End-Stage Dementia Program

Author

AseraCare Hospice

Posted on

Jun 09, 2021

Book/Edition

Nebraska - Eastern Region

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Older adults with dementia and their caregivers face serious challenges. Dementia symptoms can include confusion, agitation and memory loss, which may lead to feelings of anger and frustration. But with education and support, you can maintain a positive relationship and help create a calm, comforting environment.
Amedisys is here to help bring more peaceful, gratifying moments into your loved ones end-of-life dementia care. Our specialized end-stage dementia program helps improve the quality of life of our patients and their families through education, support, pain and symptom management, and caregiver empowerment. We provide compassionate end-of-life care wherever your loved one calls home.

Did You Know? Your loved one is not alone. An estimated5.5 million Americans have Alzheimers disease, the most common form of dementia among elderly people.

End-Stage Dementia Program Highlights

Focus on improving quality of life while managing the symptoms of dementia
Specialized care from a diverse team of professionals who have intensive training in end-stage dementia care
Dementia care that is backed by the latest research and goes beyond medications
Personalized hospice and palliative care planning tailored to the older adults needs and wishes

How Hospice Care at Home Helps With Dementia
Every familys journey is different. Well work with you to create a home hospice care plan that focuses on what matters most to you and your loved one. Elderly people with dementia receive care from a compassionate team of nurses, social workers, hospice aides, chaplains, bereavement counselors and trained volunteers, in conjunction with their doctor. Our end-stage dementia hospice program offers:

Pain and symptom control so older adults with dementia can spend quality time with their caregivers and loved ones
Nonverbal pain and behavior assessment
Medical care, including visits by a nurse, for acute conditions like infections, behavioral issues and breathing difficulties
Help with nutrition and specialized feeding needs
Skin assessment and protection
Help with bathing, grooming and personal care from a hospice aide
Medications, medical equipment and supplies related to dementia
Spiritual support with a hospice chaplain
Emotional support and resources for the patient and family from a hospice social worker

Improving Your Loved Ones Quality of Life
In home hospice care, we focus on preserving quality of life as the disease progresses, not curing dementia. In addition to pain management, some of the ways we can help older adults with dementia feel more comfortable include:

A safe, relaxed environment
Therapeutic blanket to calm unsettled behaviors
Activity lap pad with various textures and moveable parts to touch, helping to reduce agitation and increase mental stimulation
Chart-a-Life collage of memorable images that allows your loved one to relive significant past experiences and maintain mental, social and emotional functioning
Comfort musicto reduce restlessness and improve sleep, memory and social interaction
Soothing comfort baths to minimize bathing stress, agitation and safety risks
Gentle touch or massage, which provides relaxation, stress reduction, improved circulation and pain relief
Journaling as a form of communication and reflection between families and patients
Connection, compassion, communication and reassurance


Did You Know? Most elderly people (80%) with Alzheimers disease and related dementias receive care in their homes, usually provided by family or friends.

Support for Senior Caregivers
We understand the gratification, as well as the intense demands, of caring for a loved one with dementia. As the disease progresses, it can be difficult to manage dementia symptoms such as confusion and personality changes.
Senior caregivers have difficult decisions to make about their loved ones care. You also face major life decisions of your own such as needing to stop working or cut back on hours to meet the needs of a loved one with dementia. The stress can take a toll. Our specialized hospice program for dementia can help by:

Exploring family needs and expectations
Providing caregiver education and support, which allows senior caregivers to spend more time as a loved one and less time as a caregiver
Supporting loved ones as they process grief, loss, anxiety, depression and other emotions
Offering respite care, which gives caregivers a needed break to rest and recharge

Dementia Symptoms We Address in Hospice Care
In our end-stage dementia program, we address safety concerns and treat the following symptoms of dementia:

Unsettled behaviors such as restlessness, confusion and Sundowners Syndrome (late-day confusion)
Pain
Fear
Depression
Fatigue
Skin breakdown
Altered nutrition

Goals of Dementia Care in Hospice
Some of the goals of our end-stage dementia program include:

Improve comfort and quality of life for patients and senior caregivers
Create lucid moments for the patient
Increase family support and satisfaction
Avoid unnecessary trips to the hospital

What Are the 7 Stages of Dementia?
Your loved ones healthcare provider may talk with you about the stages of dementia. This is a way to determine how an older adults dementia symptoms have progressed and find the best treatment for their needs.
There are several scales for rating dementia. One of the most commonly used for older adults with Alzheimers disease is the Reisberg Scale, or Global Deterioration Scale. This scale describes the seven stages of dementia, based on the severity of an elderly persons symptoms. Because people dont typically get diagnosed with dementia in the first three stages, stage 4 is considered early dementia, stages 5 and 6 are middle dementia, and stage 7 is late-stage dementia.
Dementia Stage 1:Normal functioning, with no memory loss or mental health issues
Dementia Stage 2:Normal forgetfulness associated with aging
Dementia Stage 3:Loved ones may start to notice some of the following early dementia symptoms:

Increased forgetfulness
Trouble finding the right words
Slight difficulty concentrating
Decreased work performance

Dementia Stage 4:The older adults doctor can detect cognitive issues during an exam, based on the following dementia symptoms:

Difficulty concentrating
Memory loss about recent events
Trouble managing finances or traveling alone to new places
Difficulty with complex tasks
Denial
Withdrawal from friends or family

Dementia Stage 5:Dementia symptoms intensify to include:

Major memory loss that may include important aspects of current life events (e.g., date, time, address or phone number)
Need help with some daily activities such as bathing and cooking

Dementia Stage 6:Significant declines lead to some of the following dementia symptoms:

Need extensive help with daily activities
Memory loss that may include recent events and names of close family members
Difficulty with tasks like counting down from 10
Incontinence (loss of bladder/bowel control)
Trouble speaking
Personality changes
Compulsive or repetitive behavior such as cleaning
Agitation

Dementia Stage 7:In end-stage dementia, the older adult may have the following additional symptoms:

Inability to speak
Need assistance with most daily activities
Inability to walk


Did You Know? In 2016,18%of hospice Medicare beneficiaries had Alzheimers disease or dementia as their main diagnosis.

When to Call Hospice for Dementia
Dementia is a chronic disease that sometimes follows an unpredictable course. For this reason, it can be difficult to determine the life expectancy of an elderly person with dementia. So how do you know when itstime for hospiceand palliative care?
For many families, an important consideration is quality of life. What are your loved ones goals of care? If comfort, patient and caregiver support, and quality of life are some of the top priorities, hospice care may be the best choice. We can help you gather information, make a plan and determine if your loved one is eligible for hospice care.
Signs of end-stage dementia may include:

Having trouble eating and swallowing
Limited speech, or being unable to speak
Incontinence (loss of bladder/bowel control)
Needing help to walk, or being unable to move without help
Needing help with daily activities like eating, bathing and getting dressed
Developing infections such as pneumonia
Being diagnosed with another condition such as COPD, heart failure or cancer
More frequent trips to the hospital
Feeling more agitated or restless
Memory loss, which may lead to inability to recognize friends and family

We can help you decide if it is time to bring in an Amedisys hospice care team to provide additional care and support. Hospice care provides relief for both patients and caregivers. Many families tell us their biggest regret is not getting hospice care sooner.

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Do Therapy Dogs Help Alzheimers Dementia Patients?

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Successful Communication When Your Loved One Has Dementia

When someone you love has dementia, youll notice that things are changing quickly. When they make mistakes and fumble with the little things, our instinct is to correct and remind. Thats to be expected. After all, youre hoping that a little push and a dose of reality would be enough to lead them back to the person you know and love.As you will see below, corrections and reminders wont always work. Effective communication with a dementia patient requires an adjustment of expectations. In the following, well get you started.Forced choicesEveryone likes to have a choice. But having too many options can actually be confusing to a patient with dementia. Thats because their working memory is operating in limited capacity. Working memory is where the brain retains just the right amount of information to finish a task think of dialing a new phone number. So you can see how loss of working memory can be problematic in conversation and hinder decision-making.Thats where the forced choice method can lift that burden for your loved one, and cut the confusion. Watch the video here.Help with sequencingWe take basic daily tasks for granted: eating, standing, brushing our teeth. Though these tasks feel natural and automatic, we rely on the frontal lobe to help us complete these tasks. When someone is experiencing dementia, the brain degeneration can make them lose their ability to access this command center. When you see your loved one freeze, as if in confusion, you can help them through the basic task with sequencing, by breaking down the tasks into simple steps. This video about sequencing provides some examples.The therapeutic fibYou can never go wrong with the truth, or so youre taught. But when it comes to dementia and Alzheimers, the truth actually has a cruel side. Because when someone is living with degenerative memory, they sometimes lose track of key details of their loved ones. The fact that a partner or a child is deceased or gone can literally be forgotten. In cases like these, telling the truth can be devastating it will be as if theyre hearing this horrible news for the first time. This is where a therapeutic fib can get you both through the difficult moment, and this video explains how.Admit wrongdoing when youre rightSpeaking of truth, sometimes your loved one with dementia will get basic things wrong. They may insist, for example, that they cant possibly be a grandparent because in their mind, theyre only 25 years old! This can be a painful moment, because this represent a loss in your relationship with them and you want to hold on. But fighting these beliefs is futile. This video will show you how to gently move past the conversation.Repeating themselvesHearing the same story, especially if they think youre hearing it for the first time, can get frustrating. The wrong response is trying to make them understand theyve already told it. In this segment, well show you how to get through the moment.The important thing to remember is when a person has dementia or Alzheimers, the brain is going through massive changes. That can be difficult to take. Take a look at this video, Whats Happening to Their Brain?, so you can put yourself in their shoes. Understanding whats at work can go a long way in good communication when your loved one has dementia.Learn more about how we provide specialized care in our series Insights from Arthurs featuring educational videos from Arthurs Director of Development and Senior Care Consultant Deb Nygaard. 

How St. Pauls Dementia Care Programs Enhance Quality of Life

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Local Services By This Author

AseraCare Hospice

Hospice 6307 Center St Ste 210, Omaha, Nebraska, 68106

At AseraCare Hospice, we combine a foundation of clinical excellence with exceptional care and compassion to help our patients and their families, especially in the following areas of Support, Quality, Compassion and Trust