Palliative care for community patients diagnosed with dementia: a systematic review.

Despite many efforts made by health organisations to deliver effective end-of-life care to patients with dementia, research indicates that palliative care is predominantly aimed at patients with terminal cancer, and that patients with dementia face challenges in accessing end-of-life care. This article explores the views of health professionals on providing palliative care to those patients diagnosed with dementia within the community setting. A systematic review of seven qualitative studies was performed to identify the best available evidence. The findings show that effective palliative care for patients with dementia continues being affected by many barriers and challenges. Good practice seems to be inconsistent and fragmented throughout the UK and European countries, and many health professionals are faced with difficulties associated with services and financial implications, training and education, staff support, communication, family support and dementia care.

Managing long-term conditions in primary and community care.

Health care policy in the UK continues to focus on provision of care in the community. For people with long-term conditions it has long been accepted that care should be predominantly in the primary and community care setting, with a focus on case management for those with complex needs. Community nurses are ideally placed to provide care to all people with long-term conditions, from health promotion, prevention and encouraging self-care to caring for people with more complex needs, comorbidities and end-of-life care. Community nurses are an essential element of the multidisciplinary team and should take the lead in delivering complex care at home to people with long-term conditions, while maintaining a focus on developing self-care, empowerment, community engagement and acting as an advocate for clients and their carers.