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| Research article summary (published 5 Dec 2002): |
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Withholding the artificial administration of fluids and food from elderly patients with dementia: ethnographic study.
Full Abstract
OBJECTIVE:
To clarify the practice of withholding the artificial administration of fluids and food from elderly patients with dementia in nursing homes.
DESIGN:
Qualitative, ethnographic study in two phases.
SETTING:
10 wards in two nursing homes in the Netherlands.
PARTICIPANTS:
35 patients with dementia, eight doctors, 43 nurses, and 32 families.
RESULTS:
The clinical course of dementia was considered normal and was rarely reason to begin the artificial administration of fluids and food in advanced disease. Fluids and food seemed to be given mainly when there was an acute illness or a condition that needed medical treatment and which required hydration to be effective. The medical condition of the patient, the wishes of the family, and the interpretations of the patients' quality of life by their care providers were considered more important than living wills and policy agreements.
CONCLUSIONS:
Doctors' decisions about withholding the artificial administration of fluids and food from elderly patients with dementia are influenced more by the clinical course of the illness, the presumed quality of life of the patient, and the patient's medical condition than they are by advanced planning of care. In an attempt to understand the wishes of the patient doctors try to create the broadest possible basis for the decision making process and its outcome, mainly by involving the family.
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Author information
Author/s: The, Anne-Mei (AM); Pasman, Roeline (R); Onwuteaka-Philipsen, Bregje (B); Ribbe, Miel (M); van der Wal, Gerrit (G);
Affiliation: Department of Social Medicine, Institute for Research in Extramural Medicine, Vrije University Medical Centre, 1081 BT, Amsterdam, Netherlands. am.the.emgo@med.vu.nl
Journal and publication information
Publication Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Journal: BMJ (Clinical research ed.) (BMJ), published in England. (Language: eng)
Reference: 2002-Dec; vol 325 (issue 7376) : pp 1326
Dates: Created 2002/12/06; Completed 2002/12/17; Revised 2006/11/15;
PMID: 12468479, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: BMJ. 2003 Mar 29;326(7391):713. (PMID: 12663420)
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