Typically, a cancer patient receives care from an oncologist or specialist in their particular type of cancer. Someone with heart disease sees a cardiologist. Even as a patient approaches the last months of their life, he or she relies upon a specialist in palliative care. Specialists like these undergo continuing education that qualifies them to make judgment calls to provide appropriate care for patients.
But when it comes to people with dementia, it’s a different story.
A study from University College of London has found that in the last months of their lives, only one percent of dementia patients receive specialist care. The other 99 percent are still receiving care from their general practitioner or emergency services, suggesting that we’re still not correctly planning for a disease that affects 850,000 people in the UK.
Researchers followed 85 people with advanced dementia in London for nine months. One in five patients received emergency care in the last months of their lives, suggesting that planned care is not available for dementia patients who would benefit from palliative care. Only 28 percent were seen by palliative care teams, even though two-thirds of dementia patients were found to have chronic pain and half were at high risk for bed sores. Almost half had psychological issues like agitation, depression, anxiety or sleep issues and others suffered from serious illnesses like pneumonia and blood poisoning.
Despite the complexity of these diseases, dementia patients were forced to turn to their GP or emergency care, where they may not have the resources to treat illnesses that are further complicated by dementia.
“Problems such as severe agitation are common. People may think that this is just ‘part of’ having advanced dementia and little can be done. However, [patients] can benefit hugely from specialist support,” said co-author Dr. Liz Sampson to the Daily Mail.
Although this study was small and concentrated in one geographic area, it backs up other research that suggests dementia care is reactive, rather than planned. An analysis of 10,000 dementia patients showed that they have worse outcomes when they visit the emergency room than their similarly aged counterparts. The dementia patients stayed twice as long in emergency care and had a higher risk for death and readmission than patients over 65 without dementia.
Read the full write-up here.
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Many times when a patient goes into a nursing home and there is a problem if dementia shows up on the records the doctor will start treatment for Alzheimer’s regardless of the type of dementia. That doesn’t work many times and makes a bad situation worse. No treatment may be better than the wrong treatment.