2017 Caris Clinical Leadership Development Institute: Managing the Ethical Issues of Dementia

Alzheimer’s is the sixth leading cause of death in the United States. Since 2000, deaths from dementia rose by 89% (alz.org). Dementia is one of the most feared diseases. As a healthcare community, what do we do to combat these fears and ease this anxiety?

Caris Healthcare invited Annette Mendola PHD, Director of Clinical Ethics at the University of Tennessee Medical Center, to speak at the 2017 Clinical Leadership Development Institute on issues that may arise when caring for a patient with dementia.

Mendola spoke to the hardships loved ones of dementia patients face. 35% of dementia caregivers report their personal health suffered due to caregiving (alz.org). Dementia is especially hard because there are two grieving processes. Loved ones and caregivers first grieve the mental loss of their loved ones, and then they grieve the physical loss.

When the first grieving process begins, language used to discuss this grief is important. It is particularly upsetting when a dementia patient does something out of character. Phrases like “that’s not really her” may seem helpful, but could cause pain, because that is her. A better phrase to use is “that is not the way she wants to be.” Positive and preserving language helps grieve the loss of ability and memory. When speech is aligned with scientific fact, it helps the process of understanding the pain of the situation.

Mendola touched on many virtues one needs to possess when caring for someone with dementia, one virtue being compassion. We should ask ourselves, what is it like for them? Understanding the perception and reality of a dementia patient helps us respond to the suffering. Another virtue is discernment, asking, what do they need from me? Not allowing personal fears and biases distract from the well-being of the patient. Mendola also spoke to the virtue of conscientiousness. What matters? What can I let go of? With dementia patients’ kindness is more important than truth. Sometimes it is best to meet the patient where they are living in their own truth. Instead of bringing the patient back to reality, join them in their reality.

“With the growing population of dementia patients it is important for us to know the best way to care for them,” noted Caris Vice President of Patient Care Bonita Ledgerwood. “We appreciate Annette Mendola speaking to our staff to further improve the way we care for those who need us most.”