Reflective accounts

Palliative and end of life care

A CPD article improved Anne O’Reilly’s knowledge of palliative and end of life care for people with dementia.
nurse and patient

A CPD article improved Anne OReillys knowledge of palliative and end of life care for people with dementia.

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The CPD article discussed the difference between palliative care and end of life care. It explored the provision of dementia care in care homes and how to optimise palliative and end of life care.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?

I have learned that everyone deserves a good death, which can mean different things to different people. For patients, a good death may include providing effective pain management; ensuring privacy and dignity; dying in their preferred place of care; and having family and friends with them.

The article stated that palliative care should be commenced in

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A CPD article improved Anne O’Reilly’s knowledge of palliative and end of life care for people with dementia.

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The CPD article discussed the difference between palliative care and end of life care. It explored the provision of dementia care in care homes and how to optimise palliative and end of life care.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?

I have learned that everyone deserves a ‘good death’, which can mean different things to different people. For patients, a ‘good death’ may include providing effective pain management;  ensuring privacy and dignity; dying in their preferred place of care; and having family and friends with them.

The article stated that palliative care should be commenced in a timely manner to optimise the care of people with dementia in care homes. I have learned the importance of involving people with dementia and their families in discussions about palliative and end of life care as much as possible.

An advance care plan should also be in place to inform decision making and care provision in the future. This may lead the patient to make an advance statement, a record of their wishes, or an advance decision to refuse treatment.

The article provided valuable information about the Gold Standards Framework and the 7Cs (communication, coordination, control of symptoms, continuity, continued learning, carer support and care in the dying phase), tools used to deliver effective palliative and end of life care. The 7Cs emphasise the importance of multidisciplinary team working in meeting the needs of the person with dementia.

How did you change or improve your practice as a result?

In my role as a community dementia nurse specialist I am often involved in discussing palliative and end of life care with patients who have dementia and their families. These can be challenging conversations about an emotive subject. In some cases, these discussions take place when the patient is in the later stages of the disease, which means they may not be able to be actively involved in the discussion.

The CPD article has increased my awareness of the need for these conversations to take place at the earliest opportunity.

I plan to initiate these conversations sooner, and I will make this change to my practise. I will also ensure the patient and their family are given appropriate information about dementia and its disease trajectory, enabling them to think about the future.

I will use the knowledge I have gained from reading the article to explain to others what may be involved in palliative and end of life care.

I will ensure that members of the multidisciplinary team are included in advance care planning to organise the process and ensure that we are working towards the same goal.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

One theme of the Code is to prioritise people by considering their needs and including them in decision making. Engaging in advance care planning and decision making helps to ensure that the person with dementia receives safe and appropriate care.

The information about The Gold Standards Framework and the 7Cs offers guidance and recommendations for palliative and end of life care, enabling healthcare professionals to practise effectively.

Anne O’Reilly is a community dementia nurse specialist at Central London Community Healthcare NHS Trust, London


This reflective account is based on NS849 Mitchell G et al (2016) Palliative and end of life care for people living with dementia in care homes: part 1. Nursing Standard. 30, 43, 54-60.

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