Archive for December 21st, 2009
Posted on December 21, 2009 - by Nurse Virginia
Alzheimer’s is a progressive disease
Whether it is called “end stage” or “late stage” the disease will progress until the individual no longer speaks, recognizes friends, family or caregivers and requires total care in all activities of daily living. That will mean a caregiver will have to totally dress the individual, hand feed the individual and keep them clean and dry due to total incontinence.
Few family members understand the possibility of complications when their loved one reaches this end stage of the disease. Communication between the physician and family members to do advance planning and decision making is critical.
Symptoms that signal end of life for a person with Alzheimer’s disease
Typically the individual will begin having eating problems, fevers, infections usually pneumonia. Due to their loss of ability to swallow they will start to aspirate their food into their lungs. This will cause infections and fever, sometimes these are the first indications that the individual is no longer able to swallow.
So many times the only question that is asked of the family at this time is whether they want to use antibiotics or not to fight the infection. The communication should involve that this is a symptom of end of life for this individual. That their Alzheimer’s has progressed to the point where they are losing the ability to swallow their food.
The end stage Alzheimer patient needs an end of life plan.
When the individual has no plan in place then painful, burdensome solutions may be suggested. Such as putting a feeding tube into the person’s stomach by way of an incision. Many times these decisions are made independently of any over all plan of care. So the involved family is called for one issue after another because no plan is in place.
The healthcare professional who clearly communicates that Alzheimer’s disease is a terminal disease with expected complications, not only helps the family, but is a true patient advocate.
Virginia Garberding, R.N.
Director of Education
The Wealshire, Lincolnshire Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance