Post on 17-Jan-2016
Patient Comfort?
Studies of dying cancer or ALS patients with anorexia: Little hunger or thirst
Any thirst can be treated with mouth swabs and ice chips Sense of euphoria (endorphins)
Goes away if fed Patients were left alone more
Gillick MR. NEJM, 2000
Comfort?
Eating is pleasant! depriving a person (who wants to eat) of the
pleasure of eating does not increase comfort
Pulling out the tube Return trips to GI or IR Restraints
More stool and urine Caregiver burdens high
Finucane T et al. JAMA 1999
Slow hand feeding
Survival can be substantial despite emaciation and poor po intake
Human, nurturing, time for closeness with loved ones
Finucane TE, JAMA, 1999
Caregiver Stress
Why bother?
Caregivers are at higher risk for: Medical problems Depression and anxiety Financial problems
Dementia caregivers are especially challenged due to: Protracted length of time of caregiving Difficult behaviors Lack of appreciation from the patient Need for intensive involvement with the
patient
Why bother?
Supporting the caregiver helps the patient:Less depression Less agitated behavior
How to help?
Support groupsEducation about the disease and how to be
a caregiverAdult day careHospice (for patients with advanced stage)
Resources
www.alz.org (Alzheimer Association- education, info on clinical trials, local support groups, Safe Return program, much more)
www.alzbrain.org (State of Alabama Dementia Education and Training Act sponsored education site)
UAB Alzheimer’s Family Program (205) 934-2178 (one on one counseling, support groups)
www.alzca.org (Alzheimer’s of Central Alabama- info on clinical trials, adult day care scholarships, WanderGuard, local support groups)