Barriers to excellent end-of-life care for patients with dementia

Greg Sachs, Joseph W. Shega, Deon Cox-Hayley

Research output: Contribution to journalArticle

254 Citations (Scopus)

Abstract

While great strides have been made recently in improving end-of-life care in the United States, people with dementia often die with inadequate pain control, with feeding tubes in place, and without the benefits of hospice care. In this paper, we discuss the most important and persistent challenges to providing excellent end-of-life care for patients with dementia, including dementia not being viewed as a terminal illness; the nature of the course and treatment decisions in advanced dementia; assessment and management of symptoms; the caregiver experience and bereavement; and health systems issues. We suggest approaches for overcoming these barriers in the domains of education, clinical practice, and public policy. As the population ages, general internists increasingly will be called upon to provide primary care for a growing number of patients dying with dementia. There are great opportunities to improve end-of-life care for this vulnerable and underserved population.

Original languageEnglish (US)
Pages (from-to)1057-1063
Number of pages7
JournalJournal of General Internal Medicine
Volume19
Issue number10
DOIs
StatePublished - Oct 2004
Externally publishedYes

Fingerprint

Terminal Care
Dementia
Vulnerable Populations
Hospice Care
Bereavement
Symptom Assessment
Enteral Nutrition
Public Policy
Caregivers
Primary Health Care
Education
Pain
Health
Population

Keywords

  • Alzheimer's disease
  • Dementia
  • End-of-life care
  • Hospice
  • Palliative care

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Barriers to excellent end-of-life care for patients with dementia. / Sachs, Greg; Shega, Joseph W.; Cox-Hayley, Deon.

In: Journal of General Internal Medicine, Vol. 19, No. 10, 10.2004, p. 1057-1063.

Research output: Contribution to journalArticle

Sachs, Greg ; Shega, Joseph W. ; Cox-Hayley, Deon. / Barriers to excellent end-of-life care for patients with dementia. In: Journal of General Internal Medicine. 2004 ; Vol. 19, No. 10. pp. 1057-1063.
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