This paper adds to the body of work related to the Irish National Audit of Dementia Care in acute hospitals. In this case O’Shea et al. (2015) evaluate symptom assessment relevant for palliative care of people with dementia.
Results indicate sub optimal assessment of dementia symptoms with this being poorer among those at end of life or referred for specialist palliative care (SPC). Examples among this sub group (SPC) include lack of assessment of mobility (21%), ADLs (68%), pain (27%) and cognition (34%). No record of delirium assessment was found in almost 70% of all cases and 93% of those with dementia at end of life were not assessed for behavioural and psychological symptoms of dementia. Associated with the levels of sub optimal assessment is the likely over prescription of anti-psychotic medication (also documented in this review): https://academic.oup.com/qjmed/article/109/9/589/1752790
). The authors conclude that a more systematic approach to delivery of palliative care for people with dementia must be developed and this will require the development of a multi-dimensional education programme and a model of integrated dementia palliative care coupled with research that demonstrates the benefits of applying a palliative care approach to dementia.