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. 2018 Jun;32(6):1042-1054.
doi: 10.1177/0269216318760442.

The facilitators and challenges of dying at home with dementia: A narrative synthesis

Caroline Mogan  1 , Mari Lloyd-Williams  1 , Karen Harrison Dening  1   2 , Christopher Dowrick  1
Affiliations

The facilitators and challenges of dying at home with dementia: A narrative synthesis

Caroline Mogan et al. Palliat Med. 2018 Jun.

Abstract

Background:: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia.

Aim:: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia.

Design:: Narrative synthesis of qualitative and quantitative data.

Data sources:: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search was conducted across six electronic databases (AMED, BNI, CINAHL, EMBASE, MEDLINE and PsycINFO) and reference lists of key journals were searched up to July 2017.

Results:: Searches returned 1949 unique titles, of which seven studies met all the eligibility criteria (four quantitative and three qualitative). Six key themes were identified – four facilitators and two challenges. Facilitators included ‘support from health care professionals’, ‘informal caregiver resilience and extended social networks’, ‘medications and symptom management’ and ‘appropriate equipment and home adaptations’. Challenges included ‘issues with professional services’ and ‘worsening of physical or mental health’.

Conclusion:: People with dementia may not always require specialist palliative care at the end of life. Further research is required to overcome the methodological shortcomings of previous studies and establish how community development approaches to palliative care, such as compassionate communities, can support families to allow a greater number of people with dementia to die at home.

Keywords: Dementia; compassionate communities; end of life; home care; palliative care.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA diagram of the included studies.
See this image and copyright information in PMC

References

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