Background: People with dementia and palliative care needs require complex interventions to address those needs. The European Association for Palliative Care (EAPC) White Paper offers recommendations for palliative care in dementia and highlights domains integral for this population, thus providing useful guidance to developing such interventions.
Aim: To describe the components of interventions designed for palliative care for people with dementia in aged care, and determine the extent to which they address the EAPC domains.
Methods: A systematic review with narrative synthesis. Four electronic databases and clinical trial registries were searched for peer-reviewed articles and protocols in English, reporting on palliative care interventions for people with dementia in aged care settings, and addressing EAPC Domains 2 (person-centred) or 3 (setting care goals) and ≥1 other domain.
Results: Forty-five included papers, reporting on 24 studies: quantitative (n=12), qualitative (n=2), mixed methods (n=9), and a service outline. Interventions focused on (in order of frequency): supporting family decision-making; providing dementia-specific education and training to staff or family; improving symptom assessment/management; improving care delivery through inter-professional engagement; establishing coordinating roles; and furthering person-centred care. Interventions targeted care home staff (n=19), family members (n=12) and other healthcare providers (n=4).
Discussion: There is increasing sophistication in research on this topic with included studies reflecting all the domains but only one study addressing in its design 10 of the 11 domains. Varying emphasis was accorded to different foci, and the contexts in which interventions were delivered. The review challenges methods and interventions currently used as the underrepresented domains (such as continuity of care, prognostication, and ethical and societal issues) are less amenable to single, education driven interventions.
Conflicts of interest: The authors declare no conflicts of interest.
Funding source: This study was funded by the University of Technology and University of Hertfordshire Dean’s Health Futures Development Grant.