This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Karlawish, J. H. T. Articles by Clark, C. M. Search for Related Content PubMed PubMed Citation Articles by Karlawish, J. H. T. Articles by Clark, C. M. Social Bookmarking                         What's this?

Relationship between Alzheimer's Disease Severity and Patient Participation in Decisions about Their Medical Care

David Casarett, MD, MA

Kathleen Joy Propert, ScD

Bryan D. James

M. Bioethics

Christopher M. Clark, MD

To examine the relationships between Alzheimer's disease (AD) severity and patient participation in decisions about their medical care, we performed a cross-sectional study of 74 caregivers' ratings of the degree to which AD patients participate in making decisions about their medical care. The majority of the caregivers reported that they made the final decisions about medical care (n = 48, 64%), one-quarter (n = 19, 26%) reported an equal role, and a small proportion (n = 7, 9%) reported that the patient made the final decisions. Multivariate models showed that the sig nificant predictors of the patient's participation in decisions about medical care were measures of dementia severity: Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Patients with mild-stage disease (CDR = 1 or MMSE 20) are involved in decision making largely in a collaborative role with the caregiver. Beyond mild-stage disease, the clinician can largely expect that the caregiver is making the final decisions. These results illustrate how and when caregivers can expect changes in their decision making role. (J Geriatr Psychiatry Neurol 2002; 15:68-72).

Journal of Geriatric Psychiatry and Neurology, Vol. 15, No. 2, 68-72 (2002)
DOI: 10.1177/089198870201500203


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. B. Hirschman, C. M. Joyce, B. D. James, S. X. Xie, and J. H. T. Karlawish Do Alzheimer's Disease Patients Want to Participate in a Treatment Decision, and Would Their Caregivers Let Them? Gerontologist, June 1, 2005; 45(3): 381 - 388. [Abstract] [Full Text] [PDF]

				K. B. Hirschman, S. X. Xie, C. Feudtner, and J. H. T. Karlawish How Does an Alzheimer's Disease Patient's Role in Medical Decision Making Change Over Time? J Geriatr Psychiatry Neurol, June 1, 2004; 17(2): 55 - 60. [Abstract] [PDF]