Managing End-Stage Dementia: Aminoff Suffering Syndrome and Relief of Suffering Units| Chapter 5 | Medicine and Medical Research: New Perspectives Vol. 1

 

Aminoff suffering syndrome (ASS) in advanced dementia is the new proposed term for a pathological symptomatology and entity that is characterized by a high Mini Suffering State Examination (MSSE) scale score, <6 months survival, irreversible and intractable aggravation of suffering and medical condition until demise. Dementia is considered a global public health priority. End-stage dementia (ESD) patients are completely helpless, confined to wheelchairs or bedridden, with double incontinence, malnutrition, feeding tubes, decubitus ulcers, and suffering that may continue for months or years.

 

This paper proffers a new, alternative approach and setting for end-stage dementia (ESD) patients with ASS that could pertain to the Israeli setting, and could possibly be applicable in other countries. The MSSE scale comprises 10 items relating to the patients’ characteristics, as well as the perception of their condition by medical staff and families. Each item scores 0 (no) or 1 (yes). Total score ranges between 0-10, with high scores reflecting higher degrees of suffering. Short hospitalization periods of approximately 1 month and treatment in Relief of Suffering Units may be a new, palliative approach and present a possible solution for coping with the horrendous burden of the anguish of end-of-life dementia patients, their families, and the medical and nursing staff.

 

Author(s) Details

Bechor Z. Aminoff
Geriatric Division, The Chaim Sheba Medical Center, Tel Hashomer, Human Suffering and Satisfaction Research Center, El-Ad, Israel.

 

Please see the link:- https://doi.org/10.9734/bpi/mmrnp/v1/1491

Diagnosis of Aminoff Suffering Syndrome in Advanced Alzheimer’s Disease and End-of-Life: First 10 Years | Chapter 4 | Disease and Health: Research Developments Vol. 3

The life of patients with end-stage dementia is filled with grief, secretion and stench, suppuration and wounds, crying, screaming or silent pain. This appears to be the natural and essential path of end-stage disease and aging. Its diagnosis could reduce the suffering of patients at the end of life by adequate medical and nursing care. The MSSE is the first objective clinical tool for the evaluation of suffering levels in advanced dementia. The Aminoff Suffering Syndrome in advanced Alzheimer's disease and end-of-life is characterized by a high Mini Suffering State Examination (MSSE) scale score, less than 6 months of survival, irreversible and intractable aggravation of suffering and actively dying medical condition until demise. The Aminoff Suffering Syndrome was first defined by us, presented and published 10 years ago at the 10th International Conference on Alzheimer’s Disease and Related Disorders (Madrid, 2007). Its diagnosis in end-of-life was performed by measuring the suffering level of patients by evaluating the Mini Suffering State Examination (MSSE) scale score. A high MSSE scale score with a range of 7 - 10 indicates a high level of suffering and reflects the severity of the medical condition in advanced dementia. The treatment of patients with Aminoff Suffering Syndrome at the end of life is a great challenge to medical and nursing personnel. The diagnosis of Aminoff Suffering Syndrome opens new horizons in the approach to anguish at end-of-life and provides a novel method for identifying advanced Alzheimer’s disease patients who require immediate palliative treatment. Looking ahead, the authors suggest that all medical researchers involved in geriatric care perform experimental prospective studies in their respective clinical settings.

 

Author (s) Details

 

Bechor Zvi Aminoff
The Minerva Center for the Interdisciplinary Study of End-of-Life, Tel Aviv University, Ramat Aviv, Israel and Geriatric Division, The Chaim Sheba Medical Center, Tel Hashomer, Israel.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v3/3743

End-of-Life: The New Israeli Law “The Dying Patient” and Relief of Suffering Units for Conditions Like Dementia | Chapter 13 | Achievements and Challenges of Medicine and Medical Science Vol. 11

Medical personnel and society in general are unaware that there are no tools with which to measure and diagnose the level of suffering of a dying patient. Similarly, no tools are available to estimate the 2-week or 6-month survival period of terminal dementia patients. The new Israeli Law “The Dying Patient” provides avenues for possible medical, ethical, and Halachic (Jewish religious law) solutions in view of the complexity of the treatment of an end-stage dementia patient. The treatment of an end-stage dementia (ESD) patient with a high level of comorbidity and severe disability may be far more difficult than treatment of a patient with end-stage heart or lung disease, or cancer. The difficulty lies in the complexity of the medical, nursing, cognitive, emotional, ethical, and social problems. The establishment of a hospice-like setting for dementia patients in Israel, based on palliative treatment only, similar to the Jewish hospices in the United States, is extremely important. This article proposes a new, alternative approach and setting for patients with end-stage dementia that could pertain to the Israeli setting and could possibly also be acceptable in other countries. Comparisons in demographic and clinical variables between the 3 levels of MSSE (low, intermediate, and high) were performed using analysis of variance, the Kruskal-Wallis nonparametric test, and the Fisher exact test, where applicable. The results of our research showed that care in the geriatric department failed to reduce the high level of suffering of ESD patients. Short hospitalization periods of approximately of life With Dementia Units may be a new palliative approach and present a possible solution for coping with the burden of the suffering of end-state dementia patients, their families, and the medical and nursing staff.

 

Author (s) Details

 

Bechor Zvi Aminoff
Geriatric Division, The Chaim Sheba Medical Center, Tel Hashomer and Human Suffering and Satisfaction Research Center, El-Ad, Israel.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v11/3849