bright, Marta, Contributing Writer has reference to this Academic Journal, PHwiki organized this Journal Method Design A mixed methodology was used to enable the triangulation of data in addition to build a comprehensive map of services including potential deficiencies within these services. Participants Thirty-nine interviews were conducted with professionals such as general practitioners, nurses, researchers, care home managers in addition to policy leads. A further focus group was conducted consisting of six professionals from micro, meso in addition to macro levels of health care services. Interviews took place within five European countries including the United Kingdom, Germany, the Netherl in addition to s, Italy in addition to Norway. Procedure Three Literature reviews of indexed peer-reviewed publications were conducted. These are: Palliative care services as long as people with dementia: a synthesis of the literature reporting the views in addition to experiences of professionals in addition to family carers Palliative care as long as people with dementia: a review of reviews Evaluating educational initiatives to improve palliative care as long as people with dementia: a narrative review of the evidence The existing literature surrounding palliative care in addition to dementia was surveyed including documents from the Department of Health in addition to National Council of Palliative Care. Face to face structured interviews or telephone interviews where face to face was not possible, were conducted with national experts in the five European countries. Four open questions were used. These include what aspects of palliative care as long as dementia professionals would wish to improve on in addition to what they would want to export to another country. Interviews were recorded as long as transcription or captured using contemporaneous note taking. Analysis Recorded interviews were transcribed verbatim in addition to together with the notes, will be analysed using thematic analysis. Results Interview Themes This is an on-going piece of research where additional participants will be interviewed to in as long as m the continuous development of a model of palliative care as long as dementia. The interviews have so far revealed a variety of themes containing what currently work well as long as people dying with dementia in addition to what would be recommend to other countries. These include: Gold St in addition to ards Framework (in Engl in addition to ) Liverpool Care Pathway (LCP) Doctors in nursing homes (the Netherl in addition to s) Home care (Italy – regional differences) In addition to what works well as long as people dying with dementia, the following themes have so far been identified as areas that need improvement as long as people dying with dementia: Education of staff/professionals Need as long as a structured system/pathway Diagnosis/Prognosis/Recognition of dementia Communication between disciplines in addition to settings Advanced Care Planning Coordinator/case manager Palliative Care Model of Dementia Based on the themes in addition to responses generated thus far from the interviews together with the existing literature in addition to literature reviews, the following model of palliative care has been developed. This is a model which will continue to develop in addition to be used across European systems of palliative care in addition to will aid the development in addition to successful implementation of quality indicators. Palliative Care in Dementia: A European View of the Models of Palliative Care Nathan Davies1, Steve Iliffe1, Jill Manthorpe2 in addition to Sam Ahmedzai3 1UCL, Research Department of Primary Care in addition to Population Health, Royal Free Campus, Rowl in addition to Hill St., London, NW3 2PF 2Social Care Work as long as ce Research Unit, King’s College London, Aldwych, London, UK 3Department of Oncology, The Medical School, Beech Hill Road, Sheffield p264 Background With an ageing population, people living with dementia is expected to continually rise to 81 million affected by 20401 in addition to 115 million worldwide by 20502. Generally, as the disease progresses, memory in addition to other cognitive deficits become worse, together with a loss in mobility, self-care abilities, poor nutrition, in addition to a breakdown of skin. In the final stages, it is common to have urinary tract infections, skin ulcers, pneumonia in addition to many other complications. As a progressive in addition to eventually fatal illness, a palliative care approach as long as dementia is generally accepted as the best option. Over the past decade there has been increased attention in addition to research into dementia in addition to end of life care3. However, there is a general lack of research in this field4 in addition to more research is needed as long as this group of people. Despite the growing number of people with dementia in addition to the fact that many palliative care services now care as long as non-cancer patients, people with dementia are rarely referred to such services5. Palliative care in addition to models of care are well established in addition to have long been used within cancer. However, this is still underdeveloped within dementia. Transferring these models of care directly from cancer may be inappropriate6 in addition to they may not be successful in dementia. Aim The aim of the current research is to gain an insight into the models of palliative care as long as dementia across Europe, capturing the deficiencies within these systems. These results will be used to develop a model of palliative care as long as dementia suitable as long as European Health Care Systems as part of the Implementation of Quality Indicators in Palliative Care Study (IMPACT). References Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005 Dec 17;366(9503):2112-7. Alzheimer’s Disease International. World Alzheimer’s report, 2009. http://www.alz.co.uk/research/files/WorldAlzheimerReport-ExecutiveSummary.pdf. Accessed on 19/09/2011. Van Der Steen JT. Dying with dementia: What we know after more than a decade of research. Journal of Alzheimer’s Disease 22 (1) (pp 37-55), 2010 Date of Publication: 2010 2010;(1):2010. Sampson EL. Palliative care as long as people with dementia. British Medical Bulletin 96 (1) (pp 159-174), 2010 Date of Publication: December 2010 2010;(1):December. National Council as long as Palliative Care. The power of partnership: Palliative care in dementia, 2009. Sampson EL, Burns A, Richards M. Improving end-of-life care as long as people with dementia. British Journal of Psychiatry 2011 Nov;199:357-9. Fig 1. The basic model of palliative care in dementia. Fig 2. Quality indicators of good end of life care in addition to of a good death related to outcome in dementia. Fig 3. Quality indicators of good palliative care related to structure in dementia. Prior preferences established with family involvement & patient: advanced directives etc. UK example: Gold St in addition to ard Framework in operation; pain control: use of assessment tools, psychosocial needs met; Nutrition: assessed, few PEG tubes used; Infection management agreed; Prognostication tools used Training in addition to continuous learning; audit of outcomes Stable leadership & work as long as ce, staff skill mix Evidence of increased skills Evidence of care co-ordination Community orientation If you would like further in as long as mation please contact Nathan Davies: nathan.davies.10@ucl.ac.uk Conclusions There are many areas of palliative care as long as dementia that require improvement such as education in addition to the recognition of dementia as a terminal illness. However, there are some aspects of palliative care within the European countries which do work well on which a model of palliative care as long as dementia can be developed in addition to utilised appropriately. More interviews will be conducted to identify themes in order to improve palliative care as long as dementia. This model will then be used to develop in addition to implement quality indicators to improve palliative care as long as dementia.

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