Hospice & Dementia Care

In previous articles, I have discussed challenging behaviors in Alzheimer's disease, such as wandering, that cause families distress and result in the patient being institutionalized and in this article I will address Sundowning syndrome, a behavior concerning disruption of the sleep-wake cycle, one that results in increased confusion, restlessness, agitation, and anxiety—especially after dusk—and may continue throughout the night. It has been documented to occur in 20 percent of all patients with Alzheimer's disease, and has been appropriately named...Read entire article »

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Recently I wrote an article for family members of patients who could benefit from hospice care and/or palliative care, in which I discussed the factors that physicians must consider in referring hospice or palliative care options to their patients. In this article, I will explore the topic in greater depth, discussing the similarities as well as the differences between the two primary options: hospital-based palliative care and traditional hospice-based palliative care. Hospital-Based Palliative Care Hospital-based palliative care comes into...Read entire article »

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In previous articles, I have discussed the benefits of hospice care for people with dementia or terminal illnesses. Now I will address the considerations that physicians and patients face when navigating the various options for hospice and palliative care. Choices for end-of-life care, when cure is no longer possible, have improved greatly in recent years. For instance, many hospitals now have palliative care teams to assist physicians in accessing the next level of care, allowing a peaceful life closure...Read entire article »

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Most families who care for a loved one with advanced Alzheimer’s disease ultimately opt for institutionalized patient care as the disease progresses. While many patients can remain in their homes for years, some of the behaviors associated with advanced Alzheimer’s disease are extremely difficult to control, causing families to seek care outside of the home. In this article, I will discuss one of those behaviors—wandering—and what can be done to help understand it and ensure that your loved one...Read entire article »

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The Physician’s Role The decision to enroll in hospice services can be difficult for patients and families, and may reflect a reluctance to accept a terminal diagnosis. The physician pays a central role in helping patients and families make the switch from life-prolonging treatment, when it is no longer appropriate, to an approach focused on end-of-life care goals. Patients need assurance that no matter what treatment option is chosen, the goal of comfort will always be paramount. The topic...Read entire article »

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