An audit of palliative care in dementia

A retrospective case note audit was conducted in order to determine the most prevalent symptoms in terminal dementia and to assess the palliation given. Seventeen case notes were audited. Pain and dyspnoea were the most common symptoms. The palliation and treatment of constipation and oral candidiasis was within current accepted practice. Palliation of other symptoms were inadequate compared to current accepted practice. There appears to be a reluctance to prescribe opiate analgesia, and when this was prescribed the doses were not modified to achieve full pain or symptomatic relief. Many patients were unable to take medication orally, but syringe drivers were not used. The conclusions include the need for education of both nursing and medical staff as to the current principles of palliative care.