18 Jun Caring for Persons with Advanced Dementia

With the growth of the aging population in the United States, the development of dementias such as Alzheimer’s disease becomes more prevalent. Dealing with the rising incidence is a social and ethical issue that requires much attention; not only by medical and nursing professionals, but by society in general. The management and care of persons affected must be carefully considered and planned. A person-centered approach that places the person and family in the center of care has been shown to best accommodate the needs of these persons. In addition, a team approach to care can develop a comprehensive and collaborative plan that is essential to optimizing care.

Patient-centered care that fosters hope, interdependence, partnerships, and trust can help alleviate the suffering and complications that can arise with this life-altering diagnosis. Dementia affects a person’s ability to control his or her environment, as well as his or her sense of identity. It can also affect the way a person manages other health care issues. Determining the most appropriate medical care can be complicated further when several family members are involved.

Specialty neurological care that promotes hope and empowerment to individuals and their families can mitigate the stereotypical attitudes and ageism that can marginalize those affected.  First, it is important to persons and families that dementia and its symptoms is understood.  Families need to have direct personal exposure to the illness that reflects a comprehensive and ethical approach to care. Second, they need to evaluate what is appropriate medical treatment as opposed to inappropriate care, considering the use of living wills and advanced directives.  Usually, patients and families find that comfort is the main focus to care or “comfort care”. This approach highlights the need to maintain personal integrity and dignity and prevents suffering. In addition, it reflects a more optimistic outlook, enabling persons and families to make personal choices. Third, the person and family are encouraged to find the strengths and value of their lives. Finding meaning and wellness becomes a priority and optimizing these can bring peace and reconciliation.

Vivian Carta Sanchez, NP