ABSTRACT
The majority of residents in a nursing home have some degree of dementia. The prevalence is commonly from 70% to 80% of residents. This article covers the following topics on caring for patients with dementia in long-term care: (1) the efficacy of cholinesterase inhibitors and memantine, (2) the optimal environment for maintenance of function in moderate dementia, (3) the treatment of depression and agitation, and (4) the evaluation and management of eating problems.
Subject(s)
Antiparkinson Agents/therapeutic use , Cholinesterase Inhibitors/therapeutic use , Dementia/drug therapy , Long-Term Care , Memantine/therapeutic use , Aged , Aged, 80 and over , Dementia/complications , Dementia/psychology , Depression/complications , Depression/psychology , Female , Humans , Male , Psychomotor Agitation/complications , Psychomotor Agitation/psychology , Quality of Life , Residential Facilities , Social EnvironmentABSTRACT
Seventy percent of people in the United States who have dementia die in the nursing home. This article addresses the following topics on palliative care for patients with dementia in long-term care: (1) transitions of care, (2) infections, other comorbidities, and decisions on hospitalization, (3) prognostication, (4) the evidence for and against tube feeding, (5) discussing goals of care with families/surrogate decision makers, (6) types of palliative care programs, (7) pain assessment and management, and (8) optimizing function and quality of life for residents with advanced dementia.
Subject(s)
Aging/psychology , Decision Making , Dementia/psychology , Long-Term Care , Palliative Care/methods , Patient Transfer , Aged , Aged, 80 and over , Comorbidity , Dementia/epidemiology , Dementia/therapy , Family , Female , Hospitalization , Humans , Male , Palliative Care/organization & administration , Prognosis , Quality of Life , Residential Facilities , United States/epidemiologyABSTRACT
Dementia, or neurodegenerative disease, is a disease category, and yet it is widely described in popular and professional media as a horror story. Patients with dementia and their families frequently report that they are less than pleased with their clinical encounters. This article reveals the deleterious impact that cultural assumptions about dementia have on the care provided, and, through an exploration of anthropological theories of personhood, suggests strategies for seeking improved quality of life through personhood-centered care.