Distinct attitudes of professionals from different medical specialties toward autonomy and legal instruments in the assessment of patients with Alzheimer’s disease

The evaluation of competence of Alzheimer’s disease (AD) patients to assume personal or collective responsibilities and the resulting legal implications is a relevant issue. OBJECTIVES: The aim of this study was to evaluate the attitudes of different medical specialists towards the disability of patients with Alzheimer’s disease and practitioners’ competence to interfere with decision-making autonomy. METHODS: Professionals from different areas (Neurology, Psychiatry, Geriatrics, and General Practice) were interviewed by one of the authors, after being presented a fictitious clinical case which raised several topics, namely: [1] Critical judgment and capacity of the patient to take decisions related to daily activities; [2] The role of family physicians in nominating trustees and caregivers. RESULTS: Answers to the first question did not differ regarding degree of preservation of awareness but at least 25% stressed that the patient must be carefully listened to, independent of caregiver or legal representative opinion. There were significant knowledge gaps in responses to the second question. Half of the physicians interviewed did not have adequate information about the legal aspects of caring for patients with Alzheimer’s disease. CONCLUSIONS: Legal aspects is a topic that must be incorporated into professional training in order to improve attitudes toward the long-term management of patients with dementia.