The nursing home resident with dementia. Clinical care, ethics, and policy implications

How much treatment should be given elderly patients with dementing illness is controversial. Nursing home care should be based on palliation, rehabilitation, and the control of coexisting illness. Ethical standards are advanced from the principle that the life and well-being of the demented nursing home resident should be protected. The decision to forego medical treatment is justified only when the life of an affected person is burdened by severe, unrelieved suffering or by the absence of self-awareness and relational potential. Introducing this philosophy of care to institutions requires a greater societal commitment to nursing home care.