The majority of studies were not experimental in
design but descriptive, so could only begin to address
aspects of care that should be stopped and deficits in
existing approaches to care. Downs et al. (2006) have
noted how end-of-life care for people with dementia
has yet to develop interventions that address the
particular challenges that dying with dementia poses.
The few studies that did develop dementia specific
tools to guide end-of-life care and outcome measures
specific to improve comfort and communication
demonstrated both what could be achieved and how
much more needs to be done. That none of this work
was undertaken in patients’ homes or involved family
physicians and community nursing staff is significant
and of concern.