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Advanced Dementia.
N Engl J Med. 2015 Jun 25;372(26):2533-2540
Authors: Mitchell SL
Abstract
Key Clinical Points Advanced Dementia Advanced dementia is a leading cause of death in the United States. Features include profound memory deficits (e.g., inability to recognize family), minimal verbal communication, loss of ambulatory abilities, the inability to perform activities of daily living, and urinary and fecal incontinence. The most common clinical complications are eating problems and infections, and these require management decisions. Advance care planning is a cornerstone of care. Treatment decisions should be guided by the goals of care; more than 90% of health care proxies state that patient comfort is the primary goal. Observational studies do not show any benefits of tube feeding in persons with advanced dementia, and tube feeding is not recommended. Observational studies show several benefits of hospice care. Patients with advanced dementia should be offered palliative and hospice care services if they are available.
PMID: 26107053 [PubMed - as supplied by publisher]