Abstract · Dementia syndrome relates to progressive and irreversible decline with different backgrounds. Common features of decline are that mainly the cognitive functions are influenced. The involved patients experience increasing difficulties in independent living, social adjustment and require more and more support, care and nursing. Dementia can develop at any age, but most frequently at older age and the syndrome involves increasing burdens for families, relatives and care services. Dementia at old age does not directly lead to death, but evidently shortens lifetime. Dementia at nursing homes – irrespective of other influencing agents - means a mortality factor. In our study we summarize some aspects of end-of-life decisions, caring and nursing challenges and solutions of dementia by discussing individual, social, familial and ethical consequences. Dying and palliative care are also in the focus. We put emphasis on mental hygienic support for caring family members and relatives because - besides patients - they are deeply influenced by distress and burnout risk.

Abstract · Care for people with dementia is a hard challenge for the famillies, because the critical point of this situation is that a close family member is being cared for. This is a long journey together into an unknown labyrinth, where the close family member becomes more and more distant and alienated. The family caregivers when confronted with the behaviour problems and the continous loss due to the illness haven’t got experiences about these difficulties and they must face their powerlessness hopelessly in their every day life. Very often religious faith, old memories, love, and the respect of human dignity give strength for them. After all, the coping resources of the family are the determinant factors in the process of decision-making about the institutional placement.