Palliative Care: Time to Provide It in All Stages of Progressive Dementia – By Guest Blogger, Mary Fridley

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The Palliative Care movement was started to support people through cancer treatments and has evolved to help anyone living with difficult medical conditions. It is a collaboration of effort among patient, family, physician, and the health care network.

The National Hospice and Palliative Care Organization defines it as, “ Patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice.”

Progressive dementia is the gradual deterioration of the brain that inevitably leads to death. As Nancy Reagan said, it is “the long goodbye”.

Caregivers are all too familiar with agonizing trips to the emergency department. A loved one has a sudden change in behavior, a call is placed to the primary care physician, and the recommendation is to take the patient to the hospital emergency department.

The hospital setting is frightening and confusing to normal folk but to the dementia impaired person it is a nightmare. The caregiver tries in vain to keep the patient calm and still. A sedative may be ordered that further compromises cognition. Hours later, a urinary tract infection is diagnosed and the patient is sent home with an antibiotic prescription. If palliative care were in place, a call to the physician would allow for evaluation and appropriate treatment at home where both patient and caregiver are comfortable.

Starting palliative care early in the disease allows for the anticipation, prevention, and treatment of all aspects of “suffering” throughout the stages. It allows for patient involved decision-making, family education, and access to resources and support services. Perhaps most importantly, it provides continuous evaluation of the ever-changing needs of both patient and family while reducing cost of care.


Mary C. Fridley, RN, BSN, BC
Mary is a member of the Jenerations speakers bureau. She is a Registered Nurse board certified in gerontology with more than 30 years experience in the geriatric health field. She has been a consultant to families, businesses, and care facilities and has an expertise in dementia care. Mary is a successful caregiver advice columnist and former consultant to the Anne Arundel County, MD, Department of Aging and Disabilities, and a caregiver support group facilitator for 17 years. Mary speaks extensively on subjects related to dementia, eldercare, successful aging, and caregiver issues.

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