Alzheimer's Disease: A Handbook for Caregivers

By Ronald C. Handy; James M. Turnbull et al. | Go to book overview

Chapter 20
Terminal Care of the Patient

Marcia M Johnson
Mary M Lancaster

Now it is time that we are going, I to die, and
you to live. But which of us has the happier
prospect is unknown to anyone, but God.

—Socrates


TERMINAL AND PALLIATIVE CARE

Terminal care, palliative care, and chronic care are terms that are intermingled and often used interchangeably. Terminal care can be defined as the care provided to a patient with a debilitating condition that is medically incurable or not treatable using the available technology and can be expected to cause death. This includes conditions in which death is imminent, as well as chronic and debilitating conditions from which there is no reasonable hope for recovery.

Palliative care is the active total care of patients whose disease is not responsive to curative treatment. It may also be appropriate to use it to manage suffering for patients with chronic, progressive diseases such as Alzheimer's disease. The actual term "palliative care" has been adopted by the World Health Organization (WHO) to describe the care of patients with advanced disease. When cure is no longer possible, the goal is the achievement of the best possible quality of life for patients and their families.

Chronic care is a general term that includes the care of patients with chronic illnesses and impairments, and indicates the presence of long-term disease or symptoms, such as Alzheimer's disease. All three of the above terms may be referred to when discussing the end-stage care of the patient with Alzheimer's disease.


ASSESSMENT IN ADVANCED ALZHEIMER'S DISEASE

As the patient progresses through the stages of Alzheimer's disease, he or she becomes more and more incapacitated and eventually requires total care. Astute observation and assessment are required because the patient can no longer verbally communicate her needs. Difficulty with swallowing and loss of speech

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Alzheimer's Disease: A Handbook for Caregivers
Table of contents

Table of contents

  • Alzheimer's Disease - A Handbook for Caregivers *
  • Contributors v
  • Reviewers ix
  • Foreword from First Edition xiii
  • Preface xv
  • Acknowledgments xvii
  • Contents xix
  • Chapter 1 - Alzheimer's Disease: an Overview 1
  • Unit One *
  • The Normal Brain *
  • Chapter 2 - Higher Brain Functions 11
  • Chapter 3 - Neuropsychological Assessment of Dementia 27
  • Chapter 4 - Imaging the Brain in Alzheimer's Disease 41
  • Unit 2 *
  • Alzheimer's Disease *
  • Chapter 5 - Historical Perspectives 51
  • Chapter 6 - Etiology and Pathogenesis: Current Concepts 60
  • Chapter 7 - Clinical Presentation 74
  • Chapter 8 - Clinical Diagnosis 87
  • Chapter 9 - Factors That Aggravate the Symptoms 104
  • Chapter 10 - Other Dementias 117
  • Unit Three *
  • Management *
  • Chapter 11 - General Principles of Management 143
  • Chapter 12 - Management of Difficult Behaviors 150
  • Chapter 13 - Psychopharmacology in Dementia 171
  • Chapter 4 - Specific Drug Therapy 183
  • Chapter 15 - Urinary and Fecal Incontinence 199
  • Chapter 16 - Management of Urinary Incontinence 213
  • Chapter 17 - Safety and Accident Prevention 227
  • Chapter 18 - Daily Care and Management 243
  • Chapter 19 - Developing a Day's Activity 259
  • Chapter 20 - Terminal Care of the Patient 276
  • Unit 4 *
  • Special Issues *
  • Chapter 21 - Ethical Issues 293
  • Chapter 22 - Legal Issues for Caregivers 306
  • Chapter 23 - Stress in Caregivers 316
  • Chapter 24 - Elder Abuse 328
  • Unit Five *
  • Community Support *
  • Chapter 25 - Caregiver Education and Support 341
  • Chapter 26 - Social Services 354
  • Chapter 27 - The Alzheimer's Association 367
  • Chapter 28 - Dementia Care Units 377
  • Unit Six *
  • Future Prospects *
  • Chapter 29 - Promising Areas of Research 393
  • Appendix A - Some Useful Addresses and Phone Numbers 399
  • Appendix B - Additional References 415
  • Glossary 423
  • Index 441
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