End-of-Life Care for Elderly with Advanced Dementia in Long-Term Care Facilities

Dementia is a progressive disease that is ultimately fatal. The number of old people is increasing worldwide; the number of people suffering from dementia is also increasing worldwide. Advanced dementia is referred to as late-stage dementia and includes the severe and terminal stage of the disease. People with advanced dementia experience significant physical losses, such as the inability to communicate and perform activities of daily living. Due to communication difficulty, caregivers may not be able to understand their needs. People with advanced dementia are more likely to be placed in a long-term care facility and two third of those with dementia die in a nursing home. As such, caregivers in long-term care facilities must attend to the complexities and challenges related to individuals and their end-of-life care needs. End-of-life care issues for people with advanced dementia have not been addressed in long-term care facilities in Taiwan. This is three-year study. The purposes of the study will be to understand the current end-of-life care for people with advanced dementia in Taiwan long-term care facilities, to identify factors associated with families’ satisfaction with end-of-life care for advanced dementia in Taiwan long-term care facilities by construct questionnaires survey, to understand the expectations and needs of family caregivers regarding end-of-life care of advanced dementia and the barriers of providing end-of-life care for advanced dementia by caregivers in Taiwan long-term care facilities by using in-depth interview and to establish the suitable model of end-of- life care for advanced dementia and clinical training courses regarding end-of-life care for caregivers in Taiwan long-term care facilities by using focus group interviews and systematic literature reviews .