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Antea Worldwide Palliative Care Conference

Rome, 12-14 November 2008

ABSTRACT FORM

Presenting author CARE AND DECISIONS IN END-OF-LIFE DEMENTIA
Ladislav Volicer
Authors (max 6, presenting author included): Ladislav Volicer
Email:
lvolicer@cas.usf.edu
Advanced dementia is a terminal disease because there are currently no treatments that would
Phone cure it or stop its progression. The goals of treatment in advanced dementia are preserving quality
of life, dignity and comfort. Quality of life is preserved by attention to three areas: provision of
meaningful activities, appropriate management of medical problems and treatment of behavioral
Mobile phone symptoms of dementia. Meaningful activities and comfort measures should be provided even in
very severe dementia because Alzheimer’s disease does not progress into a vegetative state. The
most important comfort measure is prevention and treatment of pain, and avoidance of
inappropriate aggressive medical interventions. Medical interventions that may not be
Please underline the most appropriate for individuals with advanced dementia include cardiopulmonary resuscitation
appropriate category for your (CPR), transfer to an acute care setting, use of antibiotics for treatment of generalized infections
abstract and use of tube feeding. CPR is rarely successful in advanced dementia and in those who initially
survive results in significant suffering. It is better to treat infections, such as pneumonia, in a
• Pain and other symptoms
chronic care setting than to transfer the resident to an acute care hospital because hospitalization
• Palliative care for cancer patients results in severe discomfort and functional decline. Comfort during generalized infections can be
• Palliative care for non cancer maintained by the use of analgesics and antipyretics and does not require the use of antibiotics.
patients Tube feeding has no benefits in individuals with advanced dementia and may result in severe
• Paediatric palliative care discomfort and decreased quality of life. Decisions about use of these interventions should be
based on patient’s previous wishes if they are known, or on his/her best interest interpreted by a
• Palliative care for the elderly
person who knows the patient the best. Management of behavioral symptoms should start with
• The actors of palliative care
non-pharmacological approaches and should recognize the difference between agitation and
• Latest on drugs resistiveness to care.
• Pain

• Illness and suffering through
media
• Marginalisation and social stigma
at the end of life
• Palliative care advocacy projects

• Prognosis and diagnosis
communication in
different cultures
• Communication between doctor-
patient and patient-
equipe
• Religions and cultures versus
suffering, death and
bereavement
• Public institution in the world:
palliative care policies
and law
• Palliative care: from villages to metropolies

• Space, light and gardens for the terminally ill patient
• End-of-life ethics
• Complementary therapies Session: Palliative care in the elderly
• Education, training and research
• Fund-raising and no-profit Chair of the session: Dott. Donatella Bartolozzi
• Bereavement support
• Volunteering in palliative care
• Rehabilitation in palliative care