At What Point Do Dementia Patients Need 24 Hour Care
When living at home is no longer an option
There may come a time when the person living with Alzheimers disease or dementia will need more care than can be provided at home. During the middle stages of Alzheimers, it becomes necessary to provide 24hour supervision to keep the person with dementia safe.
Dont Answer Questions Of Patient/loved Ones Regarding Bad Memories
People with Alzheimer’s often ask difficult questions, mostly about people who have passed away years ago. Its not helpful to remind the patient and/or loved one that a person theyre asking about has passed away. Rather than avoid the subject, you can say, He/shes not here right now, but tell me about him/her. Often the person with memory loss is looking for the sensation and security that they would have if their loved one was around.
Caregivers and/or family members should be helping patients and/or loved ones comfortable, safe, and protected. Elderly women, for example, who have had children commonly ask, Where are my babies? This question will often come up at meal time, when feeding the children was an important part of motherhood. Find a way to soothe their concern. You could say, The babies are sleeping.
As stated earlier, trying to bring a person with Alzheimer’s the present-day reality is not effective. Caregivers and/or family members should adapt to the patient and/or loved ones reality. Its ok to go anywhere in any time period in order to communicate.
What Do You Think Is Wrong With You
I assumed that the participants had adequate insight if they were able to give the correct diagnosis or, at least, to describe adequately their main symptoms. Of the 30 participants, 14 fulfilled these criteria. Most complained of problems with memory. No participant used the word dementia, but a few were able to accurately describe their conditions. Examples are shown in the first box.
The rest of the participants either denied any problems or gave implausible explanations for their predicaments, such as: loneliness,old age,stomach upset, and the like. Four patients simply said don’t know without further elaboration.
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Celebrating The Missing Loved One
I encourage families to keep photos of the deceased loved on out on display, says David. Often, those photos and memories bring comfort.
If the individual with dementia has been able to retain that their loved one has died, you can speak about them in the past tense and share memories. Continually assess your loved ones mood. If they seem agitated or upset, offer comfort.
Listen To The Emotion Behind The Questions/words
Appreciate the fact that the person with dementia has emotional memory. Thus, dont dismiss it or underestimate its power. If the person who has died was active in the life of the person with dementia, we need to be honest about why that person is no longer here. Making up stories like hes at work, shes out right now, can leave the person with dementia expecting they are coming back and when they dont, this is more upsetting for them. So respect their right to know the truth.
Be honest but keep it simple. Use direct words and not a long explanation. If it is to initially announce that someone has died, have only one person do this task. Too many people explaining at the same time can confuse and overwhelm the person with dementia. Have one person explain that a loved one has died and offer the same comfort that you would offer if the person didnt have dementia. Gage how the person with dementia responds to see how much they are recognizing the death. Depending on where they are in the disease, they may grieve as expected or may appear more confused and continue to ask questions. Some may not react at all, again, depending on where they are in the disease process.
Read the emotion behind the words they say. Often after someone has died, the person with dementia will ask for them again and again hours, days, weeks after the death. They are unable to remember this new memory. But, they may be asking because they are worried about the person.
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Their Expression Of Grief Also Reflects Where They Are In The Disease
Some families are surprised if the person with dementia doesnt appear to be as upset as expected. Adult children can be shocked for example, that Mom isnt mourning or devastated over Dads death. They may try to remind the person that someone has died. Dont project your own grief on the person with dementia. Everyone handles grief in their own way and this is no different for the person with dementia. Add to that personal grief style, the fact that the person with dementia may be beyond processing what death means, due to where their disease is. Trying to get them to acknowledge a death if they cannot is not helpful to anyone. Let them grieve how they best can and remember, its about their feelings, not ours.
Dementia And Its Effect On A Marriage
When someone you love, in particular your spouse becomes ill, you want to help them get well. But what happens when the illness is dementia? A marital relationship that could have spanned years or decades becomes subject to enormous change, and that change is not a slow linear progression of predictability. As cognitive decline worsens, its an up and down interaction of being recognized and accepted by your spouse or not. Unfortunately, while most people have every intention of honoring their vows of in sickness and in health, many are simply unprepared for the significant emotional impact that a dementia diagnosis can have on a marriage.
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How Does Peanut Butter Detect Alzheimers
The researchers discovered that those who had an impaired sense of smell in the left nostril had early-stage Alzheimers. They noted that the participants needed to be an average of 10 centimeters closer to the peanut butter container in order to smell it from their left nostril compared to their right nostril.
At What Stage Of Dementia Do Hallucinations Occur
In a nutshell
Hallucinations are caused by changes in the brain which, if they occur at all, usually happen in the middle or later stages of the dementia journey. Hallucinations are more common in dementia with Lewy bodies and Parkinsons dementia but they can also occur in Alzheimers and other types of dementia.
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How To Cope When Your Spouse Has Dementia
This article was co-authored by Trudi Griffin, LPC, MS. Trudi Griffin is a Licensed Professional Counselor in Wisconsin specializing in Addictions and Mental Health. She provides therapy to people who struggle with addictions, mental health, and trauma in community health settings and private practice. She received her MS in Clinical Mental Health Counseling from Marquette University in 2011. This article has been viewed 50,548 times.
A part of marriage is caring for your spouse when they are sick or ailing. Although a spouse with dementia may not visibly appear sick, this person is suffering from memory loss and confusion. Watching your spouses mental abilities deteriorate may be difficult. You may feel uncertain about how to help your spouse with dementia and how to adjust to this major life change. By redefining your marriage and accepting your new roles, asking for support, and taking care of yourself, you can handle this new season of your life.
Taking Care Of Yourself
The best way to support a loved one with dementia who may be grieving is to make sure you are taking care of yourself through your own grieving process. Crossroads Hospice & Palliative Care provides caregiver resources and complimentary bereavement support in all the areas we serve. Please call us at 1-888-564-3405 to speak with a bereavement specialist.
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Arguments For Limited Truth
Arguments for limited disclosure and deception quoted by Beauchamp and Childress include the following.
Therapeutic privilege
Honesty should not be confused with cruel openness, and if disclosure of the information seems to be harmful to the patient, the physician may be justified in withholding the information or even in using benevolent deception. The therapeutic privilege has a long tradition in medical practice, although more recently it has been criticized as an example of unacceptable paternalism. Misleading the patient contributes to the cult of expertise surrounding the medical profession and to a view of physicians not as providing a service, but as guardians of a special wisdom that they may determine when, and to whom, to divulge. However, paternalism frequently appears to be unavoidable in dementia care, and some professionals still defend telling lies to cognitively impaired patients. After all, anxiety, depression, and catastrophic and psychotic reactions do occur as the result of disclosure, and even suicides committed by patients unable to live with the burden have been reported.
Patients are not able to understand the information
Some patients do not want to know the truth about their condition
What Are The First Signs Of Your Body Shutting Down
You may notice their:
- Eyes tear or glaze over.
- Pulse and heartbeat are irregular or hard to feel or hear.
- Body temperature drops.
- Skin on their knees, feet, and hands turns a mottled bluish-purple
- Breathing is interrupted by gasping and slows until it stops entirely.
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Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
How Do You Tell An Alzheimers Patient Their Spouse Has Died
Here are some ideas of ways to help the person with dementia accept the death:
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Helping People With Dementia Deal With Loss And Grief
Most important for us to remember when telling a person with dementia any emotional news is that the person with dementia still has his/her emotional memory intact. While their emotional memory is intact, however, their ability to deal with emotions rationally, logically, and/or reasonably is greatly impacted by their dementia. So that persons response to emotional news may be worse or less than we expect. In addition, where their disease process is challenges their responses even more so. Thus, we need to approach loss and grief with a greater awareness based on these facts. Most importantly, we need to keep it simple and reassuring and follow their lead.
Dont Say No Dont Or Cant
One of the biggest mistakes in dealing with patients and/or loved ones with memory loss is being negative and telling them that they cant do something. Words like no,” don’t, or can’t create resistance. This comes up regularly with family members when the patient and/or loved one might be still driving, and the caregiver and/or family member has made the decision to stop them from driving. One should never say, You can’t drive anymore. They can still technically drive , and they can get very combative when told no. A way to counter this is to say, I know you still can drive, that’s not even a question, but you know what happened the other day? I was out on the highway and this car cut me off, and I had to make a split-second decision it was really scary Its likely they will say, You know what? I’m having a little trouble with those decisions too. The issue isn’t the mechanical driving, it has more to do with comprehension, and many times this answer works much better than, You can’t drive anymore, which can be construed as confrontational.
You may find a patient and/or loved one up too early or confused about time. Instead of using messages such as, Youre up too early, you need to go to bed, try leading with statements such as, You know, I’m getting sleepy. Id like a little snack before I go to bed, and then gesture for the patient and/or loved one to sit with you.
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Comforting Words For A Friend Whose Spouse Is Dying
Choosing the right words to say to a friend is not always easy. Harder still is fighting the urge to keep quiet out of fear of saying the wrong thing. Its okay to admit your fears and anxieties to your friend and ask for forgiveness when things dont come out as intended.
When your words are expressed to match your good intentions, theyll be thanking you for being a friend and giving them your love and support.
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Getting Back On Your Feet
Moving on with your life is not always easy. However the time will come when you are ready to re-establish your own life and move forward. Consider these ideas for getting back on your feet:
- Take time off – The length of time needed to adjust to life changes varies from individual to individual. Be patient dont try to rush the process.
- Accept assistance – Letting other people help you can provide you with extra support and an opportunity to express your feelings, reflect and talk. Over time this will help you understand and adjust to your loss.
- Write in a journal – Recording your thoughts and feelings in a journal or diary can help you come to terms with your grief and loss.
- Remember the person – Many people like to talk about the person they have lost, especially in earlier times before dementia affected them. Reminiscing about happy times can help. Celebrate the person with family and friends. Many people find this helpful on birthdays or anniversaries.
- Re-establish your social networks – Start to see old friends again or you may need to look around for new friends.
- Keep trying – You may not feel confident at first. You may find it difficult to make decisions, chat about ordinary things or cope with social gatherings. But dont give up. Your confidence will gradually return.
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Or Does It Make Sense To Tell Them At All
My moms best friends husband died recently. My mom had known him for more than 60 years, but I debated whether to tell her. Shes had dementia since the fall of 2012 and retains almost no new information.
We call her friend often and my mom asks after her husbandan old memory the disease hasnt stolen from her. I decided she should know.
I sat down next to my mom in the memory care unit where she lives and said, We need to call your friend. You know her husband was not well for some time. He died yesterday. My mom was shocked and readily accepted my offer to call her friend on my phone.
When they hung up, my mom and I talked about how good her friend sounded. We sat quietly for a few moments and then my mom said to me, Did you talk to her? How did she sound?
The experience made me wonder if I made the right choice to tell her.
When they hung up, my mom and I talked about how good her friend sounded. We sat quietly for a few moments and then my mom said to me, Did you talk to her? How did she sound? She had forgotten that she spoke with her friend, but she remembered that her husband had died.
The experience made me wonder if I made the right choice to tell her and what I should do if she forgets in the future. For guidance, I turned to Stephanie Rohlfs-Young, director of volunteer programs at the Alzheimers Association. The following is an excerpt of our conversation, edited for clarity and length.
MemoryWell: How should you approach it and what should you say?
Should You Tell A Person With Dementia That Their Spouse Has Died
Upon his passing, I remember thinking, Dad died, Mom has dementia. How in the world are we supposed to handle this? Obviously, she had to know. It was only fair, and there was no avoiding it. I cleaned out his side of their room the following day, and Mom got a new roommate. Yet, every day she had to be told that Dad had died. In her mind, he was back in his private room down the hall where he had lived for so many years.
It was excruciating to have to tell her on a daily basis that her husband was dead. She experienced the same degree of shock and heartbreak over and over again. Eventually, though, she began asking me, Is he really gone? I would confirm the news and she would just shake her head and say, I cant believe it. She passed away five months after Dad.
I believe a surviving spouse should be informed of the death at least once no matter what. Every person, with or without dementia, should have the opportunity to mourn the loss of their significant other. In some cases, the news will sink in over time, whether you realize it or not, and it can have a surprising effect.
For example, there was a man with late-stage Alzheimers disease who lived in my parents nursing home. His devoted wife visited daily until she died from cancer. The man attended his wifes funeral, but he seemed, as always, totally unaffected by anything around him. Shortly after, for no particular reason, he died peacefully in his sleep.
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