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DEMENTIA CARE AT LIFE’S END

ANCHOR LEAD:  ARE PEOPLE WITH DEMENTIA RECEIVING TOO MUCH MEDICAL INTERVENTION AT THE END OF LIFE?  ELIZABETH TRACEY REPORTS

Many patients with advanced dementia experience pneumonia and other medical problems at the end of life, for which they receive sometimes burdensome care.  That’s the conclusion of a recent study in the New England Journal of Medicine.  Constantine Lyketsos, an Alzheimer’s disease expert at Johns Hopkins, offers his view.

LYKETSOS:  I think the real question at the end of life in someone with dementia is do you treat conditions like pneumonia that come up very frequently.  And on balance the evidence that it’s helpful to the person’s quality of life and even their eventual outcome is mixed.  So I think it’s a highly, highly individualized decision.  It’s something that plays out in close conversations between whoever is deciding for the patient, because presumably the patient can’t decide, and a good physician who knows them and goes over the risks and benefits for specific interventions.         :32

The study did show that more informed decision makers avoided more aggressive care at the end of life.  At Johns Hopkins, I’m Elizabeth Tracey.



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