I found this excellent post on www.pallimed.org
http://www.pallimed.org/2007/04/video-assisted-advance-care-planning.html
TO summarise, it summarises an article in archives of internal medicine about video assisted advanced care planning.
In it is a link to a video showing a person with advanced dementia, which (although there wasn't a control group) probably significantly changed a group of people's opinions about how they would want to be treated if they had the condition. They did not have family members with dementia.
The truth about advanced dementia is hidden from the bulk of the population, and it's difficult to appreciate when described. The article will change my practice when discussing the intent of future cares with my patient's and their families.
Another barrier to appreciating quality of life in dementia is the stereotype of the (amusing) forgetful elder. I feel this creates the idea that dementia is funny, and by an inappropriate transference that the demented are amused by their condition. I feel it also delays diagnosis and potential treatment of this serious problem.
I'm not sure if this is something limited to western culture. I'd appreciate any enlightenment - please post on comments here.
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