title: Barriers and facilitators to the receipt of palliative care for people with dementia: the views of medical and nursing staff.
abstract: BACKGROUND
  The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms of care, but evidence indicates that many fail to access such provision at the end of life. The role of the health care team is pivotal if people with dementia are to benefit from the transition to palliative care.
  
  
  OBJECTIVE
  This paper reports on qualitative research conducted in the UK that sought to explore the experiences of health care practitioners working in palliative care and sought to establish the issues relating to end-of-life care for people with dementia.
  
  
  METHODS
  Eight focus groups and four individual interviews were held. Data were analysed using a thematic approach.
  
  
  METHODS
  The study included palliative care practitioners (n = 58) including medical, nursing and allied health professionals. Participants were recruited from acute hospitals, general practice, hospices and specialist palliative care units in the UK.
  
  
  RESULTS
  Four themes were identified: Making the transition; Competence challenged; 'The long view' and Working together. Whilst there exists good practice in this area, the barriers to timely and appropriate transitions to palliative care for people with dementia and their families continue to exist. The paper concludes with recommendations for policy and practice development.
authors.affiliation: School of Nursing & Midwifery, University of Sheffield, Sheffield, UK. t.ryan@sheffield.ac.uk
authors.forename: Tony
authors.initials: T
authors.lastname: Ryan
authors.forename: Clare
authors.initials: C
authors.lastname: Gardiner
authors.forename: Gary
authors.initials: G
authors.lastname: Bellamy
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
authors.forename: Christine
authors.initials: C
authors.lastname: Ingleton
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003266:Continuity of Patient Care / Q000592:standards; D003299:Cooperative Behavior; D003704:Dementia / Q000628:therapy*; D017144:Focus Groups; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D033183:Interdisciplinary Communication; D008503:Medical Staff; D009740:Nursing Staff; D010166:Palliative Care / Q000592:standards*; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D006113:United Kingdom