Legal and assistance aspects of Alzheimer?s disease: analysis of 100 cases

Abstract

Caring for patients with disabling cognitive diseases, such as Alzheimer’s disease (AD) and other progressive dementias, has a number of legal and social welfare implications. The two main problems to be discussed with patients and caregivers are the need for a legal guardian and requests for government financial support, both of which depend on the patient’s progressive loss of autonomy and increasing need for assistance. In order to study the presence of these two support measures, we considered 100 AD patients (56 women and 44 men) divided in four groups on the basis of the stage of the disease: mild (25), moderate (34) and severe (32), or death (9). We investigated the number of caregivers for each patient (and their relationship with the patient), the presence of a legal guardian, and whether government financial support had been obtained. The number of caregivers increased for each patient as the disease advanced (54% with moderate and 67% with severe disease had ≥1 caregiver), but only 11% of the patients had a guardian. The caregivers were most likely to be family members (70% were spouses, 45% offspring). Only 23% of the patients with moderate and 62% with severe disease received government financial support. Our data concerning the care of incompetent people (as AD patients progressively become) in juridical (guardianship/trusteeship/proxy/power of attorney) and social terms (government financial support) show that such aspects are not sufficiently taken into account until the patients reach a severe disease or have died.