1. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
End-of-Life Care for Alzheimer’s Clients: Preserving Dignity and Providing Comfort
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

2. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Objectives
Understand special challenges faced in caring for AD clients at end of life
Understand when hospice care might be an option for end of life AD clients
Participate in effective strategies for communicating with end-stage AD clients
Participate effectively in care strategies for clients at end of life
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

3. Challenges for Alzheimer’s End-of-Life Care
End-stage Alzheimer’s difficult for caregivers and family
Clients lose ability to:
Recognize loved ones
Control bowels or bladder
Communicate verbally
Make medical-care decisions
Important to prepare advanced directive
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

4. Challenges for Alzheimer’s End-of-Life Care (cont.)
AD client cannot express needs effectively
Noticing changes in behaviors critical in determining need for intervention for pain
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

5. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
When to Choose Hospice
A special program for those terminally ill
Provides a holistic approach to care
Generally utilized for those with less than six months to live
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

6. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Criteria for Hospice
No ability to communicate
Cannot walk without assistance
AND one or more of the following:
Aspiration pneumonia
Upper urinary tract infection
Sepsis or other overwhelming infections
Worsening bedsores
Weight loss > 10% over past 6 months
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

7. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Hospice Care
Covered by:
Medicare
Medicaid
Care provided wherever client resides
Private Homes
Assisted Living
Independent Living
Nursing Home
Many private insurances
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

8. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Hospice Care (cont.)
Furnishes social worker and spiritual counselor
Volunteer program helps both client and family
Continues up to a year after a client dies
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

9. Risk Factors of AD Clients Living Less than Six Months
Problems with day-to-day activities
Being a man
Unstable medical condition
Poor eating
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

10. Risk Factors of AD Clients Living Less than Six Months (cont.)
Bowel incontinence
Advanced age
Being confined to bed or sleeping most of the day
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

11. Communicating with Clients with End-Stage AD
Touch
Hold hand
Brush hair
Give gentle massage
Smell
Perfume
Flower
Food
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

12. Communicating with Clients with End-Stage AD (cont.)
Sight
Videos
Bird cage
Hearing
Read to client
Soft music
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

13. Providing Care for End-of-Life Clients
Best way to care for client who cannot give feedback
Trust instincts
Seek advice and support
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

14. Providing Care for End-of-Life Clients (cont.)
Symptoms client may experience:
Pain
Difficulty breathing
Lack of interest in eating or drinking
Pressure sores
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

15. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Pain Control
Be sensitive to client—increased agitation or confusion may mean client is in pain
Consult medical personnel
Assess causes
Discuss possible treatments
Be client’s advocate
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

16. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Pain Control (cont.)
Alternative pain control options:
Guided mental imagery
Hypnosis
Relaxation
Counseling for stress and anxiety
Spiritual support
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

17. Providing Comfort Care
Most important way to help AD client at end of life: provide comfort care
Put lotion on skin, moisturize lips
Keep client clean
Make sure client is positioned comfortably
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

18. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Difficulty Breathing
Normal for client to become congested and have trouble breathing
Consult medical staff
May help to:
Turn client’s head to side to let moisture drain from mouth
Dab mouth with moist cloth
Avoid giving food or fluids
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

19. Lack of Interest in Eating or Drinking
Normal at end-of-life
When close to dying, food and/or drink not necessary for comfort
Body can no longer process nutrients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

20. Lack of Interest in Eating or Drinking (cont.)
To treat dry mouth
Swab inside of mouth with water-soaked cotton swabs
Spoon a few tiny ice chips into mouth
Apply lip salve
Dab mouth with glycerin swabs
Brush client’s teeth
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

21. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Pressure Sores
Form of skin breakdown
Can become infected and painful
To prevent pressure sores
Turn clients in bed every 2 hours
Help clients move and reposition arms and legs
Use inflated air-suspension bed
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

22. Relating to Clients and Family and End-of-Life
Clients and families benefit from close human contact
Assume dying person can hear you
Speak in a quiet, normal tone, and say what you can to support and comfort the person
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

23. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
Please Complete Test
and Evaluation.
Thank You.
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients

24. ©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©CareTrack Resources, Inc, All Rights Reserved. May Not Be Used or Reproduced Without Permission. Contact for Assistance.
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients
©2008 CareTrack Resources: End-of-Life Care for Alzheimer’s Clients