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P122 Death, dying and dementia: Diminishing dilemmas and distress
  1. Margaret Mary Cowan1,
  2. Jo Jenner1 and
  3. Abdul Bankole2
  1. 1EllenorLions Hospice, Gravesend, England
  2. 2Littlestone Continuing Care Unit for patients with advanced dementia


Background/context There are currently 750,000 patients living with dementia in United Kingdom ( Alzheimer’s Society, 2011) with evidence of inappropriate hospital admission of patients with advanced dementia (Pace, et al, 2011). NICE, (2013) suggest a palliative care approach from diagnosis till death. Following a critical reflection relating to the end-of-life care of patient with dementia, the local hospice collaborated with local advanced dementia unit to hold bi-monthly meetings to improve planning care.

Aim As a result of this collaboration patients are supported to receive their end-of-life care in familiar surroundings resulting in equality of care to those who are cognitively intact.

Approach used Bi-monthly meetings assess newly admitted patients and identify patients approaching end-of-life. Discussions are documented in case notes with particular significance to DNACPR, preferred place of care/death and communication with relatives.

Outcomes As a result of this collaboration the outcomes are fourfold

  • Patients can expect an agreed care plan at end of life, with coordination of specialist dementia and palliative care services.

  • Carers can expect increased support, are involved in advanced care planning, have access to newly formed carers group and access to bereavement care.

  • Dementia unit staff have increased expertise, improved their uptake of education on end of life issues, have received bespoke communication training and have rapid access to specialist palliative care advice.

  • Hospice staff have improved recognition of needs of advanced dementia patients and allows them an opportunity to seek advice on control of symptoms of other dementia patients

Application to hospice practice This collaboration allows both units to transfer their skills to benefit an increasingly ageing population. It allows the hospice to plan ahead for the increase in future referrals of dementia patients in line with predictions.

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