Palliative geriatrics and dementia: key issues and challenges

Palliative care enhances the quality of life for patients and families facing life-threatening illnesses by addressing physical, psychosocial, and spiritual needs. Dementia, characterized by its progressive and terminal trajectory, presents unique challenges due to its unpredictable course and the difficulty of identifying the terminal phase. This manuscript aims to explore the integration of palliative care into the management of advanced dementia, emphasizing patient-centered approaches and timely, appropriate interventions. We discuss early intervention strategies and tailored approaches for managing nutrition, infections, symptoms, pain, and medication in advanced dementia. Key issues include ethical considerations surrounding artificial nutrition, the role of assisted feeding, cautious opioid use, and deprescribing of non-essential medications. The manuscript also addresses systemic barriers, including limited awareness, ageism, and inadequate professional training. Emphasis is placed on shared care planning, caregiver support, and continuity of care. Future directions underscore the importance of telemedicine, community-based services, and enhanced professional education to address the growing needs of an aging population. Integrating palliative care into dementia management promotes dignity, improves quality of life, and supports individuals and families throughout the course of the disease.