End-of-life and Palliative Care in Dementia: An Overview for Clinicians

Abstract Purpose of Review As the population ages, dementia has become a major cause of morbidity and mortality, utilizing palliative care services at the end of life. The unique needs and dilemmas in this population, including prognostic ambiguity, difficulty in expressing pain and suffering, unclear utility of feeding tubes, antibiotics, and anticoagulation, ethical challenges to autonomy, dignity, and privacy, entail a unique palliative care approach. In this review, we describe the evolving challenges in palliative care for people living with dementia and highlight evidence-based approaches to address them across the disease trajectory. Recent Findings Emerging evidence suggests that artificial intelligence (AI) may improve prognostic modeling. Recent randomized controlled studies assessing various palliative care interventions and models have shown mixed results regarding the effect on the person with dementia. Awareness of caregiver distress, burnout, and early grief, as a result of the loss of their loved one’s personhood, has increased. These may lead to a better holistic approach to the person with dementia. Summary Palliative care is essential to the ever-changing burden of symptoms and decision-making in dementia care. A palliative approach is best integrated early in the disease trajectory.