Palliative Care for Advanced Alzheimer's and Dementia

Gary Martin, PhD, is a Licensed Clinical Psychologist and a Geriatrics and Long Term Care Specialist who is an owner of Integrated Geriatrics Behavioral Health Associates, PA, an incorporated behavioral health provider group in Scottsdale, AZ. Dr. Martin is the Clinical Director of several retirement and assisted living communities in the Greater Phoenix area. In addition, he is the Clinical Director of fourteen LTC-based specialized Behavior Units and eleven specialized Dementia programs in the Greater Phoenix area. His areas of specialization include: program development for dementia care programs and behavioral treatment programs for high acuity patients in LTC settings; staff training, palliative care, and clinical oversight for persons with dementia; consultation with nursing homes, assisted living facilities, families, and other caregivers on treating older adults; and the education and training of health care professionals, physicians, social service staff, and medical and gerontology students in the field of clinical gerontology. Dr. Martin is the recipient of numerous awards, including the Outstanding Community Service award from the Arizona Alzheimer's Consortium, Provider of the Year award from the Arizona Business Journal, and several Best Practices Awards from Arizona nursing home advocacy groups. Dr. Martin serves on the Board of Directors of the Alzheimer's Association, Desert Southwest Chapter, and is affiliated with the APA, GSA, Psychologist in LTC (founding member, 1984). ||Marwan N. Sabbagh MD is a geriatric neurologist and dementia specialist; he is one of the leading experts in Alzheimer's disease research nationally. Dr Sabbagh received his bachelor's degree in Physiology at the University of California-Berkeley in 1987. He went on to the University of Arizona, College of Medicine in Tucson, AZ where he received his MD in 1991. He completed a neurology residency at prestigious Texas Medical Center and Baylor College of Medicine in Houston, Texas in 1995. From there, he underwent additional training in dementia/geriatric neurology training at the University of California-San Diego. Then, he served on the faculty at UCSD as assistant professor in the department of neurosciences. In 2000, he was recruited to Banner-Sun Health Research Institute to be the founding director for the center for clinical research. Since, becoming the director of the Cleo Roberts Center for Clinical Research at Banner-Sun Health Research Institute, Dr Sabbagh has conducted over 80 clinical trials and clinical research studies in Alzheimer's disease and other brain degenerative and medical conditions including being the site Principal Investigator or national principal investigator for several prevention and treatment trials for Alzheimer's disease. He serves on the board of directors for the Desert Southwest chapter of the Alzheimer's Association. Dr Sabbagh has authored or co-authored over published 100 article, chapters and abstracts in Alzheimer's disease research including in respected medical journals such as Neurology, Archives of Neurology, Journal of Alzheimer's Disease, Alzheimer's disease and Associated Disorders, Proceedings of the National Academy of Sciences, Current Alzheimer's Research and most recently in the New England Journal of Medicine. He serves as senior associate editor for the Journal of Alzheimer's Disease and Clinical Neurology News and BMC Neurology. Dr Sabbagh has authored the critically acclaimed book The Alzheimer's Answer: Reduce Your Risk and Keep Your Brain Healthy. Dr Sabbagh has also been a prominent featured speaker on Alzheimer's at many regional and national conferences

Acknowledgments xvii


Section I: Introduction to Professional Management of Advanced Dementia



1. Determining and Defining Advanced Dementia

2. The Continuum of Care

3. Caregiving




Section II: Protecting Dignity for the Patient with Dementia: Establishing an Environment and Caregiving Standards



4. Personhood

5. Creating the Optimal Milieu for Care

6. Managing Behavior Problems Associated with Advanced Dementia

7. Assessing and Addressing Pain

8. Ensuring the Appropriate Use of Medications in Advanced Dementia




Section III: Managing Activities of Daily Living



9. Eating and Nutrition

10. Dressing and Grooming

11. Bowel and Bladder Management

12. Ambulation and Mobility

13. Bathing




Section IV: Providing for Other HealthCare Needs



14. Activities Programming

15. Cultural Diversity

16. Healthcare Decisions for Advanced Dementia

17. The Continuum of Grief

18. Establishing Healthcare-Related Legal Options for the Vulnerable Patient




Glossary




Appendix A. Professional and Caregiver Resources for Advanced Dementia




Appendix B. Cultural Resources on the Web




Appendix C. Federal Guidelines for Providing Culturally Sensitive Care




Appendix D. Cultural Heritage Assessment Form




Index