Throwing the Baby Out with The Bath Water

A recent Swedish study looked at healthcare professionals end-of-life notes on the final days of individuals with dementia living in long-term care. The study found that the documentation of final days was heavy on the physical care and results and sparse on the psychosocial care.

Any academics reading will immediately discount the rest of this blog because the study was a) in Sweden; b) published in a journal with a lower impact factor and c) nursing home data only.  But those of us on the front lines for many years in both skilled nursing facilities and assisted livings see this study as confirmation of what we witness every day.

As I work with Dr. Cate, Dementia Coach clients, one of the family members’ primary concerns is not the physical care but the engagement of their loved one.  Individuals with dementia are in a process of brain change that has plateaus.  An individual in the earlier stages is usually engaged in good memory care but as the cognitive plateaus change, the engagement care declines.  As the brain becomes less able to handle large groups, these individuals no longer participate. If small groups are available, cognition may continue to affect participation.  These are the individuals who require one-on-one engagement that focuses on their individual preferences, biography, and stage.  But regardless of type of residence, this is where a gap in psychosocial care develops.   Dynamics that are responsible include training and staffing.

As a family member of a father with Alzheimer’s, I wanted Dad to have not just good medical care, but to have quality of life.  In his final days, our only regret was about his psychosocial health.

As both a family and professional caregiver of many years, Dr. Cate, Dementia Coach developed from my passion for psychosocial care.  It is that passion that has led me to develop the ME™ program for families and home health to increase both their quality of life and the quality of life of their loved one through training, example and consultation.

If you are interested in improving the quality of life of an individual in long-term care, please visit or email to start your consultation.

About Cate

Passionate about dementia care and quality of life throughout the last days of life----sums up Cate McCarty, Dr. Cate, Dementia Coach. With close to forty years of long-term care experience in nursing and recreation, a Master's in Thanatology and a PhD in Aging Studies, Dr. Cate seizes every opportunity to translate research into quality of life for individuals with dementia and all of us who have the honor to "rub elbows" with them.
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