Treating Infections in End-Stage Dementia

Infections are common in late-stage dementia, for reasons ranging from incontinence to a reduced immune system. But antibiotics, the usual treatment, aren't always the only treatment option.

If your loved one is already known to be in end-stage dementia, sometimes doctors will treat infections (and subsequent pneumonia) with comfort-care measures rather than aggressive antibiotics. Comfort care means that the person will be treated for pain and discomfort, but no lifesaving measures (such as antibiotics) will be pursued.

Every comfort-care decision is an individual one. The answer rests on many factors, including the person's overall health and prognosis, living will directives, and quality of life, among others. But know that if it's recommended in a particular case, the goal will be to make your loved one free of distress during the course of the infection.

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10 months ago, said...

I also disagree with the advice not to treat infections. It has been my experience that unfortunately, these "Palliative Care Specialists" at medical centers (or some other euphemism title) tend to recommend that families take the easy way out. Administering antibiotics is hardly extraordinary medical care in this day and age. Treating an infection, rather than letting it progress to sepsis, preserves mental status. Elderly patients tend to quickly develop confusion or worse when experiencing an acute infection. An uncontrolled infection is often fatal. When giving my loved one antibiotics, I always include appropriate probiotics in her diet at appropriate intervals every day.


over 1 year ago, said...

The discussion should distinguish between oral and IV antibiotics. Someone who can still swallow should be treated with any appropriate oral antibiotics. The hard choice comes when someone either cannot swallow or has a severe acute infection. My late wife found IV drips very uncomfortable and had recurrent UTI-s in her final year. With UTI-s there is no major concern about contagion to visitors from an untreated infection. The major concern is patient comfort. Would curing the current UTI accomplish anything beyond making the patient suffer yet another UTI in the near future?


almost 2 years ago, said...

I too disagree with the idea of not treating infections. I think we should keep them as comfortable as possible and not doing any invasive procedures like surgeries, etc. But to me if antibiotics are necessary then they should be administered. Not only for the wellbeing of the patient, but for the security of the persons visiting or caring for the patient. If the patient has an infectious disease needing antibiotics, that infection may very well be spread to the rest of the family.


about 2 years ago, said...

I disagree with the notion of not treating infections. My wife is in the final stages of Alzheimers and in hospice but we still treat UTI's with antibiotics.


almost 5 years ago, said...

As my husband cannot communicate as to any pain or discomfort he is experiencing I give him 15mls of Paracare liquid, {panadol} which I was told was not harmful, 3 times daily. This seems to keep him calm and I'm sure pain free and gives me peace of mind knowing he is comfortable.