Dementia

Dr Victor Pace trained in palliative medicine in London and has been consultant at St Christopher's Hospice since 1999. He set up and led the Palliative Care for Dementia Project, in Croydon, London, for four years; this was the first project nationally to provide specialist palliative care input systematically to patients with advanced dementia and to study the problems faced by these patients and their families. He is a member of the National Council for Palliative Care Dementia Working Group and has contributed to a number of their publications. He has also been on working groups for NICE and the National End of Life Care Programme on care in advanced dementia. His other main interest is the use of nonsteroidal anti-inflammatory drugs in palliative care. Dr Adrian Treloar is a Consultant in Old Age Psychiatry at Oxleas NHS Trust and a Visiting Senior Lecturer at the Institute of Psychiatry, London. In addition to being in charge of Medical Education for Oxleas NHSF Trust from 1999 to 2007, he produced research and helped to write national guidance on the ethics of Covert Administration of medicines. He has developed considerable expertise in the management of dementia through till death at home, and has lectured nationally and internationally on the palliative care of Dementia, as well as delirium and the management of Parkinson's disease. He has pioneered advanced care of dementia at home, enabling several dozen patients to live at home until their death, and has both researched and developed understanding of how this can be achieved. He is currently working with the National Council for Palliative Care as a member of their cross cutting dementia working group. Sharon Scott is a Registered General Nurse and over the past 16 years has gained expert knowledge and skills in providing specialist palliative care by combining clinical experience with research and academic study. Clinical experience includes hospice in-patient care, hospital palliative care overseas and community palliative care in the UK. Over the past four years she has played a leading role in developing and managing a dementia palliative care service in London. During this time she gained invaluable experience in the care of people with advanced dementia and their carers. Working with patients, carers, services and core providers enabled her to highlight gaps in service provision and care and initiate measures to address these issues and improve quality of care. Sharon provides palliative care in dementia education programmes for care homes, lectures on courses in dementia care and presents nationally on this subject.

Abbreviations ; 1. Introduction to dementia ; 2. Dementia and its management ; 3. Young onset dementia ; 4. Advanced dementia ; 5. An overview of palliative care ; 6. Distress in dementia ; 7. Principles of physical symptom assessment in dementia ; 8. Pain and pain control ; 9. Other physical symptoms ; 10. Mental distress and psycho-behavioural problems ; 11. Managing disability in dementia ; 12. Intercurrent illness ; 13. Deciding on appropriate intervention ; 14. The terminal phase ; 15. Bereavement ; 16. Communication ; 17. Person centred dementia care ; 18. Choice, capacity, care and the law ; 19. Spiritual care ; 20. Provision of appropriate care ; 21. A family carer's perspective ; 22. Caring for the carers ; 23. Some other therapies ; 24. Financial issues ; Appendix 1 - Further information ; Appendix 2 - Some relevant drug interactions ; Appendix 3 - Important neurochemical syndromes ; Appendix 4 - Body dermatomes