End Stage Dementia

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When recalling his grandmother’s end-stage of life care, Greg A. Sachs, MD, a geriatrician of the Indiana University Center for Aging Research, remembers that there has been little change in the care of patients with end-stage dementia in the past 30 years (Boyles, 2009). According to Sabat (2009), the need for improving the lives of patients with end-stage dementia; “constitutes a call to action that cannot and should not be ignored” (p. 1806).

In this study, I will seek to discover changes that I can make in the daily care routines of cognitively impaired patients to decrease their stress levels. I propose that small changes in their routines will result in lowering stress levels of these patients and improving their quality of life. This improvement will occur because increased stress decreases the mental systems available for cognitive processes in patients with diminished cognition, as in that of patients with a diagnosis of middle-to-end-stage Alzheimer’s disease (Sabat, 2006). This study will be the first of several sub-studies to examine opportunities for the elimination of unnecessary stressors for these cognitively impaired patients, which will then reduce the stress levels of caregivers who are caring for these patients.

For additional information and guidance, I will film the interactions of patients with their caregivers just as Rogers and his colleagues did of his counseling sessions with clients (Gundrum, Lietaer, & Van Hees-Matthijssen, 1999). The purpose of this filming will be to highlight areas needing change and to direct attention to where further changes in care guidelines can be made. I expect that because of this study, we will be able to provide new instructions in how to better commun...

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...his study as opposed to the level of interaction with these patients that existed before this study began.

1. Hypothesis: A reduction in the stress level of patients will enable patients to interact more with staff, family, and friends.

Null hypothesis: Due to the cognitively impaired diagnosis of patients, small changes in the stress levels of patients will make no changes in the interactions patients have with staff, family, and friends.

2. Hypothesis: Making changes to the bathing ritual to increase respect of the patient’s personal space and comfort will reduce anxiety in patients and increase his or her cooperation in the bathing ritual.

Null hypothesis: Because of the cognitive decline experienced by patients diagnosed with Alzheimer’s disease, there will be no reduction in anxiety levels of patients because of changes in bathing routines.

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