http://www.merck.com/mrkshared/mm_geriatrics/sec5/ch40.jsp
Section 5. Delirium and Dementia
this section includes
Chapter 38. Mental Status Examination | Chapter 39. Delirium | Chapter 40. Dementia | Chapter 41. Behavior Disorders in Dementia (snip)
"The most common symptom in early dementia is diminished short-term memory. Patients repeatedly ask the same questions, often after only a few minutes, or forget where belongings were placed. The inability to locate belongings may lead to paranoia that they were stolen.
Word-finding becomes difficult; patients may forget a specific word and use elaborate circumlocution to compensate (eg, a necktie may be called "that thing around the collar"). Formerly mastered activities of daily living (eg, driving, handling finances, housekeeping) may also become difficult. A change in the level of functioning is key to diagnosis.
Other symptoms of early dementia include personality changes, emotional lability, and poor judgment. Family members may report that the patient is "not acting like himself" or is doing uncharacteristic things (eg, a miserly widower gives thousands of dollars to a questionable charity). Mood swings, including depression and euphoria, commonly occur. Although early dementia usually does not affect sociability, patients may become increasingly irritable, hostile, and agitated, especially in circumstances in which they are confronted with their cognitive impairment."
Miss Mae had a housekeeper who drove her to the beauty parlour, she understood her limitations. Her diagnosis of 'dementia' is suspect IMO, Miss Mae's misfortune was her heart condition, which is now being treated.
Was doing some research on opinions and programs for "dying"
Once they can diagnose someone with dementia- the writing is on the wall. I am not a doctor, but I picture someone on lots of drugs responding much in the same way I picture someone suffering from dementia!
Here is a snip:
The team conducted a retrospective cohort study of patients with advanced dementia admitted to all Medicare- and Medicaid-certified nursing facilities in New York (derivation cohort, n = 6799) and Michigan (validation cohort, n = 4631) during 1994-1998 and 1998-2000, respectively.
A mortality risk score based on 12 MDS factors associated with 6-month mortality risk identified in the derivation cohort was evaluated in the validation cohort. Six categories of risk of mortality within 6 months were calculated. The authors provide within their report a score sheet for estimating 6-month prognosis and stratifying patients into levels of risk.
http://www.thehospice.org/phys.htm
This may be the key used by doctors. Diagnose dementia and boom- into Hospice you go!
Also- I found it interesting that the study was done at places funded by Medicaid and same type programs. I mean privatley paid care I am sure is better- so the results may be MUCH different. I will continue research on this....
also-- the Hospice where Terri died is funded (at least in part) by Medicaid:
How is Payment Provided for Medications?
Hospice receives a per diem fixed rate from Medicare, Medicaid or private insurance company to assume responsibility for providing related medications and all other services.
http://www.thehospice.org/phys06.htm