Gadd, Holly and Christman, Ronda


Objective: The World Health Organization (2019) reports that dementia is the seventh leading cause of death with an estimated 50 million people worldwide with this disease. In the United States out of one and a half million Medicare patients on hospice in 2016, only 18% had dementia (The National Hospice and Palliative Care Organization, 2017). McAteer and Wellbery (2013) identified that while referrals to services seem to be on the rise, many are not made until the patient is close to death in the last weeks of an illness. The purpose of this project was to review the literature to identify if quality of life is improved if provided earlier in the disease process and discuss the major barriers that are preventing this type of care from being provided. Methods: Databases used for this literature review included CINAHL, Medline, Academic Search Complete, and ClinicalKey. The search focused on barriers to care including prognostication, communication, and misinformation. Over 4,000 articles were found. These were narrowed down to literature that was published within the last five years, in English, and peer reviewed. Twenty articles were identified as pertinent to this project and presented in the literature review to describe the identified barriers and solutions that promote early palliative care for dementia patients. Conclusions: Palliative care has been shown to improve quality of life and is a needed service for dementia patients. Multiple barriers include access to this type of care, issues with communication, collaboration between providers, lack of care continuity, education/skills deficiencies, personal bias, lack of guidelines/prognostication tools, and general misinformation about palliative care. Solutions include further education, emphasis on collaboration, use of guidelines, and ensuring that discussions about care are being done early in the disease trajectory.