Dementia: Alzheimer’s Association Guidelines for End-of-Life Care

by Deborah Grassman

Ethical dilemmas frequently surround end-of-life care. Dementia can add yet another dimension that requires attention, especially surrounding issues of mental capacity for decision-making, as well as issues surrounding quality of life and prolongation of death. The public often associate dementia with memory loss, not realizing that memory loss is just one feature of the disease. These perceptions can make informed consent more difficult on families struggling with treatment decision-making as the disease progresses.

The Alzheimer’s Association has published guidelines for end-of-life care. I have found them indispensable in helping families sort through the “what will help; what will no longer help” dilemmas they face as they make decisions about medical treatments for their loved one. The guidelines (shown below) are clear, direct, easy to understand, and come from a source that families trust (the Alzheimer’s Association). I often give the guidelines to families as the illness advances. It not only educates them so they can make an informed consent, it also gives them self-confidence in their decision making. The latter is important; it can prevent subsequent complicated grief by alleviating feelings of guilt for the decisions made.


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