Case study on dementia end of life decisions

Suggested Learning Activities The following tools can be used in a variety of teaching and learning settings to enhance student learning and understanding of end-of-life care:

Case study on dementia end of life decisions

Advertisement At 87, Maxine Stanich cared more about improving the quality of her life than prolonging it. She suffered from a long list of health problems, including heart failure and chronic lung disease that could leave her gasping for breath. Yet a trip to a San Francisco emergency room for shortness of breath in led Stanich to get a defibrillator implanted in her chest—a medical device to keep her alive by delivering a powerful shock.

Surgery like this has become all too common among those near the end of life, experts say.

Case study on dementia end of life decisions

The practice is driven by financial incentives that reward doctors for doing procedures, as well as a medical culture in which patients and doctors are reluctant to talk about how surgical interventions should be prescribed more judiciously, said Dr. Rita Redberg, a cardiologist who treated Stanich when she sought care at the second hospital.

We also fail to have conversations about what patients value most. The cost of these surgeries—typically paid for by Medicare, the government health insurance program for people over 65—involve more than money, said Dr. Older patients who undergo surgery within a year of death spent 50 percent more time in the hospital than others, and nearly twice as many days in intensive care.

And while some robust octogenarians have many years ahead of them, studies show that surgery is also common among those who are far more frail. Doctors implant aboutof the devices each year, according to the American College of Cardiology.


Eleni Linos has shown that people with limited life expectancies are treated for nonfatal skin cancers as aggressively as younger patients.

When Less Is More Surgery poses serious risks for older people, who weather anesthesia poorly and whose skin takes longer to heal. With diminished mental acuity and an old-fashioned respect for the medical profession, some aging patients are vulnerable to unwanted interventions.

Stanich agreed to a pacemaker simply because her doctor suggested it, Giaquinto said. Redberg said doctors recently treated her mother for melanoma—the most serious type of skin cancer. When Redberg pressed a surgeon about the benefits, he said the procedure could reduce the chances of cancer coming back within three to five years.

Jacqueline Kruser, an instructor in pulmonary and critical care medicine and medical social sciences at the Northwestern University Feinberg School of Medicine. Kaiser Permanente is not affiliated with Kaiser Health News, which is an editorially independent program of the Kaiser Family Foundation.

Instead of telling patients that surgery carries a 20 percent risk of stroke, for example, doctors should lay out the best, worst and most likely outcomes. In the best-case scenario, a patient might spend weeks in the hospital after surgery, living the rest of her life in a nursing home.

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In the worst case, the same patient dies after several weeks in intensive care. In the most likely scenario, the patient survives just two to three months after surgery. She experienced an abnormal heart rhythm in the procedure room during a cardiac test —not an unusual event during a procedure in which a wire is threaded into the heart.

Based on that, doctors decided to implant a pacemaker and defibrillator the next day. Redberg was consulted when the patient objected to the device that was now embedded in her chest.

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She was very clear about what she did and did not want done. After Redberg deactivated the defibrillator, which can be reprogrammed remotely, Stanich was discharged, with home hospice service.

With nothing more than her medicines, she survived another two years and three months, dying at home just after her 90th birthday in “Case Study” of Casey Kasem. One in a series of real–life cases showing how certain strategies may make a huge difference.

Instructions to send us your Living Will for our no obligation, FREE professional evaluation and what we do/don’t cover. Anxiety may cause dementia - and meditation or mindfulness could slash the risk, study finds Anxiety may cause dementia - and meditation or mindfulness could slash the risk, study finds.

For Dementia works to improve the quality of life for people with dementia and their carers.


(Or you can phone them on ) (Or you can phone them on ) The National Dementia Strategy is a government initiative. end-of-life medical decisions No one knows better than caregivers the critical need for family members to make sure their loved-one’s end-of-life decisions are . Mid-to-late stage dementia often presents challenging behavior problems.

The anger, confusion, fear, paranoia and sadness that people with the disease are experiencing can result in aggressive and sometimes violent actions. My very first blog post on “Death and Dementia” – a site originally dedicated to creepy, unexplained murders and deaths (before originally branching out to a far less grim subject matter, mostly general horror stuff) dealt with the death of Elisa Lam.

She was a Canadian student who, on her visit to LA, mysteriously drowned in her hotel’s water tank despite the fact that she wasn’t.

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