Case Study: Appropriate Care for an 80 Year Old Man from India with Dementia

Introduction

A number of studies have reported relatively low incidence of Dementia in both rural and urban India. As is well known, age is the single most risk factor for developing dementia. The life expectancy in India is lower than in the western countries according to the recent World Bank figures. But as the life expectancy in India rises and so should the incidence of Dementia.

Case Presentation

I have known of an 80 years old business man in India who started with memory loss a couple of years ago and was diagnosed with dementia. I had followed his progress with the disease. In the past year he started wandering, he would insist on keeping his books at his place of business that he had much difficulty with and had to be carefully supervised. His disease progressed to a degree that he lost appetite, aspiration of food started causing recurrent pneumonia requiring hospitalizations. At his last hospitalization, he was given multiple antibiotics, a nasogastric tube was inserted to provide feeding and hydration. Patient at this stage was poorly cognizant of his surroundings, did not recognize his family members and did not respond to verbal commands.

What is an appropriate approach to his care at this stage?
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