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Palliative Care Principles Dementia — MRCPsych Paper B MCQ

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ModerateOld Age PsychiatryPalliative Care Principles DementiaMRCPsych Paper B

An 82-year-old woman has recently been diagnosed with Alzheimer's disease. She has mild functional impairment and is not thought to be approaching the end of life. Which statement best reflects NICE guidance on when palliative care should be offered to people living with dementia?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Offer it from diagnosis as flexible, needs-based care that reflects unpredictable progression.

NICE NG97 recommends offering flexible, needs-based palliative care from the point of dementia diagnosis, recognising that the course of dementia is unpredictable. Therefore, palliative principles are not restricted to imminent dying and should be adapted to the person's evolving physical, psychological, social and care needs. Option E confuses palliative care with care confined to the terminal phase; anticipatory healthcare planning becomes particularly important when the person is approaching the end of life. Loss of capacity is not a prerequisite, making C incorrect, and early planning is preferable while the person can participate. NICE specifies no cognitive-test threshold, excluding D. Care is offered according to need rather than only following a specific request, excluding E.

Reference: National Institute for Health and Care Excellence. Dementia: assessment, management and support for people living with dementia and their carers (NG97), section 1.10, recommendation 1.10.1. 2018; updated June 2025. https://www.nice.org.uk/guidance/ng97/chapter/Recommendations