Section 4
CASE STUDY 2 | KATHLEEN Two years ago, Kathleen was diagnosed with dementia and remains living alone in her own home. Over the last year, she has needed a lot more help from her daughter and needs help with most personal and domestic activities. One day when Kathleen was attending a day care centre, she became quite tearful when speaking to the nurse and said “I am so frightened of having to move from my home and the thoughts of being cared for and dying in a strange place”.
Possible responses using the AFIRM response may include:
cknowledge concerns “Let’s talk a little bit more about this.” “Would you like to go somewhere quieter so we can have a chat about this?”
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ind out what is known “Are you worried about not being able to remain at home?” “Is this something that is on your mind a lot?” “Can you tell me more about your fear of dying?” “What worries you about being in a strange place?” “Are their particular concerns you have about your future care?” “What is frightening you the most?”
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mmediate concern addressed “Yes many people are frightened of what will happen as their health deteriorates.” I
espond to further questions “Yes, most people prefer to remain in their homes for as long as possible but as they become increasing frail, some people need to move into more supportive accommodation such as a nursing home.” eeting suggested “As you have being thinking about your future needs, this could be a good time to arrange a meeting with the doctor and/or PHN so we can explain your options if you become increasingly unwell. 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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