Legal Fear Makes Me Practice Bad Medicine: Antibiotics for Dementia Patients

The Boston Globe reported, this week, on this study just published in the Archives of Internal Medicine.  Over one third of patients with advanced dementia have pneumonia in the last three months of life, and 42 percent of those patients will be on antibiotics in the last two weeks of life.  But the widespread practice of nursing homes routinely giving dementia patients antibiotics to treat pneumonia may be causing as much harm as good.  Patients who received no antibiotic treatments expressed the highest levels of comfort.  Comfort levels were progressively lower as the aggressiveness of care increased.

Paul Raia, vice president of clinical services for the Massachusetts and New Hampshire Alzheimer’s Association said conversations with families about treatment choices often don't happen because harried staff are worried about the legal consequences of their actions.  "Nursing homes want to make sure they aren’t going to get sued, so they are treating people as aggressively as possible and sending someone to a hospital.”