Timely dying in dementia: Use patients' judgments and broaden the concept of suffering.

ABSTRACT: Patients living with advanced dementia (PLADs) face several challenges to attain the goal of avoiding prolonged dying with severe suffering. One is how to determine when PLADs' current suffering becomes severe enough to cease all life-sustaining treatments, including withdrawing assistance with oral feeding and hydrating, a controversial order. This article broadens the concept of suffering by including suffering that cannot be observed contemporaneously and the suffering of loved ones. Four paradigm shifts operationalize these concepts. During advance care planning, patients can judge which future clinical conditions would cause severe suffering. To decide when to allow patients to die, treating physicians/providers only need to assess if patients have reached patients' previously judged,

SUBMITTER: Terman SA 

PROVIDER: S-EPMC10941520 | biostudies-literature | 2024 Jan-Mar

REPOSITORIES: biostudies-literature