Alzheimer’s in the Late Stage: The Myth of Compassionate Care

Over the next few days, we’ll be looking at the need for better care for patients in the late stage of Alzheimer’s disease.  Today’s post is Part 1 in this series.

There has been a great deal of emphasis on finding a cure for Alzheimer’s disease. However, The Cure –should it be found – will certainly take place some time faraway in The Future. Right this very minute there are families, hospitals and long-term care settings throughout our community struggling to meet the unique needs of those in the late stages of the illness.

They are most vulnerable to behavioral problems ranging from agitation and aggression to withdrawal and failure to thrive. These conditions render them a threat to themselves and to their caregivers. In the institutional setting, they pose a threat to other frail, vulnerable residents and to their professional caregivers.

Sometimes, a “cause” is recognized and resolved, and a portion of these patients will return to baseline. Unfortunately, “baseline” is a moving target in an unpredictable and progressive disease process.

Most typically, these patients are in the end stages of the illness. Damage to the brain is extensive, and functioning profoundly and irretrievably impaired. There is no potential for restoration here. Palliative or hospice care, read: aggressive comfort care is the clinical imperative.

 And the moral imperative of an informed and compassionate Society.

Good News- Bad News?

Increased life expectancy meets age related decline…

 These numbers seem to be everywhere these days:

Beginning this year, boomers will turn 65 at a rate of more than 10,000 per day.  As they age, one in eight will develop Alzheimer’s.  At 85, one in two elders will be affected. [Alzheimer’s Association]

 It is doubtful that a Cure will arrive in time to make any difference to those of us presently cresting into later life. The albeit essential campaign for a future Cure is also meager solace to those of us now providing Care for parents, spouses, and friends. Right here, right now we are failing our late stage Alzheimer’s patients who deserve effective palliative and hospice care. We are failing the responsibility-the obligation to do what’s right for victims of a devastating, terminal illness: assuring emotional and physical safety and comfort at the end of life.

 We hope you’ll join us for Part 2 in this series, when we discuss some of the issues facing patients in the late stages of Alzheimer’s disease.