Dementia patients in Taiwan endure agony before their death, similar to what happens in Japan, a Tainan-based medical center study said.
Chi Mei Medical Center director Chen Ping-jen (陳炳仁), who led the study, said feeding tubes and restraints are used on dementia patients far more often in Taiwan than in the West, where palliative care, centered on preserving the patient’s dignity and autonomy, tends to be the focus.
Chen referred to a book by two Japanese doctors, Kenji Miyamoto and his wife, Reiko Miyamoto, which discusses how terminally ill dementia patients are treated in Japan.
The book, which was translated into Chinese and released in Taiwan late last year, says that rather than tube-feeding and restraining dementia patients, as is often the case in Japan, they should be given the choice to die with dignity.
Chen, who wrote a preface for the book, said Japan’s elderly care is starkly different from that of Europe or the US, “but the way dementia patients are treated in Taiwan is extremely similar to that in Japan.”
Basing their study on data from the National Health Insurance program, Chen and his palliative care team found that 70 percent of dementia patients were tube-fed, 60 percent were intubated or on respirators, 18 percent were on kidney dialysis and one-third were revived in their final year of life.
Those ratios are much higher than in Europe and the US, and are also higher than in most other Asian nations, the study said.
The study also found that terminally ill dementia patients are four times more likely than cancer patients to be intubated, revived or put on a respirator after accounting for age, gender and similar illness.
These emergency treatments mainly took place in the last month of a patient’s life, meaning that they suffered tremendously in the weeks leading up to their deaths, the study said.
Chen’s study has been accepted, but not yet published by Geriatrics & Gerontology International, a medical journal edited by the Japan Geriatrics Society.
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