ScholarWorks@중앙대학교

초록

Introduction The rising prevalence of dementia highlights the need to ensure good quality of life for those affected. This integrative review aimed to clarify what constitutes a good death for community-dwelling people with dementia and their family caregivers and to identify structural and process factors that support or hinder its attainment. Methods Using Whittemore and Knafl's integrative review approach, a literature search was conducted in PubMed, CINAHL, Embase, Scopus and Web of Science using key terms, including dementia, community-dwelling and death. Following the screening process, 21 articles were analysed using the structure–process–outcome framework. Results Of the 21 articles included, nine explored the concept of good death, 16 addressed structural factors, and 19 examined process factors associated with quality end-of-life care that may facilitate good death. From the perspective of people with dementia and their family caregivers, a good death involves dying peacefully while preserving dignity and autonomy. Structural factors included community-based healthcare and social support resources, such as access to hospice and palliative care, a skilled professional workforce and services that support daily living and caregiver needs. Process factors included comprehensive approaches to patient care: advance care planning, symptom management, person-centred care, emergency and safety management, health management and education for family caregivers. Conclusions This review highlights that achieving a good death for community-dwelling people with dementia requires accessible, comprehensive, person-centred end-of-life care and robust support for family caregivers. Strengthening policies and developing integrated community care models are essential for upholding end-of-life dignity and honouring care preferences. Implications for Practice These findings suggest that healthcare professionals should implement community-based, person-centered care models that provide structured education and psychological support for family caregivers to facilitate a ‘good death’ for people with dementia.

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