Patients with dementia are often burdened by their symptoms, while adequate symptom control is crucial to maintain or enhance quality of life. Most Americans with dementia eventually become admitted to, and die in long-term care facilities. Prevalent and important symptoms at the end of life are pain, agitation, and shortness of breath. A holistic approach must be the focus of optimal symptom control due to the fact that symptoms may be interrelated (i.e. pain may be associated with agitation).
Adequate symptom control in dementia can be achieved with a deeper understanding of the longitudinal course of symptoms and the treatment provided. A recent study aimed to explore changes in symptoms and provided treatment for Dutch nursing home residents in varying stages of dementia during their nursing home stay. The study also explored the longitudinal association between pain and agitation, and between stage of dementia and symptoms.
The study found that pain and agitation were prevalent and frequently persisted in residents with dementia during their stay at the nursing home. However, symptom management intensified only at the end of life. Symptom control may not be adequate enough from admission, and stronger attention must be given to symptom control at an earlier stage than the end of life.