Difficult Decisions Associated with End-Of-Life Dementia
It can be easy to forget the terminal nature of Alzheimer’s and Parkinson’s Disease because the patients can sometimes live for many years with such conditions. Caregivers should remember that these will ultimately result in death and that they should plan accordingly.
Difficult Choices
As dementia progresses, the patient will exhibit lowered cognitive ability, a significantly impaired memory, and the inability to make sense of relatively simple concepts. These impairments of the mind can make the patient’s ability to communicate their desires and express physical discomfort. It can be challenging to determine, for instance, if a loved one with dementia is refusing to eat due to their mental confusion or because of the naturally decreased appetite associated with the dying process. Likewise, it can be easy to confuse an expression of physical discomfort with aggression stemming from confusion.
Providing spiritual and emotional comfort for those with dementia can pose a challenging feat. Will a loved one understand how you feel about them? Will family members have their goodbyes understood by a grandparent with advanced Alzheimer’s disease? Will discussing precious memories provide comfort or further confusion and frustration? During these times, when family members and friends don’t know how to give support to a dying loved one with dementia, skilled palliative care and hospice professionals can be an immensely helpful bridge to patient comfort.
Providing Comfort Via Sensory Stimulation
One approach to providing comfort to a loved one with dementia is through more universal comfort zones — primarily soothing sensory inputs. Enjoyable music and sounds associated with nature can have a dramatically positive effect on the mood of these patients. Gentle massaging of the hands and feet can help to relax those experiencing discomfort and confusion. These sensory techniques are some of the most beneficial modes of providing comfort to those with dementia.
Determining Proper Ongoing Care
When nearing the end of life for an Alzheimer’s or Parkinson’s patient, it is crucial to decide which treatment is going to provide the best possible quality of life. Some medications can delay symptoms for a while. Other drugs can limit some unfavorable behavioral problems. While this is the case, some caregivers may not feel comfortable administering medications intended for later-stage Alzheimer’s disease. Other concerns may be whether or not the drugs will, in fact, improve their quality of life or if they come with adverse side effects. When making treatment decisions, the positive and negative outcomes should be weighed to make the best decision possible. Ultimately, a caregiver may need to make the appropriate treatment decisions based on the ongoing condition of the patient — sometimes weighing extending life against increasing the quality of the time they have left.