title: An evaluation of palliative care contents in national dementia strategies in reference to the European Association for Palliative Care white paper.
abstract: BACKGROUND
  Dementia involves a progressive decline in many functional areas. Policy and practice guidelines should cover the entire course of the disease from early detection to the end-of-life. The present study aimed to evaluate the contents of national dementia strategies with a focus on palliative care content.
  
  
  METHODS
  We employed qualitative content analyses. Sixteen national dementia strategies from 14 countries were reviewed. Using open coding, the contents were compared to the domains and recommendations of the palliative care in dementia white paper of the European Association for Palliative Care (EAPC).
  
  
  RESULTS
  Although palliative care was not explicitly referred to in eight of the 14 countries and only to a limited extent in three countries, a number of domains from the EAPC white paper were well represented, including "person-centered care, communication, and shared decision making"; "continuity of care"; and "family care and involvement." Three countries that referred to palliative care did so explicitly, with two domains being well represented: "education of the health care team"; and "societal and ethical issues." The strategies all lacked reference to the domain of "prognostication and timely recognition of dying" and to spiritual caregiving.
  
  
  CONCLUSIONS
  National dementia strategies cover part of the recent definition of palliative care in dementia, although they do not frequently label these references as "palliative care." In view of the growing numbers of people dying with dementia, preparation for the last phase of life should be added to national strategies.
authors: Mental Health and Nursing Research Team,Tokyo Metropolitan Institute of Medical Science,Setagaya-ku,Tokyo,156-8506,Japan.
authors: Miharu
authors: M
authors: Nakanishi
authors: Department of Economics,Rutgers University,the State University of New Jersey,Camden,NJ 08102,USA.
authors: Taeko
authors: T
authors: Nakashima
authors: Division of Research,Tokyo Dementia Care Research and Training Center,Suginami-ku,Tokyo,168-0071,Japan.
authors: Yumi
authors: Y
authors: Shindo
authors: Department of Psychiatric Nursing,Graduate School of Medicine,the University of Tokyo,Bunkyo-ku,Tokyo,113-0033,Japan.
authors: Yuki
authors: Y
authors: Miyamoto
authors: Alzheimer Europe,Luxembourg,L-1417,Luxembourg.
authors: Dianne
authors: D
authors: Gove
authors: Department of Palliative Medicine,University Hospital Bonn,Bonn,53127,Germany.
authors: Lukas
authors: L
authors: Radbruch
authors: Department of General Practice & Elderly Care Medicine,EMGO Institute for Health and Care Research,VU University Medical Center,1081BT,Amsterdam,the Netherlands.
authors: Jenny T
authors: JT
authors: van der Steen
mesh_terms: D003704:Dementia / Q000451:nursing*; D005060:Europe; D006801:Humans; D038622:Internationality; D007564:Japan; D010166:Palliative Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D012016:Reference Values; D056910:Republic of Korea; D013727:Terminal Care / Q000592:standards*; D014481:United States; D003245:Consensus Statements as Topic
keywords: dementia; end-of-life; national health policy; palliative care