Social Worker/ Me: Greetings, I am one of the social workers that is responsible for taking care

of you. How have you been feeling lately.

Beth: Hi, there is a short moment where I cant really catch up with your sentences. But I am
happy to see you here. I feel safe with you

Social Worker/ Me: Its okay Beth. It is completely normal to feel confused. You know some
dementia patients have this symptom too! Where they are unable to keep up with conversation.
But you seemed to articulate well still. You’re doing great Beth.

Beth: Thank you. Thank you for assuring me. These are all normal symptoms of dementia
right?

Social Worker/ Me: Yes, Beth. Don’t worry, me and my team will work closely and provide you
assistance as much as we could. I am happy that you feel safe with me. Is there anything else
you would need my clarification on your condition?

Beth: I know Im sick. But if you don’t mind, could you let me know my actual condition? I am
ready for this.

Social Worker/ Me: Okay sure. I respect your choice. If you could recall, we had doctors run a
more thorough diagnosis on you the other day. According to the professionals, unfortunately,
your condition is listed in the Final stages of dementia.

Beth: (in shocked and confused)

What do you mean by final stages? I thought there is no stages in dementia, and it’s just some
illness where the elders slowly forget stuffs.

Social Worker/ Me: Actually, there are three stages of dementia, and in the final stages, the
symptoms are more severe. You may notice yourself unable to keep up with the long sentences
that others say, and they may have severe cognitive decline. In the final stages, it may slowly
inhibit basic bodily functions, such as respiratory complications may occur.

Beth: Oh no...

Social Worker/ Me: (pause for a while for her to process her emotions and thoughts)
I completely understand how you feel right now. Do you want a break now? We can talk about
this further when you feel slightly capable of handling the news.

Beth: No im fine please do proceed with anything about my condition.

Social Worker/ Me: Okay. Other than physiological and some obvious symptoms of dementia,
you may sometimes notice yourself having mood swings too. For example, you may feel
irritated easily, feeling confused, or fear of the unknown because you never know when the next
time would be you forget things. These are normal symptoms among dementia patients.

Beth: Okay, I see… I have not realised that these are the symptoms of dementia too. I thought I
was just unhappy about everything my family did. We had a fight the other day, without any
valid reasons. Maybe this is one of the reasons… (patient slowly zoned out, looked disbelief)

Social Worker/ Me: It’s okay. It is important to admit that these feelings of sudden realization
and confusion are totally normal. Some of the patients will also report that they feel guilty for not
treating them better before they are diagnosed will illness, and they feel like they create burden
to the family.

Beth: Yes that is exactly how i feel right now. I feel so helpless and not sure how to treat her
properly, or better now.

Social Worker/ Me: I totally understand your feelings. You can always trust me to be your
listener, I am ready to listen to what you wanted to express.

Beth: (sigh) Okay.. While I still have the consciousness, can I formulate and state some of the
goals that I wanted to attain?

Social Worker/ Me: Definitely.

Beth: Now that I am aware of my condition, and I know the worst case this could end up with, I
hope, if there is anything that happened to me, please just let me go..

Social Worker/ Me: Okay Beth, it sounds like you would like to have DNR, is that right?

Beth: Yes. And I would like to have my daughter to be my surrogate decision-maker. I fully trust
her and I believe that she will respect my decision too. Other than that, I hope that I could clarify
my goal of palliative care at this time too. In the meantime you could also give me some
suggestions for the goals that I can request.

Social Worker/Me: Sure. Do not hesitate to let me know how I could assist you. Some of the
dementia patients would highly request for us to help improve their quality of life, and for short
term goals, they would hope that we could help secure their safety. It is very common where
dementia patients would accidentally hurt themselves, and we really wanted to help prevent
that. How does these suggestions sound to you?

Beth: Yes it actually aligns with what I wanted to request from palliative care too.

Social Worker/ Me: Alright noted. We will have more social workers to work closely on the
matter.
Beth: Is there any recommendations that you would provide me? You know, judging my
condition right now, and maybe refer to your experiences in working with similar cases.

Social Worker/ Me: Thank you for your trust with our occupation and services. As of now, i
would say to enhance her psychosocial life quality first. Some of the options you may consider
is having your friends around to accompany you, or participate the activities that you used to
enjoy. You could always ask for our help to take care of you while you enjoy the activities.

Beth: Okay thank you for the suggestions. I will consider it.

Social Worker/ Me: Alright. Is there anything else that you would need for my further
clarification or assistance?

Beth: No, I think its all clearly explained so far.

Social Worker/ Me: Okay. Just a last reminder, it is completely normal to feel whatever
emotional ups and downs you have right now. If there is anything that I could help, whether its
for your family members or you yourself, please do not hesitate to let me know. We can always
formulate plans that could better accompany both the situation of yours and your family.

Beth: Alright, thank you so much.