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Holistic Care at Home

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According to the Alzheimer’s Association, more than five million Americans are living with Alzheimer’s disease, and by the year 2050, that number is expected to double due to our aging populations.

Caring for patients with Alzheimer’s or dementia can have its own special set of challenges. The matter is often compounded by the fact that approximately 80 percent of elderly patients have one chronic health condition and 50 percent have two or more chronic health conditions that must be managed.

In addition to physical health concerns, Alzheimer’s and dementia patients also have psychological challenges. They may be dealing with the death and dying of loved ones, struggling with their loss of independence, or even facing depression.

Caring for these individuals can often lead family and friends to make difficult decisions, such as the decision to seek home care or move their loved one to an assisted living or skilled nursing facility.

Home care visits, such as those provided by VNA Nazareth Home Care, part of KentuckyOne Health, send clinicians and nurses to private residences and assisted living facilities when it is difficult for patients to travel for care due to their medical conditions.

VNA nurses work to meet the mental and physical health needs of their patients. Both skilled and mental health nurses provide services to patients. Partnered with physical, occupational, and speech therapists, VNA services address a wide range of health needs.

Addressing the mental health care needs of patients, in particular those with Alzheimer’s or dementia, is an important part of care. VNA has a teaching tool called “Alzheimer’s Disease: Caring for the Patient and Family,” for home health clinicians to use with caregivers and patients to help them better understand the diagnosis of and best care for patients.

If a patient has not been diagnosed with Alzheimer’s or dementia, but exhibits symptoms, VNA clinicians screen patients with the St. Louis University Mental Status (SLUMS) Examination.

In the spring of 2014, VNA Nazareth Home Care will introduce a new mental health program with a specialized track for the care of Alzheimer’s or dementia patients. The program will include evidence-based guidelines from the American Psychological Association and the Alzheimer’s Association. VNA mental health nurses will use the program as a guide for caring for patients with Alzheimer’s or dementia.

In order to meet the complete needs of the patient, VNA nurses collaborate with neurologists and other physicians regularly to ensure patients are receiving the best care and all orders are being followed. The nurses monitor medications for efficacy and side effects and implement suggestions from physicians.

Monitoring medications is particularly important in dementia or Alzheimer’s patients. In addition to memory issues, these patients commonly suffer from one or more illnesses for which they receive treatment. It’s important to ensure their medications are working well and not interacting or causing a negative impact.

Proper medication monitoring and educating families on the symptoms of larger health concerns are also important to help avoid unnecessary hospital admissions. Alzheimer’s and dementia patients cannot always communicate correctly when they have physical ailments, so caregiver watchfulness is very important. Caregivers are instructed on what symptoms to watch for and to call VNA for assistance when concerns arise.

VNA mental health nurses also provide support to caregivers to help them manage through their emotions and find ways to reduce stress. For example, in an Alzheimer’s or dementia patient who also has heart failure, caregivers may be instructed to watch for weight gain that could be a sign of fluid build up around the heart. If they notice a change, they are instructed to contact their VNA nurse. VNA nurses can help avoid a hospital trip by coming out and providing care that keeps an issue from becoming severe.

Using a holistic approach to care can improve outcomes for patients. It can prolong an individual’s independence, ability to conduct activities of daily living, and overall quality of life.