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Review
. 2015 Jun 25;372(26):2533-40.
doi: 10.1056/NEJMcp1412652.

CLINICAL PRACTICE. Advanced Dementia

Susan L Mitchell
Review

CLINICAL PRACTICE. Advanced Dementia

Susan L Mitchell. N Engl J Med. .

Abstract

An 89-year-old male nursing home resident with a 10-year history of Alzheimer’s disease presents with a temperature of 38.3°C, a productive cough, and a respiratory rate of 28 breaths per minute. Nurses report that for the past 6 months he has been coughing at breakfast and having trouble swallowing. He has profound memory deficits, no longer recognizes his daughter (who is his health care proxy), is bedbound, is able to mumble a couple of words, and is unable to perform any activities of daily living. The nurse asks whether he should be hospitalized. How should this patient be evaluated and treated?

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Comment in

  • Advanced Dementia.
    Mitchell SL. Mitchell SL. N Engl J Med. 2015 Sep 24;373(13):1276-7. doi: 10.1056/NEJMc1509349. N Engl J Med. 2015. PMID: 26398084 Free PMC article.
  • Advanced Dementia.
    Jenkins I. Jenkins I. N Engl J Med. 2015 Sep 24;373(13):1275-6. doi: 10.1056/NEJMc1509349. N Engl J Med. 2015. PMID: 26398085 No abstract available.
  • Advanced Dementia.
    Warrillow S, Moran J, Weickhardt A. Warrillow S, et al. N Engl J Med. 2015 Sep 24;373(13):1276. doi: 10.1056/NEJMc1509349. N Engl J Med. 2015. PMID: 26398086 No abstract available.

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