| Medical Ethics | ||
| An elderly woman told her daughters that if she ever ended up with dementia she wouldn't want to live like that. Years later she developed senile dementia and her daughters had her move into a nursing home. Although she did not recognize family or friends, she enjoyed the company of others and the nursing home's cat. When she stopped eating, her daughters were asked whether she should receive a feeding tube. | ||
| Should the daughters consider her previously stated wishes as an advance directive? | ||
| Answer: | ||
| The daughters should consider her previously stated wishes as well as her current best interests. The daughters don't know how to proceed because they did not have the advance care planning conversation that clarified what their mother meant when she said that she wouldn't want to live with dementia. Was it the cognitive problems, the problems with self care, living in an institution, or the sense that living with dementia would not bring any joy? Without knowing this, the daughters are unprepared to step into her mothers shoes. | ||
| Without really knowing their mother's wishes, the decision about a feeding tube is difficult. The daughters may choose to approve the insertion of a feeding tube with the proviso that future triggers could lead to its removal or nonuse. For example, if her current quality of life deteriorates to the point where she is no longer experiencing joy, or if she physically tries to remove the tube and keeping the tube in means restraining her, it may be appropriate to remove the feeding tube at that time. | ||
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2002 Windsor University School of Medicine. All rights reserved.
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