Pandemic Dementia Scarce Resource Allocation

Eric E Smith; Philippe Couillard; John D Fisk; Zahinoor Ismail; Manuel Montero-Odasso; Julie M Robillard; Isabelle Vedel; Saskia Sivananthan; Serge Gauthier

doi:10.5770/cgj.23.457

Pandemic Dementia Scarce Resource Allocation

Can Geriatr J. 2020 Sep 1;23(3):216-218. doi: 10.5770/cgj.23.457. eCollection 2020 Sep.

Authors

Eric E Smith¹, Philippe Couillard², John D Fisk³, Zahinoor Ismail⁴, Manuel Montero-Odasso⁵, Julie M Robillard⁶, Isabelle Vedel⁷, Saskia Sivananthan⁸, Serge Gauthier⁹

Affiliations

¹ Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB.
² Department of Clinical Neurosciences and Department of Critical Care Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB.
³ Nova Scotia Health Authority, Halifax, and Department of Psychiatry, Dalhousie University, Halifax, NS.
⁴ Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB.
⁵ Departments of Medicine (Geriatrics), and Epidemiology and Biostatistics, The University of Western Ontario, London; Lawson Health Research Institute, Gait and Brain Lab, University of Western Ontario, London, ON.
⁶ Department of Medicine, University of British Columbia, Vancouver; BC Children's & Women's Hospital, Vancouver, BC.
⁷ Department of Family Medicine, McGill University, Montreal, QC.
⁸ Alzheimer Society of Canada, Toronto, ON.
⁹ Departments of Neurology, Neurosurgery and Psychiatry, McGill University, Montreal, QC, Canada.

Abstract

Hospitals and intensive care units are straining to provide care for a large surge of patients with coronavirus disease 19 (Covid-19). Contingency plans are being made for the possibility that resources for lifesaving care, including mechanical ventilators, will be in short supply. Covid-19 is more severe and more likely to be fatal in older persons. Dementia is one of the commonest severe comorbidities of aging. Persons with dementia are vulnerable and often need the support of others to make their voices heard. This commentary, created by a task force commissioned by the Alzheimer Society of Canada, provides guidance for triaging persons with dementia to scarce medical resources during the Covid-19 pandemic.

Keywords: COVID-19; critical care; dementia; ethics; mechanical ventilation.