Pain management: a fundamental component of dementia care.

Pain is a multifaceted experience with physical, psychological, social and spiritual components. Dementia, which is often accompanied by impaired communication, complicates the assessment and treatment of pain. Although older people with dementia share the same age-related pathology as other older people, they do not experience the same access to pain relief as their cognitively-unimpaired counterparts.

Improving end of life care for people with dementia.

Nurses caring for older patients across diverse settings will provide care for people with dementia approaching the end of their lives. Demographic changes mean that the number of people dying with dementia will increase, however nurses and other healthcare professionals may be unprepared to meet their needs. Factors that are essential to provide compassionate and dignified end of life care for people with dementia include effective communication with those with cognitive impairment and an awareness of likely causes of anxiety, fear and resistance to care when carrying out interventions.

Hospice transfer for patients at the end of life: part 2.

This is the second in a series of two articles on improving end of life care for terminally ill patients in a medical assessment unit. Through joint working between staff in a district general hospital and staff at a hospice, a new service was developed offering patients who are at the end of life and being cared for in the medical assessment unit the opportunity to be transferred to the hospice for palliative care instead of acute interventions. This article uses an ethical framework to examine the ethical, legal and practical considerations involved in developing the new service.

Hospice transfer for patients at the end of life: part 1.

This is the first of two articles about improving end of life care for terminally ill patients in a district general hospital. The article describes a hospice transfer service developed by joint working between staff at a medical assessment unit and a hospice to improve end of life care for patients who otherwise might die in the medical assessment unit. It discusses the care received by patients in both settings, and the practicalities of offering patients the option of rapid transfer to the hospice for end of life care, where the emphasis of care is on palliation not acute intervention.