Summary

In Chapter 6, Dosa explains that it is easier to talk to patients and their families about limiting care when a patient is suffering with a terminal disease, like cancer, as compared to a dementia patient. In the case of Alzheimer’s, as a patient deteriorates, the doctors and families must decide when it is no longer feasible to do more tests and treatments. The families often get a false sense of hope when their loved one recovers from an acute illness. Each time the patient must fight one of these acute illnesses, he is weaker and less able to recover from the next illness.

Dosa uses the Rubensteins’ situation to illustrate this point. Ruth had become a regular patient for Dosa about a year after he diagnosed her with Alzheimer’s. Frank was patient with his wife during her decline and did not...