Dementia: What Choices Do You Have?

What is dementia?
This refers to a group of diseases that cause “confusion” with memory loss. Types of dementia include Alzheimer’s (the most common one), Vascular type (caused by small strokes), Parkinson’s-associated dementia, and others such as Lewy-Body Dementia.  Dementia is progressive and incurable, lasting from three to 10 years.  Progressive means the symptoms get worse over time. Incurable means that the memory loss is permanent. Memory loss makes it difficult to remember names and places, how to do the usual activities of living, etc.  People with dementia eventually require complete care; over half of all nursing home residents have some type of dementia.

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Feeding Tubes – Myths & Realities

Feeding tubes were designed to artificially provide nutrition in the hopes of maintaining body weight and health, and to prevent dehydration and starvation, when a person could not eat enough calories for whatever reason.

There are two kinds of tubes.  One is inserted through the nose to the stomach and taped in place.  It is temporary, for up to six weeks, and is usually for people who cannot eat because they are on a breathing machine while in Intensive Care or have had some other procedure preventing them from swallowing.  It requires no anesthetic to insert.

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Making Difficult Decisions: Palliative Care vs Aggressive Treatment of Cancer

The following article is from the Washington Post, April 30/12.  It is by a woman diagnosed with aggressive breast cancer, describing her experiences and reasons for choosing to not have aggressive treatment of the cancer.

It is similar to another article included on this website Acceptance: when to say stop (Waging Peace in the War on Cancer). Both articles offer a perspective for patients and their families when deciding whether to focus on a primary goal of comfort or cure in the face of an incurable disease.

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Treatment Dilemmas in Dementia: When Can You Say Stop?

Many families have told me that dementia is a diagnosis worse than cancer.  

An excellent article published in the New York Times on June 20, 2010, [ see the link below *], and written by Katy Butler [the patient’s daughter], describes eloquently what living with dementia can be like for many families. She summarizes the problems caregivers deal with, the effects on the family, and the ethical choices they sometimes face when confronted with the dilemma of “what is the right thing to do”.

 

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Are Seniors Overmedicated?

Although seniors constitute 13% of the population, they consume 30% of all prescription drugs, prompting many seniors and their families to ask, “Why all these pills?”  I’ve seen patients taking as many as 20 different prescription and OTC (over-the-counter) medications.  Are all these drugs really necessary, or, could they be causing more harm than good? The following facts suggest that we should be concerned about this high consumption of medications:

 

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The Downward Spiral: Predicting Survival For People Over The Age Of 70 And Who Are Admitted To Hospital

Everyone wants to live as long as possible but also as comfortable as possible – clean, dry, pain-free, and well fed.  Years ago most people died fairly quickly:  they were active until they developed pneumonia or some overwhelming infection from an injury.  Now, our drugs and technology can keep people alive for months or years but not necessarily without pain – chronic diseases can produce a “slow death”.

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