New Guide: Bringing Comfort to Nursing Home Residents with Dementia

CAST | June 22, 2016

Seventy-five percent of people with dementia will spend time in a nursing home, most typically in the moderate and advanced stages of their conditions. A new guide outlines how nursing homes can bring comfort to those residents and, by extension, to their families and friends.

Palliative Care for People with Dementia: Why Comfort Matters in Long-Term Care was released in late June by CaringKind, formerly known as the Alzheimer’s Association, New York City Chapter.

The guide shares the lessons that CaringKind learned during a 30-month process to help 3 New York City nursing homes and their hospice partners implement “dementia-capable palliative care.” Those nursing homes, which are all LeadingAge members, include:

The CaringKind initiative was based on the groundbreaking Comfort Matters™ initiative spearheaded by the Beatitudes Campus, a Leading Age member in Phoenix, AZ.

That model adapts palliation – defined as preventing or relieving distress -- to the care of people with dementia. It encourages nursing home staff to take active steps to “discover what comforts someone and even gives them pleasure, and … to prevent or avoid unnecessary pain and suffering before they take hold,” according to the guide.

The LeadingAge Center for Applied Research participated in the research components of both the Beatitudes and the CaringKind projects.

Bringing Palliation to Dementia Care

Nursing homes must make modifications in how they offer and deliver palliative care so that it will be most effective for residents with advanced dementia.

“Staff trained in dementia care is necessary but not sufficient,” says the guide. “Organizational systems must be aligned to support a palliative approach and to insure that staff efforts are effective.”

The CaringKind publication offers myriad tips on how nursing homes can use a palliative care approach to better address needs that residents with advanced dementia often express exclusively through their behavior.

“These behavioral expressions are almost always signs of distress,” says the guide, adding that dementia-enabled palliative care addresses “needs underlying behaviors rather than the behaviors themselves.”

Components of the CaringKind Guide

In addition to offering guidance on starting a dementia-enabled palliative care program, Palliative Care for People with Dementia explores how nursing homes can maximize the comfort of residents with dementia by:

  • Educating staff members about palliative care for people with advanced dementia, and providing an orientation to a comfort approach
  • Improving the care planning process for people with dementia
  • Working as partners with families to find true comfort for residents
  • Practicing consistent assignment
  • Implementing an effective pain program
  • Balancing stimulation and rest for residents with advanced dementia
  • Creating comfortable care environments
  • Making the most of meals
  • Implementing activities that offer meaningful engagement
  • Helping families make decisions about treatment and end-of-life care
  • Supporting the palliative care approach with organizational policies, procedures, and protocols

About CaringKind

CaringKind has been working for more than 30 years to create, deliver, and promote comprehensive and compassionate care and support services for individuals and families affected by Alzheimer’s disease and related dementias, and to eliminate Alzheimer’s disease through the advancement of research.

The organization provides programs and services for individuals with dementia, and their family and professional caregivers; works to increase public awareness about Alzheimer’s disease; collaborates with research centers; and informs public policy through advocacy.