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Am J Alzheimers Dis Other Demen. 2018 Dec 13:1533317518817614. doi: 10.1177/1533317518817614. [Epub ahead of print]

Empowering Patients with Alzheimer's Disease To Avoid Unwanted Medical Care: A Look At The Dementia Care Triad.

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1 Alden March Bioethics Institute, Albany Medical College, Albany, NY, USA.
2 Albany Law School, Alden March Bioethics Institute, Albany, NY, USA.
3 Department of Medicine, Albany Medical College, Albany, NY, USA.
4 New York State Department of Health, Albany, NY, USA.


Patients with Alzheimer's disease and other types of dementia with acute medical problems, who have lost capacity and are without advance directives, are at risk of being over treated inhospitals. To deal with this growing demographic and ethical crisis, patients with dementia need to plan for their future medical care while they have capacity to do so. This article will examine the role of each member of the dementia care triad and how to empower the patient to participate in planning future medical care. A case will be made that physicians have the same professional disclosure obligations to dementia patients as they do to all other capable patients with terminal illnesses. Because there is little consensus about what facts should be included in a diagnostic disclosure, this article will offer a proposal to empower newly diagnosed patients with dementia with capacity to plan for their future medical care.


advance directives; capacity; dementia; dementia care triad


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