ACC End-of-Life Care and Palliative Support 1 — Questions and Answers
Question 1: What is the primary goal of palliative care for Alzheimer's patients?
- To cure the underlying disease and restore cognitive function
- To provide comfort, relieve suffering, and improve quality of life (Correct answer)
- To delay placement in a long-term care facility
- To administer aggressive medical treatments to prolong life
Correct answer: To provide comfort, relieve suffering, and improve quality of life
Palliative care focuses on relieving symptoms, managing pain, and improving the quality of life for patients and their families, not on curing disease.
Question 2: Which document allows a person with Alzheimer's disease to specify their wishes for end-of-life medical care while they are still able to make decisions?
- A power of attorney for financial matters
- A living will or advance directive (Correct answer)
- A do-not-distribute order
- A HIPAA release form
Correct answer: A living will or advance directive
A living will or advance directive is a legal document that records a person's wishes about medical treatment and end-of-life care in case they become unable to communicate.
Question 3: At what stage of Alzheimer's disease is it most appropriate to begin discussing end-of-life care planning with the patient and family?
- Only in the late stage when the patient is unresponsive
- After the patient has been placed in a memory care facility
- In the early stage, when the patient can still participate in decision-making (Correct answer)
- When the physician estimates less than one week of life remaining
Correct answer: In the early stage, when the patient can still participate in decision-making
Early-stage planning is ideal because the patient can still express their own values, preferences, and wishes while they have decision-making capacity.
Question 4: What does a Do Not Resuscitate (DNR) order indicate for an Alzheimer's patient?
- The patient refuses all forms of medication
- Caregivers should not attempt CPR if the patient's heart stops (Correct answer)
- The patient does not wish to be admitted to a hospital
- Medical staff should not communicate with family members
Correct answer: Caregivers should not attempt CPR if the patient's heart stops
A DNR order is a medical order instructing healthcare providers not to perform CPR if the patient experiences cardiac or respiratory arrest.
Question 5: Which of the following is a common physical sign that an Alzheimer's patient may be approaching the end of life?
- Increased appetite and weight gain
- Improved orientation and recognition of family
- Decreased urine output and mottled skin (Correct answer)
- Higher energy levels and increased mobility
Correct answer: Decreased urine output and mottled skin
Decreased urine output and mottled (blotchy, discolored) skin are recognized signs that the body is shutting down in the final days of life.
Question 6: Which approach is most appropriate when providing comfort care to a non-verbal, late-stage Alzheimer's patient?
- Limiting physical touch to avoid overstimulation
- Using gentle touch, soothing voice, and familiar music to provide comfort (Correct answer)
- Focusing only on medical interventions to manage physical symptoms
- Reducing family visits to minimize emotional distress for the patient
Correct answer: Using gentle touch, soothing voice, and familiar music to provide comfort
Sensory comfort measures such as gentle touch, calm speech, and familiar music can reduce anxiety and provide meaningful comfort even for non-verbal patients.
Question 7: What is the primary distinction between hospice care and standard palliative care?
- Hospice care includes curative treatments while palliative care does not
- Palliative care is only available in hospitals, while hospice is only at home
- Hospice care is for patients expected to live six months or less and foregoes curative treatment (Correct answer)
- Palliative care requires a DNR order while hospice does not
Correct answer: Hospice care is for patients expected to live six months or less and foregoes curative treatment
Hospice is a specific type of palliative care for patients with a terminal prognosis of six months or less who choose comfort over curative treatment, while palliative care can begin at any disease stage alongside other treatments.
ACC End-of-Life Care and Palliative Support 1
What is the primary goal of palliative care for Alzheimer's patients?