Thought this article is about end-of-life care for those with dementia, I think most of the article (certainly the three crucial questions mentioned below) is applicable to everyone, whether dealing with dementia or not.

The first sentence of this article captures it well: "It’s hard for physicians to determine with much precision how long anyone with a terminal disease can expect to live, but it’s particularly challenging when the disease is advanced dementia." These points were also interesting:

* When the researchers looked at how many of these patients [in the study] died within six months, they concluded that current guidelines amount to a crapshoot.

* A 2004 study in The Journal of General Internal Medicine estimated that fewer than one in 10 people dying of dementia receives hospice services. ... Nationally, by way of comparison, more than 40 percent of Americans who die each year are in hospice care.

* Dr. Mitchell’s suggestion is to scrap the whole certification system for dementia patients, to allow them access to palliative care, or 'comfort care,' without regard to their expected lifespans, since there’s no accurate way to estimate them.

* Caregivers can request better end of life care for people with severe dementia by asking some tough but crucial questions: “Is this hospitalization really necessary?” “Will this procedure increase his comfort?” “Is she a candidate for hospice care?”

Here's a link to the article:
http://newoldage.blogs.nytimes.com/2010 ... -dementia/

Robin