Panting for Breath in End-Stage Dementia

Abstract

Abstract When a person with advanced dementia develops respiratory symptoms, infection, pulmonary embolism, and heart failure are considerations. Pneumonia often has a high mortality rate and high symptom burden. While a decision to focus on palliative treatment is often appropriate, even with prior discussions families may experience considerable distress. Dyspnea can usually be controlled with opioids, typically morphine. Other symptoms, such as reduced oral intake and dehydration, pain, fever, and neuropsychiatric symptoms, are also discussed. The need for careful symptom monitoring, preferably with observation scales, and swift interventions to alleviate the symptom burden is highlighted. Family support and guidance on a daily basis are important treatment foci.

Authors 4

1. Hermien W. Goderie-Plomp Aachen Department of Public Health and Primary Care

   Radboud University Medical Center · Radboud University Nijmegen · Leiden University Medical Center · Queen's University Belfast · University of Missouri

   Affiliation as printed

   Associate Professor Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands

   Department of Family and Community Medicine University of Missouri, Columbia, Missouri USA

   Elderly Care and Palliative Care Physician De Zellingen, Rotterdam The Netherlands Lecturer in Palliative Care

   Lecturer in Pharmacy Practice School of Pharmacy, Queen's University Belfast, Belfast United Kingdom

   Leiden University Medical Center, Leiden The Netherlands

   Senior Researcher Radboud university medical center, Department of Primary and Community Care, Nijmegen The Netherlands

2. Carole Parsons Aachen Department of Public Health and Primary Care

   Radboud University Medical Center · Radboud University Nijmegen · Leiden University Medical Center · Queen's University Belfast · University of Missouri

   Affiliation as printed

   Associate Professor Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands

   Department of Family and Community Medicine University of Missouri, Columbia, Missouri USA

   Elderly Care and Palliative Care Physician De Zellingen, Rotterdam The Netherlands Lecturer in Palliative Care

   Lecturer in Pharmacy Practice School of Pharmacy, Queen's University Belfast, Belfast United Kingdom

   Leiden University Medical Center, Leiden The Netherlands

   Senior Researcher Radboud university medical center, Department of Primary and Community Care, Nijmegen The Netherlands

3. David R. Mehr Aachen Department of Public Health and Primary Care

   Radboud University Medical Center · Radboud University Nijmegen · Leiden University Medical Center · Queen's University Belfast · University of Missouri

   Affiliation as printed

   Associate Professor Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands

   Department of Family and Community Medicine University of Missouri, Columbia, Missouri USA

   Elderly Care and Palliative Care Physician De Zellingen, Rotterdam The Netherlands Lecturer in Palliative Care

   Lecturer in Pharmacy Practice School of Pharmacy, Queen's University Belfast, Belfast United Kingdom

   Leiden University Medical Center, Leiden The Netherlands

   Senior Researcher Radboud university medical center, Department of Primary and Community Care, Nijmegen The Netherlands

4. Jenny Theodora van der Steen Aachen Department of Public Health and Primary Care

   Radboud University Medical Center · Radboud University Nijmegen · Leiden University Medical Center · Queen's University Belfast · University of Missouri

   Affiliation as printed

   Associate Professor Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands

   Department of Family and Community Medicine University of Missouri, Columbia, Missouri USA

   Elderly Care and Palliative Care Physician De Zellingen, Rotterdam The Netherlands Lecturer in Palliative Care

   Lecturer in Pharmacy Practice School of Pharmacy, Queen's University Belfast, Belfast United Kingdom

   Leiden University Medical Center, Leiden The Netherlands

   Senior Researcher Radboud university medical center, Department of Primary and Community Care, Nijmegen The Netherlands