title: Palliative care in advanced dementia.
abstract: Because neurodegenerative dementias are progressive and ultimately fatal, a palliative approach focusing on comfort, quality of life, and family support can have benefits for patients, families, and the health system. Elements of a palliative approach include discussion of prognosis and goals of care, completion of advance directives, and a thoughtful approach to common complications of advanced dementia. Physicians caring for patients with dementia should formulate a plan for end-of-life care in partnership with patients, families, and caregivers, and be prepared to manage common symptoms at the end of life in dementia, including pain and delirium.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Merel
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356429, Seattle, WA 98195-6429, USA. Electronic address: smerel@uw.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Merel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 Northeast Pacific Street, Box 359760, Seattle, WA 98195-6429, USA.
authors.forename: Shaune
authors.initials: S
authors.lastname: DeMers
authors.affiliation: Geriatrics and Extended Care, VA Puget Sound Health Care System, University of Washington, 1660 South Columbian Way, S 182 GEC, Seattle, WA 98108, USA; Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Vig
mesh_terms: D000368:Aged; D003704:Dementia / Q000628:therapy*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D011787:Quality of Health Care
keywords: Advance directives; Cognitive impairment; Dementia; End-of-life care; Palliative care; Skilled nursing facilities