Dementia is a terminal illness – study

Patients with advanced dementia experience distressing symptoms similar to patients dying of more commonly recognized terminal conditions, such as cancer, revealed by researchers.

The clinical course of advanced dementia, including uncomfortable symptoms such as pain and high mortality, is similar to that experienced by patients of other terminal conditions.

The researchers at the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School, published the study in the Oct. 15 issue of the New England Journal of Medicine.

“Dementia is a terminal illness,” says lead author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research.

The study underscores the need to improve the quality of palliative care in nursing homes to reduce the physical suffering of patients with advanced dementia, and to improve communication with their family members. “This will help to ensure that patients and families understand what to expect in advanced dementia, so that appropriate advance care plans can be made,” says Dr. Mitchell.

Over the course of the study, 177 patients died. The researchers found that the most common complications were pneumonia, fevers and eating problems, and that these complications were associated with high six-month mortality rates. Uncomfortable symptoms, including pain, pressure ulcers, shortness of breath, and aspiration, were also common and increased as the end of life approached.

“A better understanding of the clinical trajectory of end-stage dementia is a critical step toward improving the care of patients with this condition,” says Dr. Mitchell. “This knowledge will help to give health-care providers, patients and families more realistic expectations about what they will confront as the disease progresses and the end of life approaches.”

Source: Hebrew SeniorLife Institute for Aging Research, USA



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