Pharmacological approaches

Medication use in patients with dementia at the end of life


This Research presents a summary of the findings of a project entitled Assessment of factors which influence physician decision-making regarding medication use in patients with dementia at the end of life (Parsons, et al., 2012). The project was undertaken in both ROI and NI.

Key findings are that there is considerable variability in decision-making among NI and ROI doctors about continuation or discontinuation of some medications at the end of life in patients with dementia, especially in relation to antibiotics, and dementia medications. The research showed that the presence of an advance directive did not necessarily have an effect on doctor decision-making regarding medications. The findings highlight the importance of clinical practice guidelines as a tool for helping doctors make decisions on the prescription of medications such as statins and anti-psychotics for people with dementia and the absence of such guidelines at the time in ROI (although clinical practice guidelines for general practitioners have since been introduced in ROI).  A conclusion drawn is that the wishes and comfort of the person with dementia and the person’s family should be at the forefront of decision making when it comes to end of life care in dementia.