End-of-Life: The New Israeli Law “The Dying Patient” and Relief of Suffering Units for Conditions Like Dementia

Medical personnel and society in general are unaware that there are no tools with which to measure and diagnose the level of suffering of a dying patient. Similarly, no tools are available to estimate the 2-week or 6-month survival period of terminal dementia patients. The new Israeli Law “The Dying Patient” provides avenues for possible medical, ethical, and Halachic (Jewish religious law) solutions in view of the complexity of the treatment of an end-stage dementia patient. The treatment of an end-stage dementia (ESD) patient with a high level of comorbidity and severe disability may be far more difficult than treatment of a patient with end-stage heart or lung disease, or cancer. The difficulty lies in the complexity of the medical, nursing, cognitive, emotional, ethical, and social problems. The establishment of a hospice-like setting for dementia patients in Israel, based on palliative treatment only, similar to the Jewish hospices in the United States, is extremely important. This article proposes a new, alternative approach and setting for patients with end-stage dementia that could pertain to the Israeli setting and could possibly also be acceptable in other countries. Comparisons in demographic and clinical variables between the 3 levels of MSSE (low, intermediate, and high) were performed using analysis of variance, the Kruskal-Wallis nonparametric test, and the Fisher exact test, where applicable. The results of our research showed that care in the geriatric department failed to reduce the high level of suffering of ESD patients. Short hospitalization periods of approximately of life With Dementia Units may be a new palliative approach and present a possible solution for coping with the burden of the suffering of end-state dementia patients, their families, and the medical and nursing staff.