Advance care planning and neurological disorders: end-of-life care for the aged with neurological diseases

The advance care planning was enacted with the intention of facilitating a dignified death. However, its original purpose often falls short for elderly patients suffering from severe neurological disorders. This review examines the practical challenges observed in clinical settings, focusing on how the current system may not adequately apply to, or in some cases even infringes upon the rights of, elderly patients with severe neurological conditions. It highlights critical issues such as the absence of decision-making capacity due to cognitive decline or loss of consciousness, the limited accessibility and utilization of institutional ethics committees, and the subjective prognosis judgments made by medical professionals. This paper aims to provide patients, their families, and healthcare providers with a clear understanding of the current system’s limitations, fostering awareness of the dilemmas and problems that arise in the process of making life-sustaining treatment decisions.