Palliative Care in Advanced Dementia.

Dementia syndrome is common and expected to increase significantly among older people and characterized by the loss of cognitive, psychological and physical functions. Palliative care is applicable for people with dementia, however they are less likely to have access to palliative care. This narrative review summarizes specifics of palliative care in advanced dementia.

Hirudotherapy attenuates arthritic pain in patients with various chronic pain syndromes: A retrospective analysis.

Objective: Osteoarthritis is a degenerative disease that affects synovial joints. Micro-injuries of articular structures initiate inflammatory processes, leading to persistent pain. Due to various risk factors, osteoarthritis is often diagnosed in multimorbid patients.

The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach.

Background: Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress.

Communication about the desire to die: Development and evaluation of a first needs-oriented training concept - A pilot study.

Objective: Patients' desire to die (DD) is rarely discussed in palliative care (PC) due to health professionals' (HPs) feeling of uncertainty. The aim of the study was to develop and evaluate a training to increase HPs' self-confidence in responding professionally to patient's DD and to assess the feasibility of this approach.

Methods: The training course was developed via focus groups and relevant literature and refined with an advisory board.

Needs of people with advanced dementia in their final phase of life: A multi-perspective qualitative study in nursing homes.

Background: People with advanced dementia present an important target group for palliative care. They suffer a range of symptoms, and their verbal communication abilities are highly restricted. At present, little is known about their needs in the final phase of life.

Needs of people with severe dementia at the end-of-life: a systematic review.

Background: Epidemiological data shows an increasing number of people affected by dementia. It is mentioned that people with severe dementia have special care needs which are intensified at the end-of-life.

Objective: This paper offers a systematic analysis of the current status of research on the needs of people with severe dementia in the last phase of their lives.

Palliative treatment of chronic neurologic disorders.

Patients with chronic neurologic disorders suffer from the burden of disease progression without the hope for a cure. Therefore, symptom management and palliative care approaches should be included from the beginning of the illness. Palliative care aims at improving a patient's quality of life by alleviating suffering due to physical, psychosocial, and spiritual factors.

Dying with dementia: symptom burden, quality of care, and place of death.

Background: No detailed information has been available until now about the care setting, circumstances and place of death, symptom burden, and quality of care of persons with end-stage dementia in Germany.

Methods: This cross-sectional study is based on a random sample of 5000 persons who died in the period from 25 May to 24 August 2008 in the German federal state of Rhineland-Palatinate. Their surviving relatives were contacted and asked to participate in a questionnaire survey.