Geriatrics D Refusal Phenomenon with End Stage Dementia Patients

Aminoff Bechor Zvi, MD, PhD

Geriatric division, Sheba Medical Center, Tel-Hashomer, 52621; Human Suffering and Satisfaction Research Center, El-Ad, Israel;E-mail: bechorz@yahoo.com

Behavioral and social sciences

In memory to Geriatrics D department which refused and closed due to failure coping with suffering of end stage and dying dementia patients, caregiver staff, and family members.

The “Geriatrics D Refusal phenomenon” of end stage dementia (ESD) patients has never been was described in medical literature. Refusal phenomenon is entirely clear-cut different from the well-known “burn out syndrome”, and it is separate and independent part of abuse and neglect of elderly patients. In the Geriatrics D Refusal phenomenon every effort is made in order not to admit ESD patients and there are numerous techniques are employed of getting rid these patients from the department.

In the Geriatrics D Refusal phenomenon, both sides –the Health Insurance Funds and caregiver hospital staff reject the importance of the challenge to provide appropriate care to ESD patients. The refusal phenomenon of ESD patients by health services is one of main causes of suffering of in end stage dementia.

We developed novel objective tool for measuring suffering in ESD Mini Suffering Examination (MSSE) which was published in our book – Measurement of Suffering in end-stage Alzheimer’s disease, Dyonon, Tel-Aviv, 2007.

The results of our research regarding of measuring suffering of dying dementia patients: was proven that MSSE score on the day of admission was 5.62± 2.31, and increased to 6.89±1.95 at the last day of life (P < 0.0001). ). According to MSSE scale, 63.4% of patients died with high level of suffering, respectively. Only one respond for these disturbed results was closing of geriatric department in which developed MSSE scale and provided objective experimental suffering measuring of ESD patients.