Kill The Terminally Demented
ironjustice
A "terminal illness" will be one of the reasons they ALLOW you to have
yourself killed by the physician ..
NOW what this study allows for is physicians to kill those with
dementia IF a law allows FOR the termination of life in terminally ill
patients.
Plus WHEN you have end of life instructions IF say you WISH to be
killed if you have a "terminal" illness this will now allow a stupid
doctor .. IE: one who cannot even diagnose dementia to NOW kill you.
The majority of dementia is VASCULAR dementia / lack of blood flow to
be treated by bloodletting as opposed to .. TERMINALLY .. demented.
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Institute for Aging Research study says dementia is a terminal illness
Published: Wednesday, October 14, 2009 - 16:37 in Health & Medicine
The clinical course of advanced dementia, including uncomfortable
symptoms such as pain and high mortality, is similar to that
experienced
by patients of other terminal conditions, according to scientists at
the
Institute for Aging Research of Hebrew SeniorLife, an affiliate of
Harvard
Medical School.
The study, published in the Oct. 15 issue of the New England Journal
of
Medicine, is the first to rigorously describe the clinical course of
advanced
dementia, a leading cause of death in the United States.
Previous studies suggest that patients with advanced dementia are
under-recognized as being at high risk of death and receive
suboptimal
palliative care, which aims to improve the comfort of terminally ill
patients.
"Dementia is a terminal illness," says lead author Susan L. Mitchell,
M.D.,
M.P.H., a senior scientist at the Institute for Aging Research.
"As the end of life approaches, the pattern in which patients with
advanced
dementia experience distressing symptoms is similar to patients dying
of
more commonly recognized terminal conditions, such as cancer."
The study underscores the need to improve the quality of palliative
care
in nursing homes to reduce the physical suffering of patients with
advanced dementia, and to improve communication with their family
members.
"This will help to ensure that patients and families understand what
to
expect in advanced dementia, so that appropriate advance care plans
can be made," says Dr. Mitchell.
In an accompanying editorial in the New England Journal of Medicine,
Greg A. Sachs, M.D., of the Indiana University Center for Aging
Research,
says Dr. Mitchell's paper "moves the field forward in major ways with
regard
to both prognosis and the terminal nature of advanced dementia" and
should
be used to inform public policy about palliative care for patients
with the
disease.
The "Choices, Attitudes and Strategies for Care of Advanced Dementia
at the End-of-Life," or CASCADE, study prospectively followed the
clinical
course of 323 nursing home residents with advanced dementia living in
22
Boston-area nursing homes for up to 18 months.
At the final stage of the disease, patients had profound memory
deficits
such that they could not recognize close family members, spoke fewer
than
six words, and were non-ambulatory and incontinent.
Over the course of the study, 177 patients died.
The researchers found that the most common complications were
pneumonia,
fevers and eating problems, and that these complications were
associated with
high six-month mortality rates.
Uncomfortable symptoms, including pain, pressure ulcers, shortness of
breath,
and aspiration, were also common and increased as the end of life
approached.
Dr. Mitchell, an Associate Professor of Medicine at Harvard Medical
School,
said that she and her team found that while 96 percent of the
patients' health-care
proxies believed that comfort care was the primary goal of care for
their loved one,
nearly 41 percent of patients who died during the study underwent at
least one
intervention, including hospitalization, an emergency room visit,
intravenous therapy,
or tube feeding, in the last three months of life.
However, patients whose health-care proxies understood the clinical
course of the
disease were less likely to receive aggressive treatment near the end
of life.
"Many of the patients in our study underwent interventions of
questionable benefit
in the last three months of life," says Dr. Mitchell.
"However, when their health-care proxies were aware of the poor
prognosis and
expected clinical complications in advanced dementia, patients were
less likely to
undergo these interventions and more likely to receive palliative care
in their final
days of life."
At the beginning of the study, 81 percent of the proxies felt they
understood which
clinical complications to expect in advanced dementia, yet only one
third said that
a physician had counseled them about these complications.
Currently, more than 5 million Americans suffer from dementia, a
number that is
expected to increase by almost three-fold in the next 40 years.
A recent study by Alzheimer's Disease International estimates that the
number of
people with dementia worldwide will exceed 35 million by 2050.
Dementia is a group of symptoms severe enough to interfere with daily
functioning,
including memory loss, difficulty communicating, personality change,
and an inability
to reason. Alzheimer's disease is the most common form of dementia.
"A better understanding of the clinical trajectory of end-stage
dementia is a critical
step toward improving the care of patients with this condition," says
Dr. Mitchell.
"This knowledge will help to give health-care providers, patients and
families more
realistic expectations about what they will confront as the disease
progresses
and the end of life approaches."
Source: Hebrew SeniorLife Institute for Aging Research
Who loves ya.
Tom
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