Emergency department use and responsiveness to the palliative care needs of patients with dementia at the end of life: A scoping review.

Objectives: More than 50% of patients with dementia visit the emergency department (ED) each year. Patients with dementia experience frequently unrelieved symptoms that can benefit from . Response to needs in the ED can be quite challenging and access to is generally scarce. The aim of this scoping review is to assess ED use and responsiveness to needs of patients with dementia in their last year of life.

Methods: A scoping literature review following the Joanna Briggs Institute methodology. Electronic search of the literature was undertaken in Medline (PubMed), Web of Science, Scopus, Scielo, and APA PsycInfo, last updated on 19 February 2024.

Results: Twenty-four studies were identified and confirmed that patients with dementia frequently resort to the ED near the end of life, frequently more than once in their last year of life. Eight studies directly addressed needs, suggesting significant rates of needs among patients with dementia and in comparison, to other oncological or non-oncological conditions. Infections and neuropsychiatric symptoms were the main reasons of admission to the ED. Access to was confirmed to be low.

Significance Of Results: This scoping review indicates that patients with dementia frequently resource to the ED in their last year of life with unmet needs. Although scarce access to and the existence of important barriers in the ED, intervention in this setting can be seen as an opportunity to attend needs and referral to services.