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...study followed 323 Boston-area nursing-home residents with advanced dementia for 18 months. These patients were unable to recognize family members, incontinent and unable to get around on their own. Researchers tracked the progression of their disease, complications and survival rates; they also recorded the treatments each patient received as well as their health-care proxies' understanding of advanced dementia and the patient's prognosis. Over the course of the study, 55% of the residents died, with nearly half of those deaths occurring within the first six months of the study. Patients' median survival span was 478 days...
Dementia is not a single illness but a collection or consequence of many, including Parkinson's disease, vascular dementia and Alzheimer's disease (which accounts for some 70% of all dementia cases). In the advanced stages of dementia, it is often impossible to tell which disease the patient had at the outset, as the end result is the same, according to Mitchell's study: a syndrome of symptoms and complications - eating problems (86%), pneumonia (41%), difficulty breathing (46%), pain (39%) and fever (53%) - caused by brain failure. "Dementia ends up involving much more than just the brain," says Dr. Claudia...
Experts say part of the reason it is so common to intervene in dementia cases is that the patient, by definition, cannot make medical decisions autonomously, leaving a relative or friend to serve as their health-care proxy. "Family members are much less likely to forgo treatments or let go. An 80-year-old patient will tell you, 'I have lived a good, long life. I have no regrets.' But talk to his 50-year-old son, and he isn't ready. Being the decision maker for someone else is a much harder thing to do," says Sachs, who says...
...seeds of this study were planted about two years ago, when a patient named Damir Janigro was being prepped for spinal surgery. Janigro, who is also a neuroscientist at the clinic, lay captive to the nerve-racking din of the operating room and in his frazzled state thought about how dentists often give their patients earphones to help ease anxiety. (See the top 10 medical breakthroughs...
With health-care expenditures through the roof, this patient benefit is practically free, says Janigro, who used his own iPod and that of a colleague's to pump in the music for the study. "The clinic doesn't have a budget for iPods yet, but soon I think we will. It's a no-brainer," he says. "There's nothing more calming than sleep...