ABSTRACT
From the very first signs and symptoms of dementia, clinicians, caregivers, and patients must face unique and important legal and ethical issues. These issues arise because the disease, in whatever form it takes, impairs an individual's capacity to make decisions and to function independently. End-of-life issues, in particular, have become more prominent and more complex in the past few decades because the practice of medicine has increasingly achieved the ability to prolong the lives of individuals with dementia, despite their severe physical and mental incapacity. The ability of a clinician to understand these issues and to intervene effectively and appropriately depends upon conducting a thorough assessment to determine a diagnosis of dementia and its stage; an awareness of the religious, cultural, and philosophic factors that influence decision-making for both the patient and family; and personal involvement with the patient, family, and other surrogate decision-makers.
