End of life care

9. Infections

People with later-stage dementia are at greater risk of infections such as urinary tract infections or chest infections (eg pneumonia). These can be caused by lower fluid intake, swallowing problems and reduced mobility.

There is some controversy about using antibiotics to treat infections if someone has advanced dementia. However, it may be appropriate to use antibiotics to ease distress and discomfort at the end of life even if the infection cannot be cured.

The use of antibiotics should be considered on an individual basis. Doctors will weigh up the likely benefits, risk of side effects, the burden of giving the drugs, and the person's wishes (if known). If the person has recurrent infections, the care team will talk to you about what they think is in the person's interests if they have another serious infection. In particular, they may discuss with you whether admitting the person to hospital for further antibiotics – often injected into a vein – is really best for them.