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continued:

Alzheimer's disease: Anticipating end-of-life needs

Consider hospice or palliative care

Hospice care focuses on pain management and comfort care at the end of life. Hospice care is typically reserved for people who have fewer than six months to live. Because this time frame can be difficult to predict in end-stage Alzheimer's, hospice care is generally considered appropriate when a person who has end-stage Alzheimer's:

  • Has lost the ability to communicate in any meaningful way
  • Can no longer walk without assistance
  • Has at least one dementia-related medical complication, such as aspiration pneumonia, urinary tract infection, infection or weight loss

Hospice care can be provided anywhere, including a nursing home. If your loved one lives longer than six months after starting hospice care, the benefit can be extended. Likewise, you can choose to stop hospice care at any time.

Palliative care — which aims to improve quality of life for people who have advanced illnesses — also may be appropriate. Unlike hospice care, palliative care is available at any time during a serious or life-threatening illness. It's offered in conjunction with other medical treatment and is meant to help ease symptoms, relieve pain, address spiritual and psychological concerns, and maintain dignity and comfort.

Connect through the senses

Even if your loved one doesn't recognize you or can't communicate verbally, you can still show reassurance and love. To maintain a connection, use your loved one's senses:

  • Touch. Hold your loved one's hand. Brush his or her hair. Gently massage your loved one's hands, legs or feet.
  • Smell. The scent of a favorite perfume, flower or food may be comforting.
  • Sight. Show your loved one a video with scenes of nature and soft, calming sounds. If your loved one lives in a facility with a bird cage, take him or her to watch the birds.
  • Hearing. Read aloud, even if your loved one can't understand the words. The tone and rhythm of your voice may be soothing.

Dying with dignity

Helping someone who has Alzheimer's through the last years of life is a difficult journey. As the disease progresses, you'll make more decisions for your loved one. Among the most profound are decisions that ensure respect, dignity and physical comfort until the end of life.

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References
  1. Dementia care practice recommendations for assisted living residences and nursing homes. Alzheimer's Association. http://www.alz.org/national/documents/brochure_DCPRphase3.pdf. Accessed Dec. 2, 2010.
  2. End-of-life care. Alzheimer's Association. http://www.alz.org/documents/national/endoflifeEI.pdf. Accessed Dec. 2, 2010.
  3. Late-stage care. Alzheimer's Association. http://www.alz.org/national/documents/brochure_latestage.pdf. Accessed Dec. 2, 2010.
  4. Palliative care: The relief you need when you're experiencing the symptoms of serious illness. National Institute of Nursing Research. http://www.ninr.nih.gov/NewsAndInformation/NINRPublications/. Accessed Dec. 2, 2010.
  5. Van der Steen JT. Dying with dementia: What we know after more than a decade of research. Journal of Alzheimer's disease. 2010;22:37.
HQ00618 March 1, 2011

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