Areas for guidance
CASE STUDY 1 | TOM Tom has been a resident in a nursing home for the past six months and has become increasingly frail. He is currently unable to walk and has a very poor appetite which has caused him to lose a noticeable amount of weight in recent months. His wife regularly visits and has become anxious about her husband’s deteriorating health. His wife, who is distressed, approaches a healthcare assistant asking “Could my husband die from not eating enough?”. As a healthcare assistant, you know that his wife visits regularly but you aren’t sure what she knows about her husband’s diagnosis and care plan.
Possible responses using the AFIRM response may include:
cknowledge concerns “Your husband is certainly eating less now.” ind out what is known “How do you feel your husband is doing?” “What’s your biggest concern right now?”
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mmediate concern addressed “We know that your husband has dementia and reduced appetite is a common problem as dementia progresses.” “There are many ways to help people in this situation to eat, but we know that it may be more comfortable for your husband to eat only when he feels like it.” espond to further questions “Yes, your husband is walking much less and that has gradually reduced over the past year which can be another sign that his dementia progressing.” eeting suggested “Given that your husband’s condition is changing, this could be a good time to arrange to meet the nurse manager to discuss his current health and future care needs.” “This meeting would also be a good time to answer any other questions you may have.” “Would you like a meeting to be organised?”
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Facilitating discussions on future and end-of-life care with a person with dementia
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