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Alzheimer's disease: Anticipating end-of-life needs
Consider hospice 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.
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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- 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. 17, 2008.
- End-of-life care. Alzheimer's Association. http://www.alz.org/documents/national/endoflifeEI.pdf. Accessed Dec. 17, 2008.
- Late-stage care. Alzheimer's Association. http://www.alz.org/national/documents/brochure_latestage.pdf. Accessed Dec. 17, 2008.
- Sachs GA, et al. Barriers to excellent end-of-life care for patients with dementia. Journal of General Internal Medicine. 2004;19:1057.
- Fast fact and concept #150: Prognostication in dementia. American Academy of Hospice and Palliative Medicine. http://www.aahpm.org/cgi-bin/wkcgi/view?status=A%20&search=125&id=659&offset=0&limit=25. Accessed Dec. 17, 2008.
