Antea Worldwide Palliative Care Conference

Rome, 12-14 November 2008

ABSTRACT FORM

Presenting author DEMENTIA: ILLNESS AWARENESS AND DECISON-MAKING CAPACITY IN

Daniela Tarquini
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dtarquini@tele2.it
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abstract
• Pain and other symptoms
• Palliative care for cancer patients
• Palliative care for non cancer
patients
• Paediatric palliative care
• Palliative care for the elderly
• The actors of palliative care
• Latest on drugs
PALLIATIVE CARE
Author: Daniela Tarquini
The problem of dementias is achieving more and more importance in Western Countries, due to
the increasing number of patient affected, age being the principal risk factor. It has been
calculated that the prevalence could be of 1000000 patients in Italy, in 2025.
We know that physicians are required by law and medical ethics to obtain the informed content
before initiating any kind of treatment or taking any decision about life of patients. The premise
of obtaining a valid informed consent is giving appropriate information to a competent patient.
With the progression of dementia all individual eventually lose their decison-making capacity,
but this disease has different stages and in the mild one, as in a number of patients in the
moderate one, we can still have decision-making capacities preserved, often related to the
difficulty of the task. The instruments that can help to assess the patient’s competence are the
neuropsychological bacteries, the simplest of which is MMSE, and the MacArtur Competence
Assessment tools for treatment, a structured interview. Both must be integrated by other data
coming from the clinical assessment. Respecting the autonomy of patients is universally
considered a basic principle of ethics, thus our main goal should be to encourage the patient
makes his/her own decison about treatment, particurarly about the end of life . Often demented
patients, even aware of their illness, are not given a clear diagnosis by physicians. We take for
granted that patients do not want to know. Communication of the diagnosis is the first step that
enables the patient to make advance directives, according to medical deontological code, or to
designate what we call in italian “amministratore di sostegno” who could have his will
respected.

• Pain

• Illness and suffering through

media
• Marginalisation and social stigma
at the end of life
• Palliative care advocacy projects

• Prognosis and diagnosis

communication in
different cultures
• Communication between doctor-
patient and patient-
equipe
• Religions and cultures versus
suffering, death and
bereavement
• Public institution in the world:
Session: Neurology in palliative care
palliative care policies
and law Chair: Dott. Ignazio R. Causarano

• Palliative care: from villages to

metropolies
• Space, light and gardens for the
terminally ill patient
• End-of-life ethics
• Complementary therapies
• Education, training and research
• Fund-raising and no-profit
• Bereavement support
• Volunteering in palliative care
• Rehabilitation in palliative care
• Palliative care quality indicators
• Neurology in palliative care