Dementia: What Choices Do You Have?

What is dementia?
This refers to a group of diseases that cause “confusion” with memory loss. Types of dementia include Alzheimer’s (the most common one), Vascular type (caused by small strokes), Parkinson’s-associated dementia, and others such as Lewy-Body Dementia.  Dementia is progressive and incurable, lasting from three to 10 years.  Progressive means the symptoms get worse over time. Incurable means that the memory loss is permanent. Memory loss makes it difficult to remember names and places, how to do the usual activities of living, etc.  People with dementia eventually require complete care; over half of all nursing home residents have some type of dementia.


Feeding Tubes – Myths & Realities

Feeding tubes were designed to artificially provide nutrition in the hopes of maintaining body weight and health, and to prevent dehydration and starvation, when a person could not eat enough calories for whatever reason.

There are two kinds of tubes.  One is inserted through the nose to the stomach and taped in place.  It is temporary, for up to six weeks, and is usually for people who cannot eat because they are on a breathing machine while in Intensive Care or have had some other procedure preventing them from swallowing.  It requires no anesthetic to insert.


When To Consider “Do Not Admit To Hospital”

What does a “Do Not Admit To Hospital” (DNATH) mean?
A “DNATH” order means a resident will not be admitted to the hospital for any reason (although, depending on the situation, there could be exceptions, jointly determined by the family and doctor).  However, a resident could be sent just to the emergency room for something like a laceration which will not quit bleeding and needs to be sutured.


Goal Focused Care: How To Choose The Most Appropriate Healthcare While In LTC

Planning for the future is something many do everyday.  Healthcare is no different. Every patient has the right to participate when deciding what kind of medical care is appropriate for them. This information is being offered to help patients and families in nursing homes clarify healthcare related goals and make important decisions about medical treatment.


M & M’s for Dementia: Morphine & Marguerita’s Are A Good Option

A woman was in our Palliative Care Unit dying from Alzheimer’s Disease and I was talking with her daughter about what she wanted if she were to get Alzheimer’s herself; there’s an increased risk of the children developing it if a parent has it.  She said all she wanted was “M&M’s”!  I thought she meant the candies.  “No” she said, “Morphine and Margueritas!”


Medications Commonly Used in Nursing Homes to Help Resident Symptoms

Particularly as someone approaches their last year of life, and has decided they only want to be “kept comfortable”, it can be confusing trying to decide what might help reach that comfort goal and what will not likely be helpful.  The following describes some choices which might help them live more comfortably.

First and most important, our experience – supported by the published research – confirms that the fewer drugs a senior takes, the more comfortable they are and the longer they live!  For more information, ask the nurse for the handout Polypharmacy [or read it on the website].