Dementia: when to discuss advance care planning


  • Mary Corcoran
  • Univadis Medical News
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While there is significant debate on when exactly the best time is to initiate conversations about advance care planning (ACP) with people with dementia, new recommendations suggest that these conversations should take place early after initial diagnosis. 

In a new study in Palliative Care: Research and Treatment, researchers say that while many professionals feel that entering into discussions about ACP for end-of-life care is both too soon and insensitive within the initial diagnostic process, these discussions need to be initiated early as decision-making capacity may be lost early in the disease trajectory. 

They highlight a number of milestone periods that can act as triggers to discuss ACP including at certain transition points such as changes in care setting or health care events including patient deterioration or decline. 

“We need to have greater confidence to initiate ACP conversations to directly involve the person with dementia themselves if we are to ensure that their wishes and preferences are realised,” the authors say. 

They suggest that a case management approach to supporting families affected by dementia can support ACP discussions throughout the trajectory of the disease.