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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Palliative Care 1/2015

Identification of the palliative phase in people with dementia: a variety of opinions between healthcare professionals

BMC Palliative Care > Ausgabe 1/2015
Jasper van Riet Paap, Elena Mariani, Rabih Chattat, Raymond Koopmans, Hélène Kerhervé, Wojciech Leppert, Maria Forycka, Lukas Radbruch, Birgit Jaspers, Kris Vissers, Myrra Vernooij-Dassen, Yvonne Engels, on behalf of the IMPACT research team
Wichtige Hinweise
Jasper van Riet Paap and Elena Mariani shared first author.

Competing interests

The authors declare that they have no competing interest.

Authors’ contribution

YE and MVD are responsible for the design of the study. JvRP, EM, HK, WL, MF, BJ are responsible for the data collection and analysis. JvRP and EM drafted the first manuscript. YE, MVD, KV, RC, RK, and LR provided extensive feedback to draft versions of the manuscripts. All authors reviewed draft versions of the manuscript and approved the final manuscript. We thank all participating researchers and services involved in the IMPACT consortium for their support.



People with dementia can benefit from a palliative care approach. Recommendations, such as those of the EAPC have been proposed to strengthen the provision of palliative care for this group of patients. Yet, it remains challenging for professionals to identify when a person with dementia is in need of palliative care. The objective of this study therefore was to explore when professionals in long-term care settings consider a person with dementia in need of palliative care.


Teams with in total 84 professionals working in 13 long-term care settings from 6 countries (France, Germany, Italy, Norway, Poland and the Netherlands) received a case-vignette concerning a person with dementia recently admitted to a nursing home. Teams were asked to discuss when they considered people with dementia eligible for palliative care. The constant comparative method was used to analyse their answers.


Three different time points in the disease trajectory when people with dementia were considered to be eligible for palliative care were extracted: (1) early in the disease trajectory; (2) when signs and symptoms of advanced dementia are present; and (3) from the time point that curative treatment of co-morbidities is futile. Yet, none of these time points was uniformly considered by the professional teams across Europe. In some cases, professionals working in the same nursing home didn’t even reach consensus when considering persons with dementia eligible for palliative care.


The results of the study identified that professionals across Europe have different opinions regarding the time point when to consider a person with dementia in need of palliative care.
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