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End-of-life Care For Dementia

By REGINA D. Posvar LPN,RNA
By REGINA D. Posvar LPN,RNA

Q: Dear Regina, My dad is not able to get out of bed for one year now. His condition has changed that he does not want to eat very much. He does not seem to be ill with anything. I know the end is near. I want him to be comfortable. Is there something more I can do for him?

A: This is a difficult time. There is no one answer that fits everyone and family that experiences these last moments. I can tell you that comfort care for end of life care has been the best practice that I have experienced.

Although your dad may not say much or eat much he still can have enjoyment in these last days. This can include free of pain. Once pain is managed then his comfort will allow him to enjoy the things he likes: Touch therapy – this can happen with applying lotion to full body. The human touch is still needed at this stage in life; Aroma therapy – Your dad’s favorite smells can fill his room. If he was a builder by trade and wood was his tool bring things with a wood smell or candles that are scented. Maybe he was a gardener on his leisure time or he loves your mom’s baking. Bring in the smell of apple pie. These smells trigger good memories and may help him rest better; Music therapy – I am positive there is some type of music he enjoyed. Even if it was wild music playing it in the background will calm, (be aware if some music causes irritable stimulation). You can even sing a song he liked as a child. For many it was a church song or nursery rhyme. Reading to him a favourite story he once liked; Vision effects – his vision is distorted at this time but if he does see at all it is best to have a clutter free environment and solid inviting colours around. Just think of all the things he once enjoyed and see if you can modify them.

These are things we all can enjoy for end of life care. For foods it is not about nutrition at this time. It is about what he likes the taste of. So let him eat the foods he likes as he will not eat it all, just enough to enjoy the taste to his liking. This is how you can help him to enjoy his last days. Enjoy this time with him.

It is never easy to let go of someone you love, it is harder to watch them leave in pain and feel helpless. Many of us have experienced this and it still affects us to this day. Had we known would we have done it differently? Could we have done it differently? What is it that we need to help someone live their last days in comfort and enjoyment? Email and share your suggestions.

Q: Dear Ms Posvar, my mom has become very troublesome the last two or three months. She has not been able to recognize objects anymore. And what I mean what she thinks she needs to eat everything. I think she is hungry so I try to get her to eat and she just plays with the food. I try to feed her and that is a mess. I am afraid she will put the wrong thing in her mouth. Is this normal? I cannot leave her alone at all. Sometimes she seems so anxious. I have an appointment with her doctor next week; maybe she can help us calm her down. What do you suggest?

A: It sounds like your mom is in the sensation stage of the disease. And this is a very busy level. She is caught in the moment. Keeping her engaged in anything will be a max of twenty minutes. You are correct in your concern for safety. Keep sharp objects out of her view and reach.

Because she likes fascinating things keep those things around her. Bright safe objects that have different textures so she can rub, touch and feel them. This gives her pleasure. If she puts it in her mouth make sure it is too big for her to swallow or strong enough if she likes to pull things apart. If you find she likes to pull things apart give her something to take apart. This is the way her brain is functioning to make sense of things that give her pleasure. When she is resisting please stop and think about how it might feel to her. Remember she doesn’t understand what you are saying most of the time so use short sentences and visual cues to help her. I suggest that you learn more ways to communicate with her that will help her and decrease your fears of her hurting herself. You will need to have regular breaks to recharge your own battery. Contact the Alzheimer’s Association to find out what is available for respite relief.

Tip: Music in the background combined with aroma therapy stimulates the brain Send questions to angelsofthewest@outlook.com or call/text to 486-4509

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