Dementia in Nursing Homes Requires Special Care…and Compassion

Aging isn’t always dignified. That’s especially true for people with dementia. Alzheimer’s disease dismantles a person’s life piece by piece: short-term memory is the first to go, followed by long-term memory, recognition of family members, recognition of self, all cognitive abilities. In addition, a person loses physical capabilities–the ability to walk, to talk, to balance, and even to eat.

Eventually, a person with dementia becomes totally dependent on the care of others. Because the medical needs are intensive, families are generally unable to provide adequate care and a loved one is placed in the hands of a long-term care facility.

We’d like to think that a nursing home that courts families of dementia patients would provide trained and compassionate care. Unfortunately, that’s not always true.

In a letter to the Chicago Tribune, Kim Warchol (of Dementia Care Specialists, Inc.) notes that nursing home residents can’t achieve their best lives unless nursing home staff are properly trained to provide safe, therapeutic care. She states:

“Based on my experience, between 60 to 80 percent of those living in geriatric nursing facilities have dementia, and well over 50 percent of those admitted to assisted living facilities have functional loss due to cognitive impairment. And with a new diagnosis being made every 70 seconds, long-term care facilities must empower their staff for the challenges ahead.” [Kim Warchol, letter to Chicago Tribune]

Her wish is that new laws be enacted to encourage facilities to move from an impairment-based practice to an abilities-based practice, which respects the person behind the disease. What a fantastic idea. Why does it have to even be mentioned as a “revolutionary” concept? It seems basic–dignity for all, but especially for those who lose everything else.

Feeding Dementia Patients with Dignity

A related article in the New York Times this week talks about the “revolutionary” concept of feeding dementia patients with dignity. After a person loses the ability to eat, the family typically is asked whether they would prefer to have a gastric feeding tube inserted so nourishment can be forced, or not…which is the equivalent of withholding nourishment. The decision is always heartbreaking.

But get this…some social workers are suggesting that there is a third option: to feed the patient carefully and slowly by hand, stopping when the person has enough, starts choking, or becomes agitated.

Doctors are calling this new option in palliative care “comfort feeding only.” In a recent paper in The Journal of the American Geriatrics Society, the authors argue that feeding tubes do not necessarily prolong life in patients with advanced dementia, and that surveys indicate that a vast majority of nursing home residents say they would rather die than live with a feeding tube.

“Just imagine someone interacting with the patient, talking to them, cueing them into eating,” Dr. Teno [Joan Teno, professor of community health at Brown University’s medical school] said, “as opposed to someone walking to the bedside and pouring a bottle of Ensure down the feeding tube.” [from New York Times article]

Dignity…who knew it could be so revolutionary. At HensonFuerst, every day we fight for the basic dignities of people in nursing homes. We agree that special training should be required of everyone who treats dementia patients, but we would like to take that one step further. Let’s require compassion, caring, and, yes, dignity for our parents and grandparents when they live their days in a nursing home.

HensonFuerst Attorneys provide a voice for people in long-term care, and their families. If you have questions about how your loved one is being treated and suspect neglect or mistreatment, feel free to contact us. If you have questions, HensonFuerst has answers.

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