Session 9.
Person-Centred Dementia Care Plan.
The Late Stage of Dementia.
Thank you so much for joining me for Session 9 of this 10-part course.
We are nearing the end of the program and I'm really glad you're here.
I trust that you may have started to use some of the strategies outlined over the last 8 days and that small positive shifts are happening for yourself and the person living with dementia.
Today we are addressing a difficult topic,
That of end-stage dementia.
Some of you might already be navigating this phase with the individual you're helping.
For others,
You might be looking ahead to gather useful information for compassionate care when the disease has progressed to end-stage for the person you're looking after.
I sympathise with anyone going through this part of the journey.
It's tough to stay on track mentally,
Emotionally and physically.
Today,
I'd like for you to step gently through the content.
Acknowledge any thoughts,
Worries or emotions that may arise as a normal part of the process of dealing with late-stage dementia care planning.
From a personal experience,
I know how tough this is,
So I'm with you.
Take breaks whenever you need to.
Mindfulness is an easy and accessible practice that is supportive.
If you can find inner stability and resilience by meditating,
Even for a minute,
You might gain a little control over intrusive thoughts,
Feelings and emotions.
Tough days may feel a little easier after pausing in the present moment.
When interventions that used to work well are now ineffective and when you're feeling stuck or unable to figure out how best to help the person in your care,
Using mindfulness allows you to regroup and begin again.
Despite the obstacles you and the person in your care face,
Healing modalities like meditation allow for a stronger connection between yourself and the individual who is in late-stage dementia.
Happiness is a skill that you can develop with practice.
Small actions,
Many times,
Create change.
Sit or stand somewhere comfortable and calm.
Focus on the sounds around you.
Keep your breath steady.
Let go of thoughts about the future.
Breathe in and out gently.
Today,
Contemplate inclining towards the good.
The good in yourself,
Your friends,
Your loved ones and the person in your care.
Inclining towards the good helps us remember we're all doing the best we can.
There's no perfect,
There's no right or wrong way.
All of us can come back to this moment,
This breath and begin again.
You've sustained your commitment to compassionate care thus far and now your resolve to continue is a strength.
Incline towards the good on the in-breath and the out-breath.
If things get tough,
And they probably will,
You can always recenter by coming back to the good,
The kind,
The calm,
The sure.
Your intention to remain compassionate,
Empathic and to do good is your strength,
So just trust your instincts.
Okay,
You can open your eyes if they've been closed and take a moment to find a pleasant thing to look at in your environment.
Please be aware that the following person living with dementia tips are primarily for you,
The carer.
As the disease progresses,
The individual in your care may be more incapacitated and will often require you to seek professional advice on their behalf.
Late stage,
Symptoms,
Severe cognitive and physical decline,
Inability to communicate or perform daily tasks independently,
Potential for swallowing difficulty and mobility issues.
Duration,
Two or less years.
Towards end of life,
Professionals can take steps to reduce pain and distress,
Often using palliative care medication.
If swallowing becomes difficult,
Medication may be administered via skin patches,
Small injections or syringe pumps to provide steady relief.
Speak to medical staff about pain management and comfort care.
Medication can be adjusted as needed to ease discomfort in those final stages.
Care partner,
Speak clearly,
Slowly and calmly,
Using simple,
Respectful language.
Avoid elder speak.
If insincere,
The person may sense a condescending tone.
Maintain eye contact,
Use gentle gestures and keep facial expressions relaxed,
Even if you feel overwhelmed.
Calm,
Peaceful expressions of love and support comfort the person in care.
Always include the person in conversations about their care.
Avoid talking about them as if they're not present.
Accept what they say.
Validate their feelings and experiences,
Even if they seem nonsensical.
Offer reassurance.
The following tips are primarily for you as the carer to remain mindful of,
As the person may have limited capacity.
So these are for the person living with dementia that you're caring for.
Take care of yourself.
Share your diagnosis as appropriate.
Seek emotional support and medical advice.
Discuss wishes for end-of-life care with staff or loved ones.
Accept symptom relief and palliative care.
Encourage visits from family and friends for emotional support.
Ask for help when needed.
Use music and nature sounds for relaxation.
Tips and tools.
Prioritise comfort,
Safety,
And sensory stimulation while maintaining dignity and respect.
Trust healthcare professionals to guide care decisions and communicate any concerns or changes you observe so treatment can be adjusted.
Accept help and allow yourself breaks,
Even if it's just a moment in a quiet room nearby.
Staff will keep you informed if the person is nearing end of life.
This happened with my late mum when she was in the late stages of palliative care.
It's important to nourish yourself,
Even with simple food,
Between visits to help maintain your strength and,
If you can,
Rest when possible.
I know that's harder to do when you're in the middle of it.
Tell the person in the final stages they are loved.
Remind yourself you're doing the best you can.
It's OK to say no when needed.
For example,
If extended family or friends want a visit at a difficult time,
Kindly let them know when another time might be better.
Thank you for listening.
Today we've explored challenging themes and compassionate care options for late-stage dementia.
Take your time to reflect and care gently for both yourself and the person living with dementia.
Let's leave it there for now.
Step gently,
And I'll connect with you for our final session on day 10.
