Dementia,grief and dying

Abstract

Four case studies are presented to illustrate dilemmas in the care of demented people who are grieving or who are themselves dying. The grieving process is complicated in those who suffer from cognitive impairment, but patients can be helped to mourn if carers recognize their memory difficulty and facilitate learning over a prolonged period. Sometimes the grief may be exhibited as behavioural changes which may not be recognized as representing grief. Relatives' attitudes and those of staff can further complicate management of the bereaved person, but an awareness of the relatives' fears may allow staff to modify their own and relatives' attitudes, and thus assist the demented bereaved person's mourning. The person with dementia who is dying can also present a complex of problems, and an understanding of the effects of dementia is essential in allowing sensitive management of their terminal illness.