CASE STUDY: A dementia diagnosis

After years of declining health, Graeme’s Alzheimer’s diagnosis still came as a blow to the family.  His wife Sarah, son and daughter rallied around to provide the support and attention he needed.

In the years leading up to the diagnosis, Graeme and Sarah, with the support of their GP, had the presence of mind to make sure his affairs were in order, including his will and guardianship arrangements. They also started the difficult, but important conversation about what Graeme would want regarding his future health care.

“We discussed end of life situations when he was coherent and aware of his condition and its possible outcome. We both agreed that he may have to go into a nursing home, which eventually was the case. Graeme had expressed his wish not to have his life prolonged if he was unwell,” explains Sarah.

Sarah cites peace of mind as one of the most valuable benefits of starting the advance care planning process early and believes it offered a lot of comfort for Graeme, for herself and her children.

“Two of our children live in Western Australia so they relied on me to offer the best care for their father. One son lives in Hobart so he was with me all the way,” says Sarah.

Eventually, the time came where Graeme needed to live in a nursing home. “When Graeme went into full-time care, with the help of Graeme’s GP, the director of the nursing home and the doctor in charge of geriatric care at the Royal Hobart Hospital, we outlined a plan which proved very helpful when he was nearing the end of his life, explains Sarah.

Both the nursing home and Graeme’s GP were given copies of Graeme’s advance care directive which made clear his preference to avoid life-prolonging care.

In time, Graeme’s health deteriorated and it was obvious that Graeme was very unwell. Their GP offered for Graeme to be hospitalised and given antibiotic treatment for a urinary tract infection, but ultimately it was agreed that Graeme’s preferences, as outlined in his advance care directive, would be respected. Graeme passed away peacefully in the nursing home. He was not given life-prolonging treatment but he received comfort care, ensuring his final days were pain-free.

“I felt hugely relieved that Graeme and I had a meaningful end-of-life discussion, eight years before he died. I knew that I was making the right decision not to prolong his life. It was easier for the GP too. Making this decision between us, and then later with the GP, made it so much easier for me to deal with Graeme’s end of his life, and all that goes with it after death,” says Sarah.