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TOO MUCH CARE?

ANCHOR LEAD:  WHO SHOULD DECIDE WHEN A PATIENT WITH ADVANCED DEMENTIA SHOULD OR SHOULDN’T RECEIVE MEDICAL CARE?  ELIZABETH TRACEY REPORTS

Many patients with advanced dementia who develop conditions like pneumonia, fever or difficulty swallowing receive a substantial amount of medical intervention for these conditions, which is sometimes quite troublesome for the patient.  That’s according to a recent study in the New England Journal of Medicine. When should such care be withheld?  Constantine Lyketsos, an Alzheimer’s disease expert at Johns Hopkins, comments.

LYKETSOS:  We have a very good way right now of making these decisions.   People die every day of dementia.  This issue is being dealt with everyday and I think ultimately, for the most part, good decisions are being made.  So it’s not a death panel issue.  Now, should the healthcare reform come out and say absolutely not, here’s the criterion for the very late stages of dementia.  We’re not going to pay for anything more that you need.  I don’t think so, I think they should leave it to the families and the clinician.  Because if they do it with dementia then they’ve got to do it with cancer, they’ve got to do it with every other terminal state.            :32

At Johns Hopkins, I’m Elizabeth Tracey.



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