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February 27, 1987

Caring for the Patient With Alzheimer's Disease

Author Affiliations

Massachusetts General Hospital Boston

Massachusetts General Hospital Boston

JAMA. 1987;257(8):1051. doi:10.1001/jama.1987.03390080041022

To the Editor.—  The brave work of Volicer et al1 is to be saluted because it represents medicine struggling to regain control over decision making and technology. Nowhere is this more crucial than in caring for the patient with end-stage Alzheimer's disease, where the goal of patient comfort can be so easily ruined by strict, unthinking adherence to standard medical procedures. The hospice approach has been greatly facilitated by the consensus developed among nurses, physicians, social workers, and families. This is not only good care, it is an essential strategy for medicine in the struggle against legalistic determination of a type of care that nobody wants. As Dr Lynn's editorial2 emphasizes, the guiding principle has to be to make the most humane decisions possible for each particular patient with Alzheimer's disease. When physician, nurse, social worker, administrator, and family all stand together on this, outsiders trying to dictate