Evaluation of the implementation of the Gold Standards Framework and Liverpool Care Pathway for the Dying on End of Life care for people with dementia

There has been a growing awareness of how important the perspective of the person is with dementia (Cheston et al 2003). Dementia is an irreversible degenerative syndrome characterised by deficits in memory, language and personality change resulting in difficulties with self care management, self neglect and psychiatric syndromes (Harris 2006). Alzheimer’s disease is the most common form of dementia which develops gradually and occurs most commonly after the age of sixty years of age. Kitwood (1997) acknowledges that often as a result of admission to a care home or hospitalisation dementia can sometimes advance extremely fast. One area in the care of older people which has received little attention is ‘end of life’ care of people with dementia, many of who are more likely to die in care homes. There is currently limited research evidence about the quality of dying for people with dementia in long term care settings. Whilst there are numerous moral and ethical difficulties to surmount when undertaking research into sensitive areas such as older people with dementia, Hughes and Robinson (2006) also identify three main areas of difficulties to providing good palliative care with advanced dementia in nursing and residential homes; communication, organisation (systems) and education (specialist knowledge and skills).