A palliative approach to existential issues and death in end-stage dementia care.

Abstract

The aim of this study was to investigate how, in relation to the palliative philosophy of care, municipal staff caring for patients with dementia deal with existential issues, the dying process, and bereavement follow up with next of kin. Methods: Thirty-one semi-structured interviews were performed and analyzed using a modified phenomenographic method. Results: Those interviewed experienced existential issues as difficult to handle, and they felt lost. Three patterns of answers emerged: 1) attempting to minimize or ignore the issue, 2) pleading, in relation to the patient, that no one has control over issues concerning life and death, and 3) showing affection for the patient. When faced with dying patients, they made things easier for the family, and their goal was that the patient should not be left alone. No systematic bereavement follow up of next of kin occurred. Discussion: Suggestions are made for improving municipal care, and applying palliative care principles for patients dying of dementia.