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Decision-making in older people with dementia

Published online by Cambridge University Press:  28 October 2013

M. Aurora Viloria Jiménez ,
Mónica Chung Jaén ,
Marta Vigara García  and
Helena Barahona‐Alvarez
M. Aurora Viloria Jiménez*
Affiliation:
Memory Unit of the Geriatric Department, Hospital Clinico San Carlos, Madrid, Spain Palliative Care Unit, Hospital Clinico San Carlos, Madrid, Spain
Mónica Chung Jaén
Affiliation:
Memory Unit of the Geriatric Department, Hospital Clinico San Carlos, Madrid, Spain
Marta Vigara García
Affiliation:
Memory Unit of the Geriatric Department, Hospital Clinico San Carlos, Madrid, Spain
Helena Barahona‐Alvarez
Affiliation:
Palliative Care Unit, Hospital Clinico San Carlos, Madrid, Spain
*
Address for correspondence: Dr Aurora Viloria Jiménez, Servicio de Geriatría, Hospital Clínico San Carlos, c/Profesor Martín Lagos s/n, Madrid 28040, Spain. Email: auviji@yahoo.com
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Summary

Dementia is a syndrome characterized by a progressive impairment in cognition, function and behaviour, with a considerable burden in terms of health and social care, and economic costs. As Alzheimer's disease and other dementias advance, the patient's capacity, competence and possibility of participation in decision-making decrease. Key points in managing people with dementia include screening of cognitive impairment, neuropsychological assessment, laboratory tests and neuroimaging, genetic tests, informed consent, inclusion in clinical trials and discussion of advance directives, driving, managing finances and testamentary capacity, pharmolocogical and non-pharmacological treatment and also palliative and end-of-life care. In this article we review these crucial points in decision-making for people with dementia and their families and caregivers.

Keywords

dementiadecision makingcapacityethical principles
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 23 , Issue 4 , November 2013 , pp. 307 - 316
Copyright
Copyright © Cambridge University Press 2013 

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