As Alzheimer's and other dementias progress into the later stages, some people opt for additional support and care through home health care, a facility such as a nursing home, or hospice care. However, another less known choice also exists: palliative care.

Many people assume that palliative care is the same as hospice care, but that's not quite true. They're similar in that they both focus on the care and comfort of the person. Hospice care, however, includes the decision to opt out of aggressive care. It's appropriate for someone who, in the opinion of the physician, has less than six months to live and does not want invasive or potentially life-extending medical interventions such as a feeding tube or resuscitation.

Palliative care includes a strong emphasis on pain control and support. However, palliative care can be utilized throughout a serious disease process whether the goal is curative or comfort-related. Someone who chooses palliative care support can still receive aggressive care and treatment for a disease and, at  the same time, benefit from the additional support and comfort that palliative care offers.

For more on how palliative care can be a benefit for someone with dementia and when someone might be appropriate for palliative care, here's a link to the full article: Palliative Care: How Can It Help Someone with Dementia?

Related Information

How to Designate a Power of Attorney for Healthcare Decisions

Dementia and End-of-Life Decisions: Do Not Resusciate or Full Code?

What Are Living Wills and How Can They Benefit People with Dementia?

Recently in our Alzheimer's About.com forum, a reader described hurtful comments made by his or her Grandma who has Alzheimer's disease. The question asked was, "How should I respond to Grandma?"

A couple of other people wrote in with some great ideas. One suggested coming prepared to steer the conversation towards "safe" subjects and topics of interest to Grandma. Another encouraged the reader to continue to visit regardless and to try not to take those remarks personally. It's powerful when readers share their own in-the-trenches experiences and others come along side to encourage them.

I was thinking about that question of how to respond to those rude or careless comments made by people with Alzheimer's, and wrote an article with 6 tips that I hope are helpful for others in that same situation: Living with Alzheimer's: What to Say When Grandma's Not Nice

Related Articles

Conversation Starters for Talking with People Who Have Dementia

Tips for Positive Visits with People  in the Early Stages of Dementia

Ideas for Meaningful Activities in Dementia

If you were a fly on the wall of my house, chances are you'd hear, "Too much tv and video games will rot your brains!"

Turns out, I may have to revise that opinion.

A study published online in the journal Plos One has demonstrated a pretty surprising (at least, it's surprising to me) effect of a video game on cognition.

The study involved 681 participants who were categorized according to their ages: 50-64 and age 65 & over. They were then randomly assigned to one of two different groups:

• A control group of people who worked on crossword puzzles online for a total of 10 hours
• A group of people who were split into 3 different groups and played the video game Road Tour which focuses on improving visual processing speed

Of those who played the video game, some received onsite training on playing the game at the university labs for 10 hours, and others received the same onsite training along with an additional 4 hour booster training. The participants in the third subgroup were given a copy of the video game to use at home on their own computers for 10 hours.

The results were startling. All three subgroups in both age categories experienced a significant cognitive benefit from playing the video game, while those who participated in the online crossword puzzles experienced normal cognitive decline as expected per their age.

Cognition was measured by several different tests including the Useful Field of View test, the Trail Making (Trails) A and B Tests, Symbol Digit Modalities Test, Stroop Color and Word Tests, Controlled Oral Word Association Test, and the Digit Vigilance Test.

The researchers concluded that the brain training in this video game offered between 1.5 and 6.6 years of protection on the participants' age-related cognitive decline. The variance is due to the results on the different tests, from a low of a benefit of 1.5 years demonstrated on the Trail Making B test and a high of 6.6 years on the Symbol Digit Modalities Test.

Achieving results like this from only 10 hours of training, and training that can be completed in your own home, is pretty remarkable. And no, I don't have any financial or other ties to the makers of the video game.

The video game Road Test is now called "Double Decision" and is available online. A free trial is available at https://brainhq.positscience.com/default/start? under the "Attention" heading. Out of curiosity I did try it, and I definitely have room for improvement!

Have you ever heard someone say, "I can't wait for the time when I can't care for myself so I get to live in a nursing home!"? Nah, me either. Yet, that's the reality for many.

Emotions can swirl at the thought of turning over the care of a loved one to a facility like a nursing home. For some, that's their worst nightmare. For others, it's an evil necessity- a last resort. Some feel a relief in getting help with care that was too taxing. For still others,  it becomes a blessing that allows them to return to the role of a wife or son. Sometimes, it may feel like it's a mix of all of the above, and more.

Having been in the role of both a clinical professional and a family member, I think it's safe to assume we all want the best possible care for our loved ones. One way we can help our loved one adjust to a facility is to help ourselves with that adjustment, and that may mean coping with some of the guilt, grief, loss, relief and other emotions generated by such a life change. Of course, that doesn't mean it'll be easy and you won't have any difficult times, but hopefully it'll lighten the emotional load as you continue to care for and visit your loved one.

Further Resources:

8 Ways to Cope with Guilt and Grief Following Nursing Home Placement

How to Know If and When It's Time for Nursing Home Care

In-Home Care Options

How to Research and Choose a Nursing Home

Home Health Care for People with Dementia

5 Ways to Help a Loved One with Dementia Adjust to a Nursing Home

How Does Medicaid Coverage for Nursing Homes Work?

7 Signs of Caregiver Overload