Care planning in dementia: tips for clinicians.

Care planning in dementia is made more complicated by the increasing prevalence of multiple chronic comorbidities, also termed 'frailty'. Consideration of the reciprocal impact of dementia and other health issues is critical to appropriate care planning. This may be best achieved through an ordered process whereby the clinician first considers medical evidence and its limitations to the medical, physical and social determinants of the patient's health trajectory and quality of life. The next step is to provide information and recommendations to the patient and a second decision maker (who will become increasingly involved as dementia progresses). The end point of care planning is an informed and empowered decision maker who is able to dynamically apply skills to measure any treatment option that may be proposed, while having access to the decisional support of a health professional familiar with the patient's health status.