XVIII World Congress of International Association of Gerontology, Rio-de-Janeiro, Brazil, 2005
Suffering in dying dementia patients: Evaluation by means of the (MSSE) scale
B. Z. Aminoff, MD, PhD, S. Noy, MD, PhD,A. Adunsky, MD
Geriatric D Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel
CPH20. End of life issues
Key words: Dementia, suffering, end-of-life
Purpose: A prospective cohort study with 6 months follow-up to evaluate the level of suffering in patients dying with dementia.
Participants: Seventy-one end-stage dementia patients (28 females and 43 males), who died within 6 months from day of admission to a general geriatric department, over a 24-month period.
Method: Patients were evaluated by means of the scale (MSSE 10 items, range 0-10; range 7-10 indicates a high level of suffering) on the first day of admission and during the last week of life.
Results: Mean survival time was 38.1±5.1 days from day of admission to the department. The total score of MSSE scale on the day of admission was 5.62±2.31, and increased to 6.89±1.95 during the last week of life with a significant difference (P <0.0001). More end stage dementia patients died in the high level of suffering category (63.4% versus 40.8% on day of admission to department), or intermediate level of suffering (29.6% versus 35.2%). Only 7% of end-stage dementia patients died in the low level of suffering category. Conclusions: The traditional treatment approach proved to be unsuccessful in preventing, or diminishing the suffering level of patients dying with dementia. The MSSE scale is recommended as an objective tool for the evaluation of the level of suffering in patients dying with dementia and could be used to diminish the high level of suffering in dementia patients and enable dying with dignity.