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Making the Transition to Hospice with Alzheimer’s and Other Forms of Dementia

Alzheimer’s disease and other forms of dementia are progressive diseases that eventually lead to end of life for those suffering. When your loved one reaches more challenging stages of dementia, hospice care is extremely valuable. Hospice is a specialized type of care that focuses on comfort and quality of life for patients who are terminally ill—with a prognosis of six months or less if their disease runs its normal course.

How to Transition to Hospice Care with Ease and Peace of Mind

Transitioning to hospice care can be a difficult decision, but it can also be a relief for both patients and caregivers. Hospice care can provide your loved one with the support and care they need during their final months of life. You do not need to wait until the very end to initiate hospice—which is a common misconception.

To transition to hospice care with ease and peace of mind, here are a few tips:

Talk to your loved one’s Primary Care Physician (PCP).

If your loved one does not have a Primary Care Physician, we can help you obtain an order for hospice care. The PCP will write an order to initiate hospice. This is step one.

Get to know the hospice team.

Once you meet with us, you will be assigned a team of caregivers who will work with you to create a care plan for your loved one. The hospice team will include nurses, social workers, aides, and other professionals who are skilled in caring for people with dementia.

Let us take care of the rest!

We will bring in all necessary supplies and durable medical equipment (DME) that your loved one will need to be safe and comfortable in the place they call home.

More Ways We Can Help…

Our Hospice agency can provide a variety of services to help you and your loved one transition to hospice care. These services may include:

Caregiver support. Hospice offer a variety of support services for caregivers, such as respite care, support groups, and counseling.
Symptom management. Hospice will help manage your loved one’s symptoms, such as pain, nausea, and anxiety.
Spiritual support. Hospice offers spiritual support for patients and their families, regardless of their religious beliefs.
Volunteers. Hospice volunteers are a vital part of our program and offer a variety of services to you and your loved one.

If you are considering hospice care for your loved one with Alzheimer’s or another form of dementia, please contact us today. We make the process simple, letting you focus on what matters most!

Caring for and Loving Someone with Alzheimer’s

Alzheimer’s disease is a progressive brain disorder that slowly destroys memory and thinking skills. It is the most common cause of dementia in older adults. Alzheimer’s disease affects everyone differently, but it eventually leads to severe cognitive impairment and death.

There is no cure for Alzheimer’s disease, but there are treatments that can help manage the symptoms and slow the progression of the disease. Caring for someone with Alzheimer’s can be challenging, but it is also a rewarding experience.

Here are some tips for caring for and loving someone with Alzheimer’s:

Educate yourself about the disease.

The more you know about Alzheimer’s disease, the better equipped you will be to care for your loved one. There are many resources available online and in your community that can provide you with information and support.

Create a safe and supportive environment.

People with Alzheimer’s disease are at risk of falls, wandering, and other accidents. It is important to create a safe and supportive environment for your loved one. This may involve removing tripping hazards, installing locks on doors, and using GPS tracking devices (such as medical alert bracelets or inserting Air Tag-like devices in shoes).

Establish a routine.

People with Alzheimer’s disease often thrive on routine. Establish a regular schedule for meals, activities, and bedtime. This can help to reduce stress and anxiety. (Tip: use colorful plates to help make food easily identifiable).

Be patient and understanding.

Alzheimer’s disease can cause people to behave in ways that are frustrating and confusing. It is important to be patient and understanding. Remember that your loved one is not trying to be difficult. (Try not to raise your voice—rather, use a calming tone as much as possible).

Take care of yourself.

Caring for someone with Alzheimer’s can be physically and emotionally demanding. It is important to take care of yourself. Get enough sleep, eat healthy foods, and exercise regularly. Make time for activities that you enjoy.

Here are some specific ways to show love and support to someone with Alzheimer’s:

Spend time with your loved one.

Even if your loved one cannot engage in conversations or activities like they used to, they still enjoy spending time with you. Make time to simply sit with your loved one, hold their hand, or listen to music together. (Music therapy has proven to be effective in calming/lessening anxiety + helps with activities such as reminiscing).

Reassure your loved one that you love them.

Tell your loved one that you love them and appreciate them. Let them know that you are there for them and will always support them.

Help your loved one maintain their sense of identity.

Encourage your loved one to continue doing activities that they enjoy. Help them to stay connected with their loved ones and community.

Celebrate your loved one’s accomplishments.

No matter how small, celebrate your loved one’s accomplishments. This will help to boost their self-esteem and confidence.

Caring for someone with Alzheimer’s can be challenging, but it is also a rewarding experience. By following the tips above, you can provide your loved one with the care and support they need.

Life is a Journey. We are With You Every Step of The Way!

How to Know it May be Time for Hospice

Watching someone you love suffer from Alzheimer’s or another memory debilitating illness is incredibly difficult, and it can be even more challenging to decide when it’s time to consider hospice care. Here, we are sharing five signs it may be the right time to consider the extra support of hospice care for an Alzheimer’s patient.

Physician determines they are at or beyond stage 7 of the Functional Assessment Staging Scale

The Functional Assessment Staging (FAST) Scale is a tool used to determine if changes in a patient’s condition are related to Alzheimer’s disease or another condition. If due to Alzheimer’s, the changes will occur in sequential order. Alzheimer’s disease-related changes do not skip FAST stages.

Unable to ambulate independently

This means a person is no longer able to get around on their own. For example, they require assistance getting from room to room.

Requires assistance to dress or bathe

Without assistance, you may notice they put their shoes on the wrong feet or their day-time ‘street’ clothes on over their pajamas. They are also unable to bathe without assistance.

Becomes incontinent

This includes urinary or fecal incontinence or both.

Unable to speak or communicate

This may begin as the patient only saying 5-6 words per day and gradually reduce to only speaking one word clearly until they can no longer speak or communicate at all. This will also include the inability to smile.

Why Choose Hospice

Hospice care is for patients with a life limiting illness and a life expectancy of six months or less. The main focus is to manage pain and symptoms and ultimately keep the patient comfortable. When you choose hospice for your loved one, their care team can help you to understand what to expect in the final stages of Alzheimer’s. They will also provide support to you and the rest of your family throughout the end-of-life process.

If you would like more information on hospice care for Alzheimer’s patients, please contact us. We are here to answer any questions you may have.

Changes in Communication

As Alzheimer’s and Brain Awareness Month continues, we want to discuss a very important topic- communication and Alzheimer’s. As the disease progresses, a person’s ability to communicate gradually diminishes. Changes in communication vary from person to person, but there are several common issues you can expect to see, including difficulty finding the right words and organizing words logically.

Effective Communication

If someone you love is living with the disease, you know it can be challenging at times to communicate with them. The video above discusses the following ten tips for effectively communicating with your loved one.

Never argue. Instead, listen.
Never reason. Instead, divert.
Never shame. Instead, distract.
Never lecture. Instead, reassure.
Never say ‘remember.’ Instead, reminisce.
Never say ‘you can’t.’ Instead, remind them what they can do.
Never say ‘I told you.’ Instead, just repeat.
Never demand. Instead, just ask.
Never condescend. Instead, encourage.
Never force. Instead, reinforce.

Help Make Communication Easier

In addition to these tips, there are steps you can take to help make communication easier, including:

Making eye contact and calling the person by name
Being aware of things like your tone, how loud your voice is, how you look at them, and your body language
Encouraging two-way conversation for as long as possible
Using other methods, such as gently touching
Distracting the person if communication creates problems

You also want to encourage the person to communicate with you. You can do this by doing things like holding their hand while you talk and showing a warm, loving manner. It is also important to be patient with angry outbursts and remember that it is just the illness talking.

If The Person is Aware of Memory Loss

Since the disease is being diagnosed at earlier stages, many people are aware of how it is impacting their memory. This can make communication even more sensitive because they may become frustrated when they are aware of the memory loss. Here are some tips for how to help someone who knows they have memory problems.

Take time to listen. They may want to talk about the changes they are noticing
Be as sensitive as you can and try to understand it is a struggle for them to communicate. Don’t correct them every time they forget something or say something odd
Be patient when they have a difficult time finding the right words
Find a balance between helping them find the right words and putting words in their mouth
Be aware of nonverbal communication. As they lose the ability to speak clearly, they may rely on other ways to communicate their thoughts and feelings

Additional Resources

For more information on Alzheimer’s disease and how it impacts communication, visit the links or reach out to the contacts below:

** NIA Alzheimer’s and Related Dementias Education and Referral (ADEAR) Center

800-438-4380 (toll-free)

adear@nia.nih.gov

** Family Caregiver Alliance

800-445-8106 (toll-free)

info@caregiver.org

** Alzheimer’s Association

Dear Caregiver,

If you are caring for a loved one who is living with Alzheimer’s disease, you do not need us to tell you that it’s not easy. This progressive disease is difficult to cope with – for both the person living with it and their loved ones. People living with Alzheimer’s may become frustrated when they find themselves struggling to do things they used to do without any problem. And it is hard for you, as the caregiver, to watch the person they once were gradually fade away. They may have brief moments of clarity where it feels like they are themselves again; only to break your heart when the moment is gone. While there is nothing anyone can do or say to “fix” what you and your loved one are going through, we want you to know you do not have to face it alone. The Alzheimer’s Association has an abundance of resources for both those living with Alzheimer’s and their caregivers. There are support and educational programs available for both, as well. Take advantage of these resources. They are there to help make things a little easier.

Understanding Alzheimer’s Disease

It all starts with gaining a better understanding of the disease and how it progresses. Alzheimer’s leads to nerve cell death and tissue loss throughout the brain. This results in the brain shrinking dramatically over time which impacts nearly all its functions. Although scientists are not completely certain what causes cell death and tissue loss in a brain affected by Alzheimer’s, plaques and tangles appear to be the culprits. Plaques form when protein pieces called beta-amyloid clump together, and tangles destroy a vital cell transport system made up of proteins. Plaques and tangles tend to spread through the cortex in a predictable pattern as Alzheimer’s disease progresses, but the rate of progression varies greatly.

Early Stage

In the earliest stages, plaques and tangles begin to form in brain areas involved in learning and memory, as well as thinking and planning. In this stage, a person can still function independently but may start to notice they are sometimes forgetting familiar words or where to find everyday objects. Someone in this stage may struggle to:

Think of the right word or name for something
Remember the name of someone they just met
Remember something they just read
Plan or organize things

Middle Stage

In the middle stage, more plaques and tangles develop in the regions of the brain important for memory, thinking, and planning. This leads to the development of problems with memory or thinking that are severe enough to interfere with work or social life. In this stage, someone with Alzheimer’s may have trouble handling money, expressing themselves, and organizing their thoughts. Plaques and tangles also spread to areas involved in speaking and understanding speech and the sense of where your body is in relation to objects around you. It is in this stage that many people are first diagnosed. Symptoms vary from person to person, but may include:

Forgetting events or personal history
Feeling moody or withdrawn
Being unable to recall personal information such as their address
Confusion about what day it is or where they are

Late Stage

Most of the cortex is seriously damaged by the time someone reaches the late stage of Alzheimer’s disease. By this point, the brain shrinks dramatically due to widespread cell death. Individuals often lose their ability to communicate, recognize family and loved ones, and to care for themselves in this stage. In this stage, symptoms are severe and may include:

Need for around-the-clock personal care
Loss of awareness of recent experiences and their surroundings
Changes in physical abilities such as walking and eventually swallowing
Difficulty communicating
Vulnerability to infections, especially pneumonia

Resources for Each Stage

The Alzheimer’s Association provides excellent resources for caregivers for each stage. Visit the links below to learn more. Early-Stage Caregiving Middle-Stage Caregiving Late-Stage Caregiving Additional Information

Yours truly,

Apreva Hospice

Speak with our Hospice Care Team Now

JOINT COMMISSION ACCREDITATION

Joint Commission-accredited hospices are the partner of choice throughout the care continuum because of their deep abiding commitment to quality end-of-life care. Apreva Hospice is one of the few hospices in San Diego County with this distinct and honorable title. An accreditation from Joint Commission shows dedication to the optimum patient experience, commitment to strong interdisciplinary care management, and a robust patient safety initiative.

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Apreva Hospice prides itself by partnering with the We Honor Veterans Program. We have a team of highly-trained individuals who work with our Veteran patients during their time of need.