Caring for Dementia Patients at End of Life
By : Hospice & Palliative Care Association of New York State ( HPCANYS )
There are more than five million Americans living with Alzheimer ’ s Disease and it is the sixth leading cause of death in this country . In fact , in 2014 , 14.8 percent of patients admitted to hospice had a primary diagnosis of dementia . Dementia is defined as a group of disorders involving mental decline that typically interferes with activities of daily living and affects at least one core mental function , such as memory , language , visuospatial or executive functioning ; Alzheimer ’ s disease accounts for 70 % of all dementias .
Being a caregiver for someone with Alzheimer ’ s requires flexibility and patience . It can require making changes in everyone ’ s lifestyles in ways that they don ’ t like and can ’ t imagine . As the abilities of a person with Alzheimer ’ s change and functioning independently becomes more difficult , caregivers take on greater responsibility . Sadly , Alzheimer ’ s only gets worse . There will be good days and bad days , but the bad days will get worse and the good days will become more and more rare .
While it is important for everyone to plan for the future , it is especially critical for those with an Alzheimer ’ s diagnosis to consider advance care planning . Early planning allows the person with dementia to be involved and express his or her wishes for future care and decisions . This eliminates guesswork for families , and allows for the person with dementia to designate decision makers on his or her behalf . In addition to sharing the patient ’ s wishes with family , advance directives should also be discussed with doctors and other health care providers to ensure they ’ re aware of their patient ’ s wishes .
People with cognitive impairment may require both drug treatment and other types of support . The National Institute on Aging supports a team approach integrating the services of physicians , nurses , other health care professionals , social workers and community organizations . This approach may improve medical and behavioral outcomes for both the patient and caregiver .
The advanced stages of Alzheimer ’ s disease last on average between 1.5 and 2 years , but for 20 to 30 percent of patients , the disease can manifest symptoms for as long as 15 years .
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25 Adviser a publication of LeadingAge New York | Spring 2017