Lloyd-Williams Mari, Mogan Caroline, Dening Karen Harrison
Academic Palliative and Supportive Care Studies Group (APSCSG), IPHS, University of Liverpool, Liverpool, Liverpool, Merseyside, England.
Curr Opin Support Palliat Care. 2017 Dec;11(4):328-333. doi: 10.1097/SPC.0000000000000295.
Dementia is now recognized as a progressive life-limiting illness where many patients can benefit from access to palliative care.
The present review has focused on three areas namely, advanced care planning in supporting palliative care for dementia, hospice provision for people with dementia and provision of care within family home. In advanced care planning, there is little research on systematically developed and implemented advance care planning interventions or whether they achieve desired outcomes for end-of-life care. There is limited research on hospice-based care for patients with dementia and most studies are U.S. based. Equally studies exploring how family carers can be supported and facilitated to care at home for the person with dementia to the end of life are exploratory rather than determining what factors may be important.
There are relatively few studies, especially quantitative studies or intervention studies being carried out to determine most effective means of providing palliative care for people with dementia, particularly with respect to advanced care planning, the provision of hospice-based care and support at home. Despite increased public awareness of dementia as a terminal illness, more research is required to support patients with dementia and their families at the end of life.
痴呆症如今被视为一种渐进性的、危及生命的疾病，许多患者可从姑息治疗中受益。
本综述聚焦于三个领域，即支持痴呆症姑息治疗的预先护理计划、为痴呆症患者提供临终关怀服务以及在家庭中提供护理。在预先护理计划方面，关于系统制定和实施的预先护理计划干预措施，或者这些措施是否能实现临终护理的预期结果，研究较少。关于为痴呆症患者提供临终关怀服务的研究有限，且大多数研究基于美国。同样，探索如何支持和便利家庭护理人员在家中照顾痴呆症患者直至生命结束的研究多为探索性研究，而非确定哪些因素可能至关重要。
为确定为痴呆症患者提供姑息治疗的最有效方法，尤其是在预先护理计划、临终关怀服务提供及家庭支持方面，开展的研究相对较少，特别是定量研究或干预研究。尽管公众对痴呆症作为绝症的认识有所提高，但在生命末期仍需要更多研究来支持痴呆症患者及其家人。
