As dementia does not necessarily follow a predictable course and nearness to death is hard to predict, people with dementia who are dying are often not perceived as having a terminal condition. They may not receive optimal palliative care and may have unmet needs ranging from pain relief to emotional support.
The perception that people with dementia have already experienced ‘social death’ may add to inadequate care at end of life. A dementia-friendly environment uses physical and social strategies to overcome this tendency.
A person-centred approach to care demands that living is presumed and a person living and dying with dementia is accorded respect, dignity, sensory and cultural support until clinical death is pronounced.
- Provide a comfortable, familiar physical environment for the person who is dying.
- Aid the presence of relatives and friends so they may remain involved with the person until they die.
- Respect people’s end of life choices, having involved family, staff and doctors in early discussions about end of life decisions.
- Design bedrooms with sufficient space for visitors, pain relief equipment, sensory support, spiritual and cultural needs.
- Continue to treat the person with respect and dignity, expressing feelings of love and acceptance even when the person no longer speaks or reacts.
- Train staff in palliative care and follow palliative care guidelines.
- Accept that other people in a facility may have important relationships with a person who is dying.
- Provide emotional support to family members and friends.