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Palliative Care for Elderly Dementia Patients

Dementia is a broad-based term that is used to describe many conditions or syndromes, such as Alzheimer's Disease. In fact, dementia is not a disease, just the descriptive catch-phrase that embodies the loss or diminishing of one's mental abilities to the point where that loss interferes with the person's ability to manage their daily activities of living or their daily life.

Dementia can include the loss of:

  • the ability to remember things that are familiar, such as family names or the address of the person's home.
  • the ability to reason. A good example would be mixing up the past with the present and not being able to look at facts, such as the calendar, to see what the year is.
  • the ability to think rationally about a situation such as who is a friend and who is an enemy.

Dementia is not considered a normal onset of aging and it occurs in many different forms – Lewy body dementia, frontotemporal disorders, and vascular dementia.

Learn more about:

  • Lewy Body Dementia – Brain chemistry changes due to protein deposits.
  • Frontotemporal Disorders – dementia from frontal lobe or front brain injuries and damage.
  • Vascular Dementia – dementia that results from conditions or accidents that damage the blood vessels within the brain – stroke is a good example.

Why are Seniors Susceptible to Dementia?

While genetics play a role in some forms of dementia they are not always the single cause of dementia. For many people, it is a combination of events that stem from genetics to lifestyle. For example, frontotemporal disorders are caused by physical damage to the brain. A boxer or football player are two lifestyle examples of people who might suffer from dementia. A person who has had a stroke is another example. While genetics may have played a role in the development of thick blood, it is more likely that the stroke is caused by a combination of lifestyle – diet, smoking, or alcoholism – and genetics.

Why then, are the elderly more susceptible to dementia? Mostly because of age. People have had longer time facing environmental factors such as high blood pressure, poor diet that leads to diseases such as diabetes, arterial disease, heart disease, and other factors that increase the likelihood of dementia.

While we have pointed to lifestyle as a major contributor, for some, genetics is the only factor. Those people who have the genes that develop Huntington's Disease are an example. The severity and age at onset might still be influenced by environmental choices and for many people, there is not just one type of dementia, but a mixture of types.

Learn more about how to reduce environmental issues that may cause dementia.

How can Dementia Patients Benefit from Palliative Care?

Better Management of Pain

One of the greatest contributions that palliative care brings to a patient with dementia is better assessment, treatment, and management of pain. There are many studies that point out that pain is one of the key issues from which people with dementia suffer and that is most often unreported or under assessed. Part of the reason for this is lack of training and another is the impaired communication needs of people with dementia. In a patient who cannot talk but does not have dementia, a scale is used to assess pain. Sometimes, facial expressions can cue a healthcare provider as ask about pain for those people who do not have dementia. However, dementia often causes people to grimace and to contort their faces and they are not always able to recognize a happy face from a sad face as depicted on the assessment tool.

Access to Medical Professionals who Understand Dementia

Palliative care also is a gateway between families of those with dementia and healthcare professionals who have special training in helping people with dementia improve the quality of their lives.

This is important because studies have shown that people who suffer from dementia are undertreated by healthcare professionals such as their primary care doctors and that a referral to a palliative care unit or organization is lacking. These studies have also shown that those people with dementia often denied access to key medications and care that can help improve their quality of life. [1]

Access to healthcare professionals also means an improvement in the development of care planning and the plan of care that is specific to the patient and their needs.

All of these benefits help to make advances in the quality of care that a person with dementia receives and moves the process in a positive direction towards improving the quality of life of those who suffer from dementia, including the families of those patients.

When Should Palliative Care be Considered for Dementia?

As soon as a diagnosis is made. Palliative care is not the same as hospice, which focuses on end-of-life care. Palliative care can begin in the early stages of the illness and may offer access to treatments that are aggressive and outside of the mainstream. The focus of palliative care is to improve the life of people who suffer from a life-limiting disease.

Early interaction with a palliative team helps people explore all of their options for treatment – while they are still able – and to help in the formation of their plan of care, even for end-of-life care. That is a process that helps to uphold dignity and quality of life.

What Should be Expected in Palliative Care?

Palliative care is different from hospice care, though many hospices have a palliative care approach. Palliative care is not limited to end-of-life care, but to care throughout the entire disease process, from diagnosis to death.

Expect professional healthcare standards from a professional, experienced and educated healthcare team. It is these qualities that help bring access to:

  • cutting-edge treatment
  • better patient care planning and medications
  • better management of pain and other negative symptoms
  • improved quality of life for both the patient and the family
  • access to and participation in the development of a personal care plan that spans all aspects of the disease process
  • access to resources that help the patient and the family
  • access to end-of-life care, grief counseling, and other non-patient services.

These are all aspects that go beyond hospice and focus on the entire disease process, even when hospice is needed.

How Much Does Dementia Specific Palliative Care Cost?

Many aspects of palliative care are covered by Medicare, Medicaid or disability insurance. People can supplement these benefits through the addition of long-term care insurance which often picks up the costs that Medicare does not cover. The cost of caring for someone on dementia under palliative care can range from $0 to $10,000 or more per month. The difference in costs is dependent upon the type of care requires, the type of insurance the patient has, and whether or not they have a gap insurance policy.

How do you Pay for Palliative Care for Dementia?

There are four ways to pay for palliative care – insurance, gap insurance, long-term care insurance, and cash. Many people have a combination of all of these to help cover their medical needs as they age.

Where Can I Find Palliative Care for Dementia Patients?

There are many national organizations and societies that can help you find palliative care in your area such as the National Hospice and Palliative Care Organization which has a search tool by zip code. You can also call our helpline or use our directory search.

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