Kerstin Stieber Roger, PhD, Assistant Professor, Department of Family Social Sciences, Faculty of Human Ecology, University of Manitoba, Winnipeg, MB.

This article discusses current research in the social sciences on end-of-life care and people living with dementia. Given the projected increase within the next twenty years of older adults living with dementia, end-of-life care for this demographic will become more relevant than ever before. The main themes emerging in the literature are discussed in this article: personhood, decision-making, counselling and spirituality, pain management, training for professionals, and settings of primary care. Recommendations for further research are offered.
Keywords: care, dementia, end-of-life, family, personhood.

D’Arcy Little, MD, CCFP, lecturer and Academic Fellow, Department of Family and Community Medicine, University of Toronto; Director of Medical Education, York Community Services; 2002 Royal Canadian Legion Scholar in Care of the Elderly, Toronto, ON.

Part II of this series briefly reviews the literature on the success of family therapy in families with dementia. A case from the author’s practice (with significant details modified to conserve privacy) is then presented with a view toward applying family therapy. Finally, as the author has an interest in medical education, a proposal on how to integrate family therapy for families with dementia into an educational program is briefly described. The author welcomes comments and suggestions at darcy.little@geriatricsandaging.ca.
Key words: dementia, Alzheimer’s disease, family therapy, family, Systems Theory.

D. Little, MD, CCFP, Lecturer and Academic Fellow, Department of Family and Community Medicine, University of Toronto; Director of Medical Education, York Community Services; 2002 Royal Canadian Legion Scholar in Care of the Elderly, Toronto, ON.

Seniors are one of the fastest growing population groups in Canada.¹ Approximately 20% of our population is over the age of 65, and this phenomenon has been referred to as the “graying” of the population.^1,2 Families often play a central role in the lives of older people. “Life’s rhythms and seasons” are usually marked within the context of the family.³ Whether independent or dependent, older people view the family as integral to their daily life and wellbeing.⁴ When dependent, the family offers crucial support,³ especially in cases of dementia. Alzheimer’s disease (AD) is the most common cause of severe intellectual deterioration in the aging.5 Approximately 8% of people over 65 years and 35% of people over 85 years suffer from dementia.6 The majority of patients with dementia live in the community and are cared for by family and/or friends.⁷ However, research into and the clinical application of family therapy techniques and principles in older people and their families has been slow to develop.