Coronavirus (COVID-19) - dementia and COVID-19: action plan

Palliative and end of life care

• We want people who have dementia to get the care that is right for their individual circumstances. In order to achieve this, it is important for clinical teams to have sensitive, timely and focussed conversations with individuals living with dementia, their loved ones and those with Power of Attorney (where appropriate) about their care wishes, should there be a risk of them becoming seriously ill. It is only by having such sensitive and compassionate conversations with people living with dementia and their loved ones, that they will get the care that is right for them when time becomes short.
• To support healthcare teams in having such discussions, the Chief Medical Officer issued COVID-19 Anticipatory Care Planning (ACP) guidance for people with dementia in September 2020. Aimed mainly at Primary Care teams, it complements and enhances existing ACP guidance and was developed in collaboration with The Life Changes Trust, Alzheimer Scotland and Healthcare Improvement Scotland.
• It is important to recognise that in some cases of overwhelming illness, particularly in individuals with significant or multiple pre-existing conditions, some treatments such as Cardiopulmonary Resuscitation (CPR) may not be effective. This can often be a difficult subject to discuss, however it is important for healthcare teams to be open and realistic with people and their loved ones, about whether this treatment is likely to be successful given the specific medical circumstances of the individual. However, we want to build on our learning from earlier in the year and have developed a range of tools to support healthcare teams in taking a more person centred and sensitive approach when having these sensitive discussions.

Commitment 18: We will continue to implement the COVID-19 Dementia Anticipatory Care Guide to help those living with dementia, and their families. Through national service improvement support from Healthcare Improvement Scotland and the two national dementia workforce programmes, health and social care staff are supported to use this guide to help those living with dementia, and their families, plan the care that is right for them.