Alzheimer's disease: Anticipating end-of-life needs

As an Alzheimer's caregiver, you might be your loved one's most powerful voice. Make decisions for your loved one that ensure respect, dignity and comfort until the end of life.
By Mayo Clinic Staff

In the early stages of Alzheimer's disease, caregivers often focus on keeping loved ones safe and comfortable. As the disease progresses, however, you might face difficult end-of-life questions. When is it time to choose comfort care over lifesaving care for your loved one? When does medical care merely prolong a person's dying? Here's help considering these and other end-of-life questions.

Create advance directives

Advance directives are written instructions regarding your loved one's preferences for medical care at the end of life. Ideally, discuss these preferences with your loved one while he or she is still able to communicate. Later, make sure copies of advance directives are included in your loved one's medical charts. This is important if your loved one moves to a nursing home or other facility for long term care or needs care in a hospital or emergency room. The advance directives will help the staff know what is — and isn't — to be done in medical emergencies.

Focus on comfort, not life extension

As Alzheimer's progresses, your loved one might not be able to communicate that he or she is in pain. Look for clues, such as a sudden increase in disruptive behavior or trouble sleeping. Physical signs might include sores, swelling or pale skin. Speak to the medical team about adjusting your loved one's treatment plan to ensure his or her comfort.

Eventually, you might need to weigh your loved one's comfort against the benefits of prolonged life. In some cases, efforts to prolong life — such as dialysis, tube feeding and antibiotics to treat bacterial infections — might result in unnecessary suffering for people who could otherwise reach the end of life in relative comfort and peace.

May. 24, 2014 See more In-depth