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Ventilator Use Surges for Nursing Home Residents with Dementia - Is This a Good Thing?

From Reuters news service: "The number of nursing home residents with advanced dementia who get hooked up to breathing machines has roughly doubled in recent years even though this doesn’t appear to help them live longer, a U.S. study suggests. In 2013, among every 1,000 nursing home residents with dementia who needed to be hospitalized for some reason, 78 were hooked up to mechanical ventilators, compared to just 39 out of 1,000 in 2000, the study found. Despite this surge, the mortality rate for these patients with mechanical ventilation remained constant at more than 80 percent. “My concern is the use of intensive care units and mechanical ventilation is like a runaway train where no one is able to hit the stop button and consider: ‘Is this what this patient wanted? Will this treatment result improved quality of life or only prolong their suffering to inevitable death?’” said lead study author Dr. Joan Teno, a geriatrics researcher at the University of Washington in Seattle. More than 5 million people in the U.S. alone are currently living with dementia, and by 2050 the condition will result in 1.6 million deaths a year, Teno and colleagues note in JAMA Internal Medicine."

I would think that this is a failure of good care advocacy and good advance directives between the elder, their family, and their attorney. The reality is that not all living wills (i.e., advance directives) are created equal and the number one reason people get unnecessary or unwanted care are the end of life is due to poorly written (i.e., vague) living wills and poor communication of these issues with the family.  

If you want to learn more about effectively communicating your end-of-life wishes, please fee free to attend one of our monthly seminars. Also, you may want to support Empath Choices for Care, an advocacy group that helps people communicate their end-of-life medical decisions. Our office uses a form of their advance directives but we choose to do things a little differently for a number of reasons.

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D. Rep DeLoach III
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