Alzheimer's disease through the prism of bioethical and legal issues

Uvod: U Hrvatskoj se prema procjenama godišnje pojavljuje 3000 novooboljelih od neke vrste demencije, a od toga 70 % slučajeva oboljelih od Alzheimerove bolesti. O oboljelima se brine 250 000 obiteljskih skrbnika. Razvoj bolesti započinje podmuklo i najčešće nakon 65. godine, ali može se javiti i ranije. Pojava prvih simptoma u osoba mlađe životne dobi predstavlja značajan dijagnostički problem u radu neurologa i velik socioekonomski problem zato što pogađa radno sposobnu populaciju. Postupci: Znanstveni radovi korišteni za pisanje diplomskog rada većinom su publicirani u vremenskom razdoblju od 5 do 10 godina i pretežno su objavljeni na engleskom jeziku. Kriteriji uključivanja znanstvenih radova temeljeni su na njihovoj prikladnosti i preciznoj usmjerenosti na odabranu tematiku diplomskog rada. Prikaz teme: Alzheimerova bolest jedan je od glavnih uzročnika invalidnosti kod osoba starije životne dobi u svijetu. Prati ju fizički, psihološki, socijalni i ekonomski utjecaj na oboljele osobe, ali i na njihove najbliže – obitelj, njegovatelje i cjelokupno društvo. Cilj je rada opisati bioetičke kliničke dvojbe vezane uz skrb na kraju života u kontekstu pravnog statusa skrbnika u odlučivanju o pravima, interesima i potrebama oboljelih, primjene informiranog pristanka oboljelih osoba na medicinski tretman, kao i mogućnosti sklapanja anticipiranih naredbi u svrhu zaštite njihovih ljudskih prava. Zaključak: Specifične kompetencije medicinske sestre potrebne su za kvalitetan rad s bolesnicima oboljelim od Alzheimerove bolesti, kao i osobama koje skrbe o njima u rješavanju njihovih problema i zadovoljavanju potreba u pružanju palijativne skrbi.Introduction: According to estimations, there are annually 3000 people who suffer from certain type of dementia in Croatia, out of which 70 % people suffer from Alzheimer’s disease. Around 250 000 guardians care about the patients. The development of the disease starts insidiously, usually after the 65th year of life, but it can appear even earlier. The appearance of the first symptoms in earlier ages represents significant diagnostical problem in neurologist’s work and big socio-economical problem because it impacts on the population which is able to work. Procedures: The scientific articles consulted for making this diploma paper are in vast majority published in 5 – 10 years period, mostly in English language. The criteria for the scientific articles’ implementation are based on their suitability and precise commitment to the topic of this diploma paper. Topic representation: Alzheimer’s disease is one of the greatest causative factors of disability in older population, which is followed by physical, psychological, social and economical influence on patients, as well as on their most beloved ones, families, caregivers and society in general. The aim of this paper is to describe bioethical and clinical doubts regarding care at the end of life in a context of legal status of the guardian in making decisions about rights, interests, needs of the patients, application of the patients’ agreement to the medical treatment, as well as about the possibility of making anticipated orders to protect their human rights. Conclusion: Specific competences of a nurse are necessary for quality work with the patients who suffer from Alzheimer’s disease, as well as of caregivers who care about the patients’ problems and fulfillment of the patients’ needs in providing palliative care