Re: Palliative care can benefit people with dementia

Dear Editor
If Yorganci and Sleeman are concerned about levels of palliative care for people with dementia they might want to join me or any of the other 1000s of GPs who do weekly rounds in the care homes across the country. They would clearly be very surprised at the level of palliative care that is being routinely delivered by GPs and the associated multi-disciplinary team.

If they joined me they could find out about the Enhanced Health in Care Home model (https://www.england.nhs.uk/community-health-services/ehch/) and the locally enhanced services that fund high quality care in care homes across the country. They could meet the extended team of psychiatry, dementia care, physiotherapy, OTs and speech and language therapists that surround each resident in care homes allowing them to have the best quality of life possible. They could shadow the many experienced nurses in those homes who consider pain and agitation every day when providing holistic care to their residents. They could sit-in on one of the ever-increasing Frailty MDT meetings happening in general practice to support those people living in their own homes.

If they wished to delve further, they could visit our local hospitals where the staff are continually reinforcing the message that hospitals are not the best place for people with dementia and that further admissions should be avoided. They could look at the Respect plus forms that we, in both primary and secondary care, fill in for the frail with the aim of reducing admissions to hospital. Finally, they could meet the social workers who work so hard to ensure those with worsening dementia are housed and cared for in appropriate places.

There are problems in the system and we can always do better. We know we should be more proactive in caring for this group but to say that people with dementia (and frailty in general) do not routinely receive palliative care is not only incorrect but belittles the standard of care given by the extended team in the community. We should be celebrating how palliation has now become an inherent part of cradle-to-grave care even if the palliative specialists do not recognise it.