IPA Press Releases

Dementia patients are persons, with all the rights and privileges the word implies

VANCOUVER,B.C. (August 19) - Ethical issues in the care of patients suffering from severe mental problems or the dementias were important topics of conversation here this week at the ninth biennial congress of the International Psychogeriatric Association.

This also was featured at plenary sessions which were part of a two-day bilingual (French and English) program put together by the IPA in collaboration with its Canadian organizing committee, the Société de Psychogératrie du Quebec and the Société de Psychogériatrie de langue Francaise.

Dr. François Primeau, a geriatric psychiatrist from Montreal and an assistant professor at McGill University, co-chaired the bilingual program. He said: "Public authorities seem to forget that patients in advanced Alzheimer's or vascular dementia are persons. But they are not a lobby group, they are not fashionable and therefore they do not get the attention they deserve."

The Congress, which concludes Friday, brought together about 2,000 physicians, scientists and related health professionals from 50 countries, who discussed all issues concerning mental health and aging. Dr. Primeau said that 75 of the delegates came from Francophone countries (France, Belgium, Switzerland and Canada). "For us from Quebec, this was an important achievement. Organizing in British Columbia where there is not a strong Francophone professional base, was just as great a challenge as if we had to go to Europe."

His colleague Dr. Serge Gauthier, a professor in the Department of Neurology and Neurosurgery at McGill University, who played a key role in the discussions of ethics, said: "Doctors and caregivers are confronted by decisions concerning physical constraints, chemical constraints, force-feeding, and end of life decisions."

Dr. Gauthier said patients in early stages of Alzheimer's or other dementias often remain mentally competent and efforts are made to ensure that their wishes are recorded on all these sensitive issues. But Dr. Primeau was quick to add that these people, while mentally able to function, often suffer from depression, made worse by thoughts about their medical prognosis. This complicates their own ability to reason and the input of both family and doctors.

Many professionals at the Congress said that love and affection are vitally necessary in the care for these patients, although there was discussion that modern fears about the word "abuse" as it might relate to hugging and caring for people, intimidate caregivers.

"The best people in this field are the physicians who are not afraid to touch the patient," Dr. Gauthier said.

Summarizing the international Congress, Dr. Gauthier said: "We discovered that no matter what the issue or whatever the language, our concerns are universal."

The bilingual program in Canada became a preview of the IPA's Tenth Congress, which will be held in the year 2001 in Nice, France. Planning is under the direction of IPA director Dr. Philippe Robert of Nice.