verprotection Phenomenon with Dying Dementia Patients
Aminoff Bechor Zvi, MD, PhD
The recently developed objective tool (MSSE) scale (Aminoff, 1999) evaluated the suffering level of end stage dementia patients. Despite intensive efforts of the medical staff, it was found that the level of suffering of dying dementia patients increased until the last day of life (Aminoff et al, 2004). Treatment is lengthy and wears out the medical and nursing staff as well as their families.
Sometimes, the family of an end stage dementia patient who is hospitalized in the geriatric department conducts a fierce struggle with the medical and nursing staff. The patient at this stage usually suffers from untreatable or irreversible diseases, an advanced cognitive decline, with serious eating disturbances and bedsores. Family members may demand “maximum treatment” including transfer to an internal department or intensive care, in order to try and improve the patient’s condition and in so doing, hope to keep him alive.
Usually the patient’s condition is unstable and becomes complicated and more serious daily. The likelihood of balancing the condition is faint despite constant medical intervention. All efforts to explain the increasing seriousness and irreversibility of the patient’s condition to the family only result in additional demands for intensification of the treatment. We have defined this phenomenon as the syndrome of overprotection of an elderly dying dementia patient which we first published as Editorial article in the American Journal of Hospice and Palliative Medicine, No. 4, July – August, 2005.
Ways and means with which to cope with the family members’ syndrome of overprotection of an end stage dementia patient are unknown. The overprotection phenomenon is an additional cause for unnecessary suffering of dying dementia patients and also for the family members themselves. A definition and comprehension of the overprotection phenomenon would help to research the ways and means by which unnecessary additional suffering for dying patients and their family members can be prevented.