In the landscape of dementia care, where challenges are numerous and solutions are often elusive, the Yale School of Medicine may have provided a beacon of hope. The Humana Foundation has generously awarded the Yale School of Medicine a grant totaling $250,000 to delve into the realm of caregiver mental health in the context of dementia patients. At the forefront of this initiative is a core objective: exploring the potential positive effects of advance care planning on caregivers and those living with dementia under their care.

In light of this forthcoming study, we will explore the topic of advance care planning, highlight its potential transformative power, and provide caregivers with actionable insights for navigating the complexities of dementia care.

The Positive Impacts of Advance Care Planning

Advance care planning is the process of discussing and preparing for future medical care decisions. It often involves older adults having meaningful conversations with their loved ones—who may later become their caregivers—about hypothetical situations that may occur where the senior is ill or unable to communicate their opinions. Through these conversations, seniors can identify treatment preferences and put those preferences into writing to serve as future directives.

By proactively addressing medical, emotional, and logistical considerations, advance care planning ensures that the senior’s loved ones and caregivers are equipped with the necessary tools and support systems to fulfill their roles effectively. Moreover, by facilitating open and honest communication, advance care planning fosters a collaborative approach to care that prioritizes the needs and preferences of the older adult who is now facing a medical condition and cannot express their own preferences.

Primary Beneficiaries: Caregivers

For caregivers providing care to a loved one with dementia, the benefits of advance care planning are manifold. Beyond the practical considerations of medical decision-making and resource allocation, advance care planning offers a sense of empowerment and peace of mind. Knowing that their loved one's wishes are documented and respected alleviates much of the uncertainty and anxiety that often accompanies caregiving.

Additionally, by providing a roadmap for navigating the complexities of dementia care, advanced care planning equips caregivers with the knowledge and skills needed to provide high-quality, person-centered care. From understanding the progression of dementia to managing challenging behaviors, caregivers are empowered to make informed decisions that enhance the well-being of both themselves and their loved ones.

Nuanced Dynamics of Advance Care Planning

Central to the success of advance care planning is the cultivation of improved communication strategies. Caregivers and healthcare professionals must engage in open and honest dialogue to ensure that the dementia sufferers' wishes and preferences are accurately documented and understood. This not only facilitates informed decision-making but also strengthens the therapeutic alliance between caregivers and healthcare providers.

Advance care planning should ideally begin with a senior in their late 60s or early 70s. By anticipating potential challenges and implementing preemptive strategies, caregivers can mitigate the impact of common stressors such as depression, anxiety, loneliness, and isolation. The planning process should start with conversations with the person receiving care, and should include the following actions:

• The individual receiving care communicates their values and wishes.
• The healthcare team is included in all communications. They can also provide valuable insights on advance directives. Advance care planning is covered by Medicare as a part of the annual wellness visit.
• All relevant advance directive forms are completed and shared with healthcare professionals and anyone involved in the dementia sufferers' care.
• Forms are updated at least once a year or after life altering events. Be sure to keep all drafts on file.
• Keep the conversations going, as many people may view their initial decisions differently later in life.

Relevant advance care information discussed and completed during the planning process may include the following:

• A Living Will
• Power of Attorney
• Power of Attorney for healthcare
• Do not resuscitate order (DNR)
• Out of hospital DNR order
• Physician orders for life-sustaining treatment (POLST)
• Medical orders for life-sustaining treatment (MOLST)
• Preferred options for palliative or hospice care

Fortunately, there are now advance care forms specifically for those that may suffer from dementia in the future, such as the Dementia Directive Form.

Creating a Supportive Ecosystem

By raising awareness about the importance of early planning and facilitating access to resources and services, advanced care planning ensures caregivers of individuals with dementia receive the care and support they need to maintain their own mental and physical wellness. From establishing support networks to accessing respite care services, advance care planning empowers caregivers to prioritize self-care and seek assistance when needed. By doing so, caregivers can mitigate the negative consequences of caregiving and maintain a sense of balance and fulfillment in their lives. Additional ways caregivers can ensure they are living healthily include:

• Keeping up with interests and hobbies.
• Taking scheduled breaks for self-care.
• Exercising or moving as often as the schedule allows.
• Maintaining a healthy diet.
• Implementing mindfulness techniques like meditation.
• Joining a support group.
• Asking for help!

Eyes on the Future Commitment

Advanced care planning holds immense promise as a transformative approach to dementia care. By prioritizing the needs and preferences of individuals with dementia, advance care planning creates optimal circumstances for providing caregivers with the appropriate tools. Through improved communication, proactive strategies, and a commitment to supporting caregivers, advance care planning also has the potential to enhance the quality of life for caregivers significantly. As we continue to explore and implement advanced care planning in dementia care settings, let us remain steadfast in our commitment to creating a compassionate and effective environment that empowers caregivers and enhances the well-being of all those affected by dementia.

Clearwater Living's Empowered Living® lifestyle philosophy provides a holistic approach to wellness, incorporating the Six Dimensions of Living Well to create an environment where practicing mindfulness becomes second nature to residents. Contact us today to learn more about Clearwater Living, holistic wellness, and additional resources for caregivers, such as our respite care services.