{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T22:38:42Z","timestamp":1793659122439,"version":"4.5.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T00:00:00Z","timestamp":1648166400000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Health Research Board funding","award":["#ILP-HSR-2017-020"],"award-info":[{"award-number":["#ILP-HSR-2017-020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Older people with dementia have multiple palliative care needs, with pain, agitation, dyspnoea, aspiration and pressure ulcers being common and persistent in advanced dementia. Anticipating the person\u2019s possible symptoms requires knowledge of the whole person, including the type of dementia, which is problematic when the dementia type is often not documented.<\/jats:p>\n               <jats:p>A palliative care approach to dementia should look at symptoms across the four pillars of palliative care, but in reality, we tend to over-focus on physical and psychological symptoms, while spiritual and emotional needs can be overlooked, especially around the time of diagnosis, where such needs may be significant.<\/jats:p>\n               <jats:p>Advance care planning (ACP) is a central tenet of good dementia palliative care, as the person may lose their ability to communicate and make complex decisions over time. Despite this, care planning is often approached too late, and with the person\u2019s family rather than with the person; much of the literature on ACP in dementia is based on proxy decision-making for people in residential care.<\/jats:p>\n               <jats:p>Thus, we need a paradigm shift in how we approach dementia, beginning with timely diagnosis that includes the dementia type, and with services able to assess and meet emotional and spiritual needs especially around the time of diagnosis, and with timely ACP as an integral part of our overall approach.<\/jats:p>","DOI":"10.1093\/ageing\/afac066","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:06:29Z","timestamp":1646597189000},"source":"Crossref","is-referenced-by-count":20,"title":["Palliative care for older people with dementia\u2014we need a paradigm shift in our approach"],"prefix":"10.1093","volume":"51","author":[{"given":"Suzanne","family":"Timmons","sequence":"first","affiliation":[{"name":"Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6854-8975","authenticated-orcid":false,"given":"Siobhan","family":"Fox","sequence":"additional","affiliation":[{"name":"Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Drennan","sequence":"additional","affiliation":[{"name":"School of Nursing, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Guerin","sequence":"additional","affiliation":[{"name":"School of Psychology, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W George","family":"Kernohan","sequence":"additional","affiliation":[{"name":"Institute of Nursing and Health Research, Ulster University, Belfast, Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"2022032516173372400_ref1","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1017\/S1041610211002924","article-title":"Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia","volume":"24","author":"Brodaty","year":"2012","journal-title":"Int Psychogeriatr"},{"key":"2022032516173372400_ref2","doi-asserted-by":"crossref","first-page":"e210677","DOI":"10.1001\/jamanetworkopen.2021.0677","article-title":"Comparison of palliative care delivery in the last year of life between adults with terminal noncancer illness or cancer","volume":"4","author":"Quinn","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2022032516173372400_ref3","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/0269216317726443","article-title":"Living and dying with advanced dementia: a prospective cohort study of symptoms, service use and care at the end of life","volume":"32","author":"Sampson","year":"2018","journal-title":"Palliat Med"},{"key":"2022032516173372400_ref4","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1192\/bjp.140.6.566","article-title":"A new clinical scale for the staging of dementia","volume":"140","author":"Hughes","year":"1982","journal-title":"Br J Psychiatry"},{"key":"2022032516173372400_ref5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13195-020-00753-9","article-title":"Characteristics and progression of patients with frontotemporal dementia in a regional memory clinic network","volume":"13","author":"Leroy","year":"2021","journal-title":"Alzheimers Res Ther"},{"key":"2022032516173372400_ref6","volume-title":"Second Irish National Audit of Dementia Care in Acute Hospitals","author":"Bracken-Scally","year":"2020"},{"key":"2022032516173372400_ref7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12982-016-0053-z","article-title":"Comparison of dementia recorded in routinely collected hospital admission data in England with dementia recorded in primary care","volume":"13","author":"Brown","year":"2016","journal-title":"Emerg Themes Epidemiol"},{"key":"2022032516173372400_ref8","first-page":"112","article-title":"How well are the diagnosis and symptoms of dementia recorded in older patients admitted to hospital?","volume":"46","author":"Crowther","year":"2017","journal-title":"Age Ageing"},{"key":"2022032516173372400_ref9","doi-asserted-by":"crossref","first-page":"380","DOI":"10.21037\/apm.2017.06.15","article-title":"The advance care planning experiences of people with dementia, family caregivers and professionals: a synthesis of the qualitative literature","volume":"6","author":"Ryan","year":"2017","journal-title":"Ann Palliat Med"},{"key":"2022032516173372400_ref10","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1080\/13607863.2013.868403","article-title":"Preserving identity and planning for advance care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia","volume":"18","author":"Hilgeman","year":"2014","journal-title":"Aging Ment Health"},{"key":"2022032516173372400_ref11","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.jamda.2019.09.010","article-title":"Educating Dutch general practitioners in dementia advance care planning: a cluster randomized controlled trial","volume":"21","author":"Tilburgs","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"2022032516173372400_ref12","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/geront\/48.6.732","article-title":"Long-term effects of bereavement and caregiver intervention on dementia caregiver depressive symptoms","volume":"48","author":"Haley","year":"2008","journal-title":"Gerontologist"},{"key":"2022032516173372400_ref13","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1177\/0269216313493685","article-title":"White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care","volume":"28","author":"Steen","year":"2014","journal-title":"Palliat Med"},{"key":"2022032516173372400_ref14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1108\/JICA-02-2020-0013","article-title":"Components of a community model of dementia palliative care","volume":"28","author":"Fox","year":"2020","journal-title":"J Integr Care"},{"key":"2022032516173372400_ref15","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/1471301209104975","article-title":"Palliative and end of life care of dementia at home is feasible and rewarding results from the Hope for Home' study","volume":"8","author":"Treloar","year":"2009","journal-title":"Dementia"},{"key":"2022032516173372400_ref16","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1111\/j.1532-5415.2009.02452.x","article-title":"Palliative access through care at home: experiences with an urban, geriatric home palliative care program","volume":"57","author":"Holley","year":"2009","journal-title":"J Am Geriatr Soc"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/51\/3\/afac066\/43027751\/afac066.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/51\/3\/afac066\/43027751\/afac066.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T22:09:36Z","timestamp":1648246176000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afac066\/6554093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afac066","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,3]]},"published":{"date-parts":[[2022,3,1]]},"article-number":"afac066"}}