Issues related to end-of-life medical care for dementia patients

Toshiomi Asahi, Akira Kogure, Haruko Hatakeyama, Keiko Mizobuchi, Ryounosuke Yamaga

Asahi Neurology and Rehabilitation Hospital

    (1)  The major cause of death at the end of life is pneumonia, and treatment may involve problems associated with the introduction of a mechanical ventilator.
    (2)  Methods of nutrient supply in the terminal phase include establishment of a gastric fistula, and a guideline for its establishment and closure has been published.  There may be some issues interfering with the smooth utilization of this guideline.
    (3)  Although the burden of caregivers to terminal-phase patients is increasing, supports for such care are insufficient.
    (4)  Although rehabilitation is also a necessary component of terminal-phase care, its introduction has not been extensively promoted.

Address correspondence to Dr. Toshiomi Asahi, Asahi Neurology and Rehabilitation Hospital (789-10 Kurigasawa, Matsudo, Chiba 270-0022, Japan)