Systematic Review for the Quality of End-of-Life Care for Patients With Dementia in the Hospital Setting

Abstract

Background:: Patients with dementia may receive suboptimal end-of-life care in hospital settings reflecting broader debate around the palliative status of dementia syndromes.

Objectives:: To synthesize literature describing the quality of end-of-life care for patients with dementia dying in hospital.

Methods:: An integrative review assessed the quality of 26 articles concerning medical, nursing, and psychosocial care of patients with dementia dying in hospital settings.

Results:: Literature reflects a growing awareness of the need to consider a palliative approach to end-of-life care for patients with dementia in hospital. Patients with dementia are less likely to receive aggressive care at the end of life, but provision of palliative care interventions is inconsistent. Health-care professionals highlighted the need for greater education around identification and management of problematic symptoms at the end of life. Engagement of family caregivers is essential in optimizing end-of-life care, and further research is required to ascertain their experiences around decision-making.

Conclusion:: Although patients with dementia appear to receive less aggressive treatment at the end of life, the provision of palliative care and symptom management may be inadequate.

Keywords: dementia; end-of-life care; geriatric medicine; hospital; palliative care; systematic review.