Abstract: An approach to the suffering of end stage dementia patients.

17th World Congress of the International Association of Gerontology, Vancouver, Canada
Gerontology 2001; 47:439-440

An Approach to the Suffering of the Patient with
End-Stage Dementia

B.Z. Aminoff, MD, PhD
Geriatric Department and Memory Clinic,The Chaim Sheba Medical Center, Tel Hashomer, Israel

Dementia patients endure profound suffering until their demise. It is impossible to alter the cognitive and functional status of dementia patients by means of medication, rehabilitation, or by any other methods. Medical ethics or religious practices do not permit either passive or active euthanasia. Thus, the only way to treat a dementia patient is by careful and accurate diagnosis to diminish and prevent suffering. The suffering of an end-stage dementia (ESD) patient is not only a function of the basic progress of the disease, but mainly that of the quality of medical and nursing care. No patient, at any stage of the disease, deserves to suffer. Conversely, at any stage of the disease suffering can be treated and prevented. Physicians, nurses, relatives and society all accept suffering in the ESD patient as a natural process of the disease, and are usually unaware of the fact that a great deal of suffering is caused by incorrect medical and nursing care, that may be inadequate, unsuccessful or negligent. No objective methods for the evaluation of the suffering of ESD are known to exist. The scale (MSSE) (Aminoff, 1999 – Berlin, 4th European Congress of Gerontology) introduced, for the first time, a method for the diagnosis and evaluation of the level of suffering of an ESD patient that may facilitate suitable treatment.