Respite care

People with dementia and their carers require access to a variety of health and social care services for treatment, information and counselling, community-based support, respite care and long-term residential care. Treatment may include behavioural therapies (e.g. reality orientation, cognitive stimulation and validation therapy) or pharmacological treatment with acetylcholinesterase inhibitors. 

The therapist can also help the family by advising them of educational sources and available support groups, such as the local chapter of the Alzheimer s Disease Association, social service and home health agencies, assistance with home behavioral management, Meals-on-Wheels, transportation and recreational programs, and respite care. 

A hospice is a program of care, not necessarily a facility, per se. In the United States, most hospice care is provided in patients homes. Some dedicated inpatient hospice facilities exist, as do hospice wings of long-term care facilities and hospice beds in hospitals. These inpatient hospices commonly provide support for the home care programs, respite care (admission of patients to allow their families to rest so that they can resume home care), admissions for difficult symptom control problems, and admissions for care in the last hours or days, when necessary. 

Once you ve addressed medical causes ask the residential home whether they feel able to look after him (If Rufus was living with family, discuss emergency respite care with carers and social services.)... 

If Jeremy needs immediate protection, the safeguarding team/social services may urgently review the placement provide respite care (Table 63T). 

In the United States, the growing influence of capitated care has driven the development of alternative care sites for a VAI. By 1997, there were 200 long-term acute care (LTAC) hospitals nationwide, with a capacity for 15,000 patients (13). The presence of intermediate and long-term facilities in Europe for the management of a VAI varies in different jurisdictions. In France, a well-developed system of care includes extended care facilities, which provide long-term care for VAIs or respite care for patients whose families need relief Irom... 

Koopmanschap MA, van Exel NJA, van den Bis GAM, et al. The desire for support and respite care preferences of Dutch informal caregivers. Health Policy 2004 68 309-320. Navaie-Waliser M, Eeldman PH, Gould DA, et al. When the caregiver needs care the plight of vulnerable caregivers. Am J Public Health 2002 92 409-413. 

Respite care and ongoing support will optimize the potential for successfiil home care as the burden of home care can be great (15). Many day centers are not used to taking patients who are ventilated. If a primary caregiver leaves or is unable to cope, the whole family system needs to be reviewed. Respite should be available, and in paUiative care patients, a hospice bed may be required. Life expectancy varies and end-of-life issues should respect the patients wishes. For this to happen, the patient and family should be encouraged to discuss a plan, possibly with the involvement of a paUiative care consultant. 

Help patient families obtain adequate caregiver assistance. Assess their healthcare benefits and financial resources, if necessaiy. Identify all possible resources for help and arrange respite care services, or care facility placement, periodically, to help prevent caregiver burnout. 

He was at PMS for two years, as a day pupil with a week s respite care once a month. Despite his initial reservations, he settled down well there, and he and his family were happy with their choice. 

The provision of support for carers through the organising of services such as day centres, sitting services, etc.—that give some respite and freedom from the demands of caring. 

The hospital became a safe haven for extended facility patients and home-bound patients that needed electricity for their care. Units that normally did not care for admitted patients became patient care areas such as the Cardiac Cath Lab and Same Day Surgery areas. SOMC opened their banquet facility as a respite area for staff and their families for sleeping and personal care. Electricity was restored at this location so staff could sleep or take a shower. 

Social services, e.g. care package, re-enablement services, respite... 

Temporary transfer to a more appropriate environment may be needed if acute medical problems have resolved but there s ongoing challenging behaviour or need for supportive care, e.g. psychiatric ward, respite/rehabilitation placement. This may reduce the risk of iatrogenic infections, e.g. C.difficile. Involve MHOA psychiatrists. 

---