The experience of dying with dementia: a retrospective study.
OBJECTIVE
To describe the last year of life of people with dementia, their symptoms, care needs, use of and satisfaction with health services and the bereavement state of the respondent.


METHODS
The study is drawn from the Regional Study of Care for the Dying, a retrospective sample survey of the carers, family members or others who knew about the last year of life of a random sample of people age 15 and over dying in the last quarter of 1990. The samples were drawn in 20 English health districts which, although self-selected, were nationally representative. There was a total of 3696 patients (response rate of 69%) dying from all causes. Within this sample, 170 dementia patients were identified and compared with 1513 cancer patients.


RESULTS
The symptoms most commonly reported in the last year were mental confusion (83%), urinary incontinence (72%), pain (64%), low mood (61%), constipation (59%) and loss of appetite (57%). Dementia patients saw their GP less often than cancer patients and their respondents rated GP assistance less highly. Dementia patients needed more help at home compared with cancer patients, and received more social services; 78% of respondents for dementia patients and 64% for cancer said they had come to terms with the patient's death.


CONCLUSIONS
Patients dying from dementia have symptoms and health care needs comparable with cancer patients. Greater attention should be given to these needs.
McCarthy
M
M
Department of Epidemiology and Public Health, University College London, UK.
Addington-Hall
J
J
Altmann
D
D
D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001601:Bereavement; D017028:Caregivers / Q000523:psychology; D015897:Comorbidity; D003704:Dementia / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology; D010166:Palliative Care / Q000523:psychology; D010348:Patient Care Team; D011788:Quality of Life; D012189:Retrospective Studies; D012803:Sick Role; D012931:Social Environment; D013727:Terminal Care / Q000523:psychology*