Information on Ethics and Dementia

Dementia care has many ethical issues.

Dementia is a medical condition that includes diminished mental capacity, memory loss, inability to problem-solve, behavioral problems, agitations, hallucinations and changes in personality. With such symptoms, a person becomes unable to articulate clearly or understand the long-term consequences of his behavior and actions. Because of this, ethics play a large role in avoiding the unintended abuse of dementia patients.

Research

According to the Alzheimer's Association, the total cost for Alzheimer's treatment in the United States from 2010 to 2050 will increase from $172 billion to $1.08 trillion dollars. With this increase, it would seem more important than ever to perform research that might lead to cures or prevention. Dementia research includes studies of the brain after death. Family members may make the decision to donate the brain of a loved one afflicted with dementia, based on their religious, ethical or personal beliefs.

Contracts

The legality of contracts such as wills or power of attorney may be called into question if they are prepared after a dementia diagnosis has been made. A person in the early stages of dementia may be able to review his will and make a list of all assets and prepare for future care. A person in the middle or late stage of dementia would not be competent to sign any contract, including a marriage certificate, power of attorney or last will and testament.

Driving

Although driving offers freedom and flexibility, it is an issue for dementia patients. If someone with dementia is allowed to drive, it may affect the lives of people on the roads (and sidewalks). When family members or caregivers take away the dementia patient's right to drive, the ethical issue is usually not one of the freedom of the patient but of the safety of the citizens. A doctor or driving professional can help evaluate a person's driving ability.

Treatment Decisions

When a treatment decision is necessary for a dementia patient, consent becomes an ethical issue. Since it is clear the patient is unable to give consent for treatment, the decision must be made in one of three ways. First, if a living will or medical treatment plan has been created prior to the onset of dementia, that plan should be followed. If there is no plan, the decision falls to the person who has medical power of attorney. Finally, if there is nobody to make medical decisions for the patient, the doctors and caregivers must make decisions in the best interests of the patient.

Caregivers

Caregivers for dementia patients are often faced with the task of providing safe care that may go against the desires of the patient. In safety matters, a patient's safety comes first. For instance, if a patient insists on having ceramic figurines in her room but often breaks the figurines at night, causing a potential safety hazard, the caregiver would be ethically obligated to remove the figurines. Safety of the patient and household members is a primary obligation in caring for people with dementia.

References

• National Institute of Neurological Disorders and Stroke: Dementia Information Sheet
• Alzheimer's Association: Changing the Trajectory of the Disease
• Psychiatric Bulletin: Ethical Issues in Dementia
• Alzheimer's Association Safety Center: Driving
• Legal and Ethical Issues for Patients with Dementia and Their Family