Dementia Essay

752 WordsMar 5, 20134 Pages
Clinical Practice Guideline Dementia Ministry Of Health Practice Guidelines 3/2007 Website: http://www.moh.gov.sg/mohcorp/uploadedFiles/Publications/Guidelines/Clinical_Practice_Guidelines/Dementia.pdf Preamble Dementia is a clinical syndrome characterized by global cognitive decline and impairments, which result in a loss of a patient’s individuality and autonomy. At different stages, the disease causes different extents of functional decline, and different severities in behavioural and psychiatric symptoms. The disease also results in varying extents of impairments in decision-making capacity, and at some point, a patient becomes mentally incompetent and ceases to be an autonomous agent. Nevertheless, the dignity of the patient should be respected at all stages irrespective of the patient’s functional status. Therapeutic goals and treatment options that are coherent and appropriate to patient’s functional status should be individually tailored and adjusted at different stages of dementia, with an emphasis on quality for life of the patient, as well as the caregiver. The important question to ask for each individual patient is therefore what value of life holds for the patient, and directed at how life is experienced by the patient under the contextual circumstances specific to the patient. It is important to distinguish such evaluations from morally inappropriate social-worth evaluations, which base treatment decisions on an individual’s ability to contribute to society. 135 The general ethical imperative must be to delay, prevent, stabilise dementia, but not to protract life and morbidity artificially in the severe stages of the disease. 136 7.2 Decision-making 1. Respect for autonomous decision making is a fundamental ethical and legal right of a mentally competent individual. This right of self-determination should be respected to the fullest possible

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