The Fife Dementia Strategy: 2010 – 2020 - The Knowledge Network

consistent with the principles laid out in legislation 76 such as the Adults with
Incapacity (Scotland) Act 77 .
As dementia progresses the person loses cognitive function which may make
it difficult for them to communicate their views and wishes. This, in turn, often
results in formal care staff turning to the carer for assistance in decision
making which may increase the emotional burden on the carer. End of life
planning must take place early by an individual trained in communication and
counselling and while the person with dementia has sufficient mental capacity.
This could include advance care statements or lasting power of attorneys. IN
developing such plans service users should be offered support from advocacy
organisations. Providers of care must be aware of such plans, ensure they are
recorded and communicated to care staff and appropriately utilised.
A palliative care approach should be used as appropriate alongside the active
management of dementia using person centred care following the diagnosis.
The Gold Standard Framework for palliative care of people with dementia and
the Liverpool Care Pathway are important parts of the dementia specific
Integrated Care Pathway and will be implemented as a part of the Local
Action Plan for Living & Dying Well which is a comprehensive plan aimed at
improving palliative and end of life care for people in Fife living in a variety of
settings including their own homes, care homes and in hospital. It focuses on
improving joint working to ensure that timely, holistic and effective care
planning is available for those with palliative and end of life care needs and is
carried out in a manner which is person centred and responsive to the needs
of the person. The action plan aims to achieve this by improving staff
education and training across all health and social care sectors, developing
multi-disciplinary palliative care networks, and introducing standardised
methods for assessing and delivering palliative and end of life care.
In order to ensure people with dementia are cared for using a palliative
approach, dementia will be included in the implementation of the Living &
Dying Well local action plan, and recognised as a progressive and incurable
condition which benefits from a palliative approach. Staff working in the
community will work in partnership with care home staff to undertake training
on palliative and end of life care.
Palliative Care Champions Delivering Training across Care Services
Palliative Care Champions in Fife Council care homes have been trained
by the NHS Fife Macmillan Cancer and Palliative Care Educator within to
facilitate small groups of care workers through a training programme with
the assistance of experiential discussions and learning, and work
booklets. The programme, the Macmillan Foundations in Palliative Care,
has four focal areas: principles of palliative care; bereavement; pain and
symptom management; and communication.
76 Roger KS (2006). A literature review of palliative care, end of life and dementia. Palliative
and Supportive Care. 4(3): 295-303.
77 Adults with Incapacity (Scotland) Act 2000.
84