By
Jennifer B. Buckley
Both groups of patients
received almost identical care
practices in their hospital stay
including; painful diagnostic
and therapeutic procedures which
can be extremely frightening for
an end-stage dementia patient
who doesn’t understand what is
happening to him or her.
However, the patients with
end-stage dementia received less
pain medication than the
cognitively intact adults. “The
under treatment of pain in
dementia patients likely results
from the fact that these
patients often cannot
communicate what they are
feeling or that they are in
pain,” according to Dr. R. Sean
Morrison, Assistant Professor,
The Lillian and Benjamin
Hertzberg Palliative Care
Institute at Mount Sinai.
Doctors and nurses sometimes
don’t realize these patients are
in pain so “standing orders” for
pain medication such as morphine
should be given, meaning with or
without the expressed interest
of the patient.
This new evidence will help to
persuade doctors and caregivers
to view pneumonia or hip
fractures as a terminal illness
in advanced stage Alzheimer’s
patients, even with aggressive
treatment. Therefore,
communication about the course
of treatment should be
established between the
physician and caregiver,
weighing the patient’s level of
comfort against life-prolonging
treatments. Caregivers, caring
for a loved-one with end-stage
dementia or Alzheimer’s, should
communicate interest to their
doctor’s about more
comprehensive palliative care.
This will ensure more comfort
for their loved-one during their
end-of-life care.
