Alzheimer disease causes cognitive and functional impairments manifested in memory impairment, personality changes, behavioral difficulties, bladder and bowel incontinence, difficulty with eating and swallowing, and recurrent respiratory or urinary infections. At the end of life, family members and clinicians face many decisions about medical care for patients with dementia, none more unsettling than that regarding artificial nutrition and hydration. Discussions with families should center on medical outcomes and weighing the benefits and burdens of this treatment.



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