Expert: Paula Damgaard - 8/16/2005

Question
Hi Paula,

My father is 72 and has been a diabetic and patient of depression for many years. Post retirement, his depression worsened. A couple of years back he started having spells of confusion, disorientation, extreme drowsiness, irritability and agitation. However, his general health has been good. His MRI report last year did not show anything abnormal in relation to his age. We have taken him to psychiatrists who never suggested the possibility of dementia or alzheimer's. He's had 3 bouts of hospitalisation since and in April this year, he was taken off all anti-depressants as he was diagnosed with dementia.

Recently he developed swallowing problems, bedsores and became extremely rigid. He is now in Intensive Care since the past 2 weeks and has developed all kinds of complications like low albumin and haemoglobin, high bilirubin, chest and urine infection. He is being given nasal feeding and blood transfusion. But he is only semi conscious and does not even open his eyes. He has become a mere skeleton and I cannot see him like this. Should we take him off all this invasive therapy?
I anxiously await your reply.

Answer
Dear Kaushiki, Unfortunately this is a question you need to ask yourself.  If you have questioned the doctors and they can't tell you that your dad is going to return to a good quality of life and feel that they have done all they can do, then you have to ask yourself what would your father want?

If indeed he does have Alzheimer's disease, (I am not sure if that is what is going on, though not being there I can't say for sure, it just seems to have occurred rather rapidly), his future is not one that is very good.  He will eventually become bedridden, unable to feed himself or do any of his daily self care.  So his quality of life is not really going to get better.  Which then puts you in the position of: if this helps to bring his misery to an end, is that not a good thing?  

One thing I would strongly recommend is asking for an autopsy.  Either full body or at least his head.  You most of all should want to know for absolute sure whether or not he has Alzheimer's disease.  If, in the hopefully, near future there are ways to help children of documented AD patients then you will have the documentation.  Without  documentation you have no real knowledge of whether or not he has Alzheimer's.  

I am sorry that you are going through such a bad time right now.  My thoughts and prayers are with you.  Please let me know if I can help any other way.  Paula