Fin de vie et maladie d'Alzheimer : étude rétrospective dans un service de gériatrie

End-of-life care for patients with end-stage Alzheimer's disease is increasingly important because of the rising number of patients with this disease. This article presents a study in Paul-Brousse Hospital (AP-HP) and reviews palliative care interventions for patients with Alzheimer's disease and other dementias. Data were collected from clinical and nursing records referring to the last 30 days of life: mental status, autonomy, comorbidities, symptoms and treatments (antibiotics, analgesics, antidepressants and nutrition/hydration). Thirty-three deaths among 182 hospitalized patients (18.1%) were retrospectively analyzed during the 4.5-year period study. The most frequent associated pathologies were infectious diseases (94%) and malnutrition (78.8%). Almost 42.4% of the patients had pressure sores. The main symptoms were: pain (100%), respiratory tract secretions (75.7%), fever (42.4%) and agitation (21.2%). The majority of patients received nutritional support (94%) and hydration fluids (64%) orally. Patients were frequently given antibiotics (71.6%), and antidepressants (48.5%). Attention to physical suffering was good; all the patients with pain had an analgesic with morphine in 82% of the cases. Our conclusion is that the need for a palliative approach to care in end-of-life dementia should be recognized.