The WA Department of Health Churchill Fellowship to explore models of palliative care for people living with dementia

Palliative care helps people with a life-limiting illness live as well and fully as possible and to die as well as possible. It is recognised internationally under the Human Right to Health. Dementia is the leading cause of death for Australian women and second leading cause of death for men. It is the leading cause of disease burden in older Australians. Palliative care can benefit people with dementia from the time of diagnosis and as the disease progresses through to advanced dementia, death and bereavement. Despite this, people living with dementia are far less likely to receive palliative care than those with other life-limiting illnesses and this tends to only be in the last days or weeks of life. One reason for this is that traditional models of palliative care were designed for people with cancer and do not suit the needs of people with dementia, who usually live with their illness for years and experience gradual functional and cognitive decline over this period.

My Churchill Fellowship allowed me to visit experts and exemplar models of palliative care for people with dementia at clinical, research and community settings in 12 cities in the USA, Netherlands, Belgium, UK, Ireland and Singapore. I identified 12 core elements for successful models of palliative care for people with dementia, which can be adapted to the Australian setting. Some of these include co-design, person- and carer-centred care, care navigation, post-diagnostic support and advance care planning.