Advanced dementia

[Extract] As a disease, dementia is now ranked as the third leading cause of death in Australia (Australian Bureau of Statistics [ABS], 2010) and the fourth leading cause of death among the population aged 65 years and over in New Zealand (Alzheimer's Association of New Zealand, 2013). The number of deaths directly attributed to dementia in 2010 represented 6.3% of all Australian deaths overall, demonstrating a 3.4% increase since 2001, almost doubling during this time period and expected to continue to rise with the projections previously detailed (ABS, 2010). It is highly probable that a similar pattern of increase will be reflected in the New Zealand population in worldwide trends (World Health Organization [WHO], 2012). Symptoms of advanced dementia frequently resemble those of a person dying from advanced cancer (Alzheimer's Association of Australia, 2011 b; Chang et al., 2009). This scenario suggests people with dementia would significantly benefit from the interventions traditionally directed to cancer-related end-of-life care (Mitchell, Teno, & Kiely, 2009; van der Steen, 2010); however palliative care interventions are infrequently accorded to this group of people so their needs are likely to be unmet (Chang et al., 2009; Chang & Walter, 2010). Further exacerbation of this lack of palliative care intervention may also be attributed to the person with advanced dementia possessing impaired communication (Johnson et al., 2009). As a result of this and the disease itself, the symptoms of dementia are likely to present as a challenge for family and professional carers.