Jan Draper, professor of nursing at the Open University, and Deborah Birch, a clinical nurse specialist working with older people in Lincoln, carried out a review of 29 studies.
They concluded that older people in the final stages of dementia often had difficulty accessing palliative care services, despite having significant healthcare needs.
High-quality care for people with end-stage dementia did not appear to have the same priority as care for cancer patients in relation to policy, planning, practice development or training, they said. As a result, the researchers called for ‘urgent improvements’.
‘We believe that clinicians and patient groups caring for patients with advanced dementia need to work together with specialist palliative care providers and health commissioners to develop, fund and evaluate appropriate cost-effective services that meet the needs of both patients and their families,’ said professor Draper.
‘If this is achieved, these improvements have the potential to increase people’s quality of life and reduce the amount of time they spend in acute hospitals,’ she added.
Jonathan Webster, consultant nurse for older people at University College London Hospitals NHS Foundation Trust, said: ‘Dementia hasn’t attracted the attention that other diseases have but it is a complex condition and there are many issues around treatment and management.
‘All nurses working with older people with dementia need to have a core skill set, and palliative care for patients in the advanced stages is a key area that needs to be addressed,’ he added.
A Department of Health strategy on dementia care in England is due to be published this year.
According to the Alzheimer’s Society, around 60,000 deaths in the UK a year are directly attributable to dementia.
Journal of Clinical Nursing (2008) 17: 1144–1162