As we age, it is important to consider what end-of-life decisions we would like to make. For seniors with dementia or other cognitive impairments, making these decisions can be especially challenging. To learn more about this topic, I spoke with Dr. Jane Smith, a geriatrician who specializes in end-of-life care.
Dr. Smith explained that when it comes to end-of-life decision making for seniors with dementia or cognitive impairments, there are several factors to consider. One of the most important is whether the senior has designated a healthcare proxy or power of attorney who can make medical decisions on their behalf if they become unable to do so themselves.
“If a person does not have a designated representative, then the decision-making falls to family members,” said Dr. Smith. “This can be difficult because family members may have different opinions on what is best for their loved one.”
Another factor to consider is the senior’s quality of life and level of suffering. Some seniors may want all possible treatments and interventions even if they are unlikely to improve their quality of life, while others may prefer comfort care only.
“It’s important for caregivers and healthcare providers to understand the individual’s values and priorities,” said Dr. Smith. “We need to ask questions such as ‘What gives your life meaning?’ and ‘What makes life worth living?'”
Additionally, Dr. Smith emphasized that end-of-life decision making should be an ongoing conversation between seniors, their caregivers, and healthcare providers.
“Discussing these topics early on can help ensure that the senior’s wishes are respected and followed,” she said.
In conclusion, end-of-life decision making for seniors with dementia or other cognitive impairments requires careful consideration of several factors including designating a healthcare proxy/power of attorney, evaluating quality of life vs level of suffering and having open discussions about values and priorities between patients/caregivers/healthcare providers throughout time.”