When a doctor tells an individual that they have dementia, this mean that their brain has a condition where they have problems with thinking and memory (Types of Dementia, 2005). As time progresses, dementia leads to loss of memory, loss of reasoning and judgment, personality and behavior changes, physical decline and death (Caring for a Person with Dementia, 2005). However, dementia patients are not the only ones who suffer from the progression of their condition. The care for dementia patient falls upon their families. While the family transitions into a caregiver role and the dementia patient needs are being met, how does the
At the end of life: Many people can die from dementia; however they can also die with another disease which doesn’t relate to their dementia even though they suffer it. Usually, the dementia will be that far advanced towards the end of life the individual may not even know what is happening or may even be too ‘ill’ to understand. However, it is important as a care worker or any professional that is trained in end of life care (palliative care) to ensure the best quality of life until the end. Each individual should be treated equally, yet individually. These individuals must not be overlooked and still have rights as well as everybody else.
Even if a person with dementia can no longer make complex decisions, it is likely that they can make more basic decisions. Every effort should be made to get their input wherever possible. Once the person with dementia begins to lose capacity it is important that their carer and/or health care professionals are consulted and involved in decision making. This method is called the multidisciplinary approach. Macmillan Cancer Support (2012) describe a multidisciplinary team (MDT) as a group of doctors and other health professionals with expertise in a specific cancer, who together discuss and manage an individual patient’s care, planning the best treatment for the individual patient.
Having a dignified approach and respecting elderly patients in a palliative care unit is important because it is enabling them to have control over their care and treatment. This is going to help the patient to feel valued and throughout their last days of life, as they have a choice. (Social care institute for excellence, 2010). By making the patient feel as comfortable and as pain-free as possible, it will help encourage family members to respond in a positive way. This is because they are seeing that their relative is in a comfortable state.
The World Health Organization (WHO, 2017) defines palliative care as a care that improves quality of life of patients and families who are facing problems associated with their life-threatening illness. This is by preventing and relieving suffering by the early identification, immaculate assessment, treatment of pain, and other problems like physical, psychosocial and spiritual issues. The goal to palliative care is to not only treat the patient but also provide comfort to both the patient and family members. Therefore the review of these literatures will provide insight on the barriers and specific needs that a patient with dementia may have.
What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and
Researchers said that patients with advanced dementia are at risk for undertreatment of pain and being treated with burdensome and nonbeneficial interventions, such as being attached to a feeding tube in their last moments of life. The study followed 323 patients in 22 different nursing homes for 18 months. All of the patients were diagnosed with advanced dementia. By the end of the study, more than half, at 54.8%, of the patients being observed had died. Out of those who had passed away, about 40% of the patients were hospitalized, were attached to a feeding tube or experienced some type of “burdensome intervention” during a few months before their death. Patients were less likely to undergo “burdensome interventions” and were more likely to have palliative care in their final moments alive when caretakers were aware of the poor prognosis and expected clinical complications when dealing with advanced dementia. Researchers said that recognition for advanced dementia as a terminal illness will provide an alteration to the care process towards advanced dementia by improving comfort rather than focusing on extending the patient’s life; a better
Palliative care approach is stated in the 2016 Australia ‘Clinical practice guidelines and principles of care for people with dementia’ which can promote quality and care consistency (Durepos rt al., 2017 Dyer et al., 2016) An Australian systematic review found person centred palliative approach can improve the quality of life for people with dementia and their family, reduce an individual symptoms, lessen caregiver burden, safeguard that treatment decisions are well informed and in the framework of the individual and family needs and goals (Hines et al., 2010; Mitchell., 2017)
We were all taught from a young age, that lying is a sin, that it should not be done and nothing good can come from lying. Researchers have come to the conclusion that this is not the case when it comes to caring for the elderly with dementia or Alzheimer 's. In most cases lying can be beneficial and therapeutic to people with cognitive diseases and or disorders.
The provision of palliative care services needs to improve. The RACF in Australia, for example, should be able to deliver the person-centred care approach that consumers with end-of-life dementia require. Behavioural and psychological symptoms of dementia should be considered as a priority to enable proper management and care for consumers in the end-stage of the disease. RACF organisations need to focus on appropriately training staff in palliative care, advance care planning, and the effects the burden of dementia has on the consumer such as pain and distress. Moreover, it is important that staff have good communication with the family about the consumer's advance care plan and wishes and that these preferences are documented when the consumer
BWV who was a 69-year-old woman resided in a nursing home in Victoria. She suffered from a progressive and fatal dementia, probably Pick’s Disease. Although she was ambulant, she was not able to communicate properly with anyone apart from her husband; therefore, her husband agreed to use artificial feeding via percutaneous gastrostomy (PEG) tube insert into her body. Subsequently, her condition became to persistent vegetation and she stayed approximately three years in hospital before her husband to request artifical feeding cease. However, BWV’s husband was not sure whether it would be lawful or not to withdraw the PEG tube from her body in Victoria; hence, he sought for assistance from the Public Advocate Victoria (PAV) who was
Nurses have to understand what the concept of power means which will have an outcome in the efficacious of care. Also giving more power to patients by spreading the knowledge will encourage them to participate in self-care (McMahon 1990). Clover et al. (2004) state that some of the patients being in the position where there was a lack of the power often escaped to the passive role where they were negotiating the rules of the nursing care provided. However, in some occasions the power between the nurses and their patients is not properly understood. In a palliative care management, the power in meaning of the control is very important for the patients, so deep analysis and understanding is necessary in this case (Morgan 2001). According to Henderson (2003) the ideal power giving in the nurse’s opinion is decision making with patients and sharing important information. Although some of the nurses believed that their opinion is the most important as they are the clinical experts and rather unwishful to share decisions together with their clients. When
Several ethical considerations of death and dying issues such as those addressed by hospice and palliative care services based on the right to die pain-free and with dignity often starts with communicating barriers, poor symptoms management and shared decision-making concerns. (Weisman, 1972). Ethical consideration can often be balanced by creating the best possible care while involving all participants, hospice and palliative care patients that are involved in the sick persons care including: family members, the patients and the caregiver all, should sympathetically work together to acknowledge and communicate end-of-life experience. According to Blendon, Szalay, & Knox, but the dying person must make decision unless they are incompetent. “Palliative care
The main problem for a family that has a dementia patient is the extra care that is to be given to the patient. Most of the time they are not aware of the full details of the condition and are ill equipped to cater to the requirements of the patient. The two options that people go for are in-house care with a private nurse or a dementia care home. Most countries have dementia care centres that specially cater to the condition. Care centres are evolving from the common mould of elderly homes where the patients are sequestered in to centres that actually improve the patients’ lifestyle through thoughtful programmes and activities.
Caregivers play an integral role in improving the quality of life for hospice patients. Most of the individuals involved in caring for the terminally ill are family members. However, caring for terminally ill patients can adversely affect the caregiver’s overall health. Gallese, Keysers and Rozzolatti (2004) emphasize that caregivers suffer from worse physical and mental health compared to their non-caregiving counterparts. One of the major causes of poor physical and mental health amongst caregivers entails the high level of stress associated with the care giving role. The caregivers’ stress is caused by a multitude of stressors such as role adjustment, end-of-life decision making and financial strain. Alternatively, stress also arises from the patient’s suffering (Hebert, Arnold & Schultz, 2007).