Palliative Care Referal Criteria In Dementia

Management of dementia involves prioritizing the referral of the right patient at right time to a palliative care specialist for the attainment of its benefit. A study published in the Journal of the American Geriatrics Society has found a lack of consensus regarding referral criteria for palliative care in patients with dementia.

Dementia is an umbrella term for a group of neurodegenerative diseases that are characterized by gradual memory loss, cognitive decline, and behavioral changes.

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‘Management of dementia involves prioritizing the referral of the patient to a palliative care specialist at right time for attainment of its benefit. The lack of consensus regarding the time of referral criteria is found to be common, which mandates the need for timely specialist palliative care referral to enhance patient and caregiver outcomes.’

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Palliative care is a branch of medicine that focuses on optimizing the quality of life and providing relief from symptoms. Dementia poses a significant symptom burden both to patients and caregivers with progressive functional deterioration.

Proper and timely referral to palliative care in dementia offer better strategies for the management of the disease. However the referral time of patients remains unclear.

The study analysis spotted out a wide array of reasons for referring patients with dementia to specialist palliative care, broadly classified under 13 themes. Several reasons that encourage the involvement of specialist palliative care and simultaneously the lack of consensus on when patients should be referred are thereby highlighted by the present diversity.

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"Given the growing recognition of unmet supportive and palliative care needs in patients with dementia, a set of consensual referral criteria may facilitate timely specialist palliative care referral to enhance patient and caregiver outcomes," says senior author David Hui, MD, MSc, of the University of Texas MD Anderson Cancer Center.

Multidisciplinary approach forms the base for palliative care treatment in dementia and improves the quality of life in patients. Certain points to be addressed for palliative care among dementia patients include the following:

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Provide the patients with simple yet key messages regarding their illness and treatment strategies. This would help ease their anxiety level
Encourage activities of daily living (ADL) to patients and their participation in social activities
Timely monitoring of orientation information like day, date, time, place, and names of people would aid in spotting out early deterioration during the disease
Caregivers need to seek help when they find themselves constrained in stress due to the tiring care given to dementia patients
Early interventions render better management of dementia

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