Development and evaluation of the REACH (recognise end of life and care holistically) out in dementia toolkit.

Aim: To identify evidence based signs and symptoms indicative of end stage dementia, and develop the REACH toolkit as an aid for staff to consider a palliative approach.

Method: A systematic literature review was conducted of policy, position documents, guidelines and publications from 1988 to 2011. Inclusion criteria were any report or article identifying the signs and symptoms of end stage dementia which were associated with increased mortality and morbidity.