Neurológia pre prax 1/2010

Management of advanced dementia – palliative approach

End-stage of dementia can be defined as a period when the disease reaches irreversible and severely reduced autonomy in basic activities of daily living with a need of persistent nursing care. Treatment options, mainly acetylcholinesterase inhibitors and memantin, decision making capacity and principles of autonomy in these patients are discussed. Indication of intensive care, the role of palliative approaches and management of complications are described. Finally, the importance of communication with the patient and the caregiver and aspects of institutionalization are mentioned more in detail.

Keywords: dementia, end stage disease, prognosis, intensive care, palliative care.