| [ Summary ] |
The ability of dementia patients to express themselves or make decisions is impaired. Deciding on treatment policies under these conditions presents many problems. If the degree of dementia is severe, decisions concerning the patient’s treatment must be made by a third party, a surrogate. The surrogate must decide how to maintain life with dignity for an individual who will not be able to regain their normal mental abilities. This may be accomplished by following written instructions previously provided by the patient. Instructions may be derived from conversations, etc. If the previous sources of instructions are not available, then the best possible choice must be made after thorough investigation. Normally a family member will become the surrogate. However, convalescence and nursing under the Adult Guardianship System does not include information regarding end of life decision making as interpreted by lawyers. Surrogate decision making is difficult because of a lack of support by the legal system. Therefore, it is a cause of great anxiety for all concerned. |