Older adults with dementia and their caregivers face serious challenges. Dementia symptoms can include confusion, agitation and memory loss, which may lead to feelings of anger and frustration. But with education and support, you can maintain a positive relationship and help create a calm, comforting environment.Amedisys is here to help bring more peaceful, gratifying moments into your loved ones end-of-life dementia care. Our specialized end-stage dementia program helps improve the quality of life of our patients and their families through education, support, pain and symptom management, and caregiver empowerment. We provide compassionate end-of-life care wherever your loved one calls home.Did You Know? Your loved one is not alone. An estimated5.5 million Americans have Alzheimers disease, the most common form of dementia among elderly people.End-Stage Dementia Program HighlightsFocus on improving quality of life while managing the symptoms of dementiaSpecialized care from a diverse team of professionals who have intensive training in end-stage dementia careDementia care that is backed by the latest research and goes beyond medicationsPersonalized hospice and palliative care planning tailored to the older adults needs and wishesHow Hospice Care at Home Helps With DementiaEvery familys journey is different. Well work with you to create a home hospice care plan that focuses on what matters most to you and your loved one. Elderly people with dementia receive care from a compassionate team of nurses, social workers, hospice aides, chaplains, bereavement counselors and trained volunteers, in conjunction with their doctor. Our end-stage dementia hospice program offers:Pain and symptom control so older adults with dementia can spend quality time with their caregivers and loved onesNonverbal pain and behavior assessmentMedical care, including visits by a nurse, for acute conditions like infections, behavioral issues and breathing difficultiesHelp with nutrition and specialized feeding needsSkin assessment and protectionHelp with bathing, grooming and personal care from a hospice aideMedications, medical equipment and supplies related to dementiaSpiritual support with a hospice chaplainEmotional support and resources for the patient and family from a hospice social workerImproving Your Loved Ones Quality of LifeIn home hospice care, we focus on preserving quality of life as the disease progresses, not curing dementia. In addition to pain management, some of the ways we can help older adults with dementia feel more comfortable include:A safe, relaxed environmentTherapeutic blanket to calm unsettled behaviorsActivity lap pad with various textures and moveable parts to touch, helping to reduce agitation and increase mental stimulationChart-a-Life collage of memorable images that allows your loved one to relive significant past experiences and maintain mental, social and emotional functioningComfort musicto reduce restlessness and improve sleep, memory and social interactionSoothing comfort baths to minimize bathing stress, agitation and safety risksGentle touch or massage, which provides relaxation, stress reduction, improved circulation and pain reliefJournaling as a form of communication and reflection between families and patientsConnection, compassion, communication and reassuranceDid You Know? Most elderly people (80%) with Alzheimers disease and related dementias receive care in their homes, usually provided by family or friends.Support for Senior CaregiversWe understand the gratification, as well as the intense demands, of caring for a loved one with dementia. As the disease progresses, it can be difficult to manage dementia symptoms such as confusion and personality changes.Senior caregivers have difficult decisions to make about their loved ones care. You also face major life decisions of your own such as needing to stop working or cut back on hours to meet the needs of a loved one with dementia. The stress can take a toll. Our specialized hospice program for dementia can help by:Exploring family needs and expectationsProviding caregiver education and support, which allows senior caregivers to spend more time as a loved one and less time as a caregiverSupporting loved ones as they process grief, loss, anxiety, depression and other emotionsOffering respite care, which gives caregivers a needed break to rest and rechargeDementia Symptoms We Address in Hospice CareIn our end-stage dementia program, we address safety concerns and treat the following symptoms of dementia:Unsettled behaviors such as restlessness, confusion and Sundowners Syndrome (late-day confusion)PainFearDepressionFatigueSkin breakdownAltered nutritionGoals of Dementia Care in HospiceSome of the goals of our end-stage dementia program include:Improve comfort and quality of life for patients and senior caregiversCreate lucid moments for the patientIncrease family support and satisfactionAvoid unnecessary trips to the hospitalWhat Are the 7 Stages of Dementia?Your loved ones healthcare provider may talk with you about the stages of dementia. This is a way to determine how an older adults dementia symptoms have progressed and find the best treatment for their needs. There are several scales for rating dementia. One of the most commonly used for older adults with Alzheimers disease is the Reisberg Scale, or Global Deterioration Scale. This scale describes the seven stages of dementia, based on the severity of an elderly persons symptoms. Because people dont typically get diagnosed with dementia in the first three stages, stage 4 is considered early dementia, stages 5 and 6 are middle dementia, and stage 7 is late-stage dementia.Dementia Stage 1:Normal functioning, with no memory loss or mental health issuesDementia Stage 2:Normal forgetfulness associated with agingDementia Stage 3:Loved ones may start to notice some of the following early dementia symptoms:Increased forgetfulnessTrouble finding the right wordsSlight difficulty concentratingDecreased work performanceDementia Stage 4:The older adults doctor can detect cognitive issues during an exam, based on the following dementia symptoms:Difficulty concentratingMemory loss about recent eventsTrouble managing finances or traveling alone to new placesDifficulty with complex tasksDenialWithdrawal from friends or familyDementia Stage 5:Dementia symptoms intensify to include:Major memory loss that may include important aspects of current life events (e.g., date, time, address or phone number)Need help with some daily activities such as bathing and cookingDementia Stage 6:Significant declines lead to some of the following dementia symptoms:Need extensive help with daily activitiesMemory loss that may include recent events and names of close family membersDifficulty with tasks like counting down from 10Incontinence (loss of bladder/bowel control)Trouble speakingPersonality changesCompulsive or repetitive behavior such as cleaningAgitationDementia Stage 7:In end-stage dementia, the older adult may have the following additional symptoms:Inability to speakNeed assistance with most daily activitiesInability to walkDid You Know? In 2016,18%of hospice Medicare beneficiaries had Alzheimers disease or dementia as their main diagnosis.When to Call Hospice for DementiaDementia is a chronic disease that sometimes follows an unpredictable course. For this reason, it can be difficult to determine the life expectancy of an elderly person with dementia. So how do you know when itstime for hospiceand palliative care?For many families, an important consideration is quality of life. What are your loved ones goals of care? If comfort, patient and caregiver support, and quality of life are some of the top priorities, hospice care may be the best choice. We can help you gather information, make a plan and determine if your loved one is eligible for hospice care.Signs of end-stage dementia may include:Having trouble eating and swallowingLimited speech, or being unable to speakIncontinence (loss of bladder/bowel control)Needing help to walk, or being unable to move without helpNeeding help with daily activities like eating, bathing and getting dressedDeveloping infections such as pneumoniaBeing diagnosed with another condition such as COPD, heart failure or cancerMore frequent trips to the hospitalFeeling more agitated or restlessMemory loss, which may lead to inability to recognize friends and familyWe can help you decide if it is time to bring in an Amedisys hospice care team to provide additional care and support. Hospice care provides relief for both patients and caregivers. Many families tell us their biggest regret is not getting hospice care sooner.

1 Out of Every 4 Americans Dying is a VeteranAs we care for our hospice patients, we see that active military personnel or Veterans may have unique and special needs that enable us to care for them in a very special way. They may have served in combat, witnessed their comrades die in battle or suffered trauma during their military service which has created memories that have been hidden away for years. They may have never told anyone about their experiences and only when they have developed a relationship with their hospice team are they able to finally share their stories and memories and achieve a true peace which heals their heart and soul.AseraCare Hospice an Amedisys company in Lincoln, NE is proud to be a Level 4 We Honor Veterans Partner. We Honor Veterans is a national program conducted by the National Hospice and Palliative Care Organization in cooperation with the Department of Veteran Affairs. This program assists hospice professionals to better understand the challenges Veterans may be facing during their end-of-life journey. We are proud to coordinate and offer special ceremonies and services such as our Vet-to-Vet cafes, We Honor Veterans pinning ceremonies, support groups and special recognition and honors on military holidays.In addition, AseraCare Hospice an Amedisys company in Lincoln, NE collaborates with the Lincoln Quilters Guild to present our Veteran patients with a Quilt of Valor. The mission of the Quilts of Valor Foundation is to cover service members and veterans touched by war with comforting and healing Quilts of Valor.As part of our Volunteer Program and our partnership with the We Honor Veterans Program, we utilize Veteran Volunteers within our Volunteer Program. Our Veteran Volunteers are active members of the military or Veterans, who are trained as a Hospice Volunteer to serve as a specialized hospice volunteer to help care and meet the needs of our Veteran patients at the end of life in our Vet to Vet Volunteer Program. Our Veteran Volunteers make regular visits to the Veteran patient, allowing them to share their stories with someone who understands military culture and/or military history.It is a great privilege for AseraCare Hospice an Amedisys company in Lincoln, NE to collaborate with the Lincoln Quilters Guild and our Veteran Volunteers to honor the Veterans who come to us for care, to thank them for their service to our country and to help them find peace and comfort in their end-of-life journeyEditors Note: This article was submitted by Bruce Jones,He is with AseraCare Hospice and may be reached at402-488-1336 or by email at Bruce.Jones@aseracare.com