Artificial hydration and nutrition in advanced Alzheimer's disease: facilitating family decision-making.
BACKGROUND
As Alzheimer's disease progresses to its final stages of dementia and dysphagia, whereby patients can no longer swallow food and fluids, families suffer with difficult decisions regarding initiation of artificial hydration and nutrition.


OBJECTIVE
Through the use of a hypothetical family scenario, this theoretical article presents the ethical principals of beneficence and autonomy as a framework for use by nurses to hear and inform family decision-makers of the physiology of death in the advanced stages of Alzheimer's and examines the current literature related to benefits and burdens of artificial hydration and nutrition.


CONCLUSIONS
While a beneficial consideration, ethical principles are critiqued for their inability to provide an absolute answer and relieve family suffering in this clinical situation.


CONCLUSIONS
A nurse-lead consensus building process is proposed to guide family decision-making regarding artificial hydration and nutrition with advanced Alzheimer's disease.
Minnesota State University, Mancato, Minnesota, USA.
Sandra K
SK
Eggenberger
Tommie P
TP
Nelms
D000368:Aged; D000544:Alzheimer Disease / Q000451:nursing / Q000628:therapy*; D003657:Decision Making / Q000941:ethics*; D003680:Deglutition Disorders / Q000451:nursing / Q000628:therapy*; D004993:Ethics, Nursing; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D018529:Nutritional Support; D011368:Professional-Family Relations