Palliative care and dementia: Is a good death possible at home?

Introduction: The suggestion has been made that modern medicine has diverted attention from preparing for death and helping people to die a good death. The branch of medicine which has addressed the care of the dying, palliative medicine, has seemed to give the impression that dying can be dignified through the management of terminal pain. However, many patients dying from cancer and non-cancer diagnoses have a range of symptoms which are less easily managed in old age. The principles of a good death have been outlined and are used to answer the question -Can people with end-stage dementia have a good death at home?" Conclusion: there are complex issues associated with the care of people with end-stage dementia at home, including the difficulties in prognostication. However, with committed informal carers, supported by appropriately funded home care organisations, and the use of advance care plans to minimise hospital admissions and unnecessarily invasive interventions, the desire of people with end-stage dementia to die a good death at home can be fulfilled. © 2011 by Nova Science Publishers, Inc. All rights reserved.