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Management: Late Stage
The resources in this section are helpful for implementing appropriate interventions, supporting patients and their families, making transitions comfortable while minimizing anxiety and behavioral problems, and maintaining respect for the patient’s wishes and quality of life in late-stage dementia.
Suggested Physician Resources
Anticipatory Guidance in Dementia Across Stage and other Fast Facts
The Palliative Care Network of Wisconsin has multiple Fast Facts for the management of late-stage dementia. These include anticipatory guidance in dementia across the stages, decision making for patients with advanced dementia and a hip fracture, and a review of dementia medications in palliative care. Other symptom-specific management topics can also be found at the site.
Appropriate Prescribing of Antipsychotic Medication in Dementia
Many antipsychotic medications are not approved for the treatment of patients with dementia-related psychosis. Nonpharmacological methods are preferred for the management of behavioral and psychological symptoms in patients living with dementia. This UK National Health System guidance reviews uses, risks and alternatives to antipsychotic medication and risk reduction in antipsychotic medication prescribing.
Dementia Care Practice Recommendations for Assisted Living Residencies and Nursing Homes
The Alzheimer’s Association Campaign for Quality and Residential Care created a resource for physicians caring for patients through later stages of the disease. The guide provides strategies, recommendations, and guidance on issues such as talking with families, decision-making, choosing facilities for care, and other parts of care management.
Prognostication in Dementia
The ePrognosis site has prognostic calculators for individuals with dementia, especially those who live in nursing homes or have been hospitalized.
Hospice Care
The Alzheimer’s Association provides an overview of information related to hospice care, including a community resource finder.
Autopsy Information
This brief primer from the Alzheimer’s Association can offer steps that are needed to prepare for autopsy and managing the process for a patient who has Alzheimer’s disease.
Patient, Family, and Caregiver Resources
Managing Dementia Across the Continuum
Adapted from ACT on Alzheimer’s®, Managing Dementia Across the Continuum is a comprehensive listing of resources for mid- to late-stage case management for the dementia patient.
Area Agencies on Aging
There are local agencies throughout the country devoted to aging. These agencies, whic often have expertise in local aging resources, can be public or private non-profit agencies designed to support care for older adults in their homes.