The goal of this program is to provide caregivers with tools necessary to help engage the person at the end of life. An Empathic Transitions kit is provided to build on engagement and engender feelings of inclusiveness and empathy.

At the end of their disease, they lose communication skills both receptively and expressively. This makes it difficult for caregivers to know the best way to engage with them. Engagement in late-stage dementia is important to their wellbeing and quality of life. However, our experience has shown that little engagement except for clinical care is happening, due to lack of knowledge.

As we began to assess the abilities of people at the end stage, we piloted various ways to engage them. It has been eye opening for staff to watch as we interact with patients. Staff members have said things like, “I didn’t even know she could talk” and “he has a sense of humor”. Incorrect assumptions are made about inabilities when in fact engagement activities result in decrease in agitation, gives the person a feeling of involvement and of course, the attention goes a long way to compliance.

In addition, we have spent time studying how to provide the best empathic care when death is imminent. This final stage is a delicate dance between medication management, environment and empathic support from family and caregivers. As the brain changes to its final end, the person is nonverbal, opens their eyes briefly and slightly, their breathing starts to change, and other physiological changes begin. We have developed an imminent care package within the Empathic Transitions kit to help increase the likelihood of comfort, support and empathy. Sometimes the person is without family support for various reasons. It becomes necessary for caregivers to assume that critical role.