Guest guest Posted December 19, 2008 Report Share Posted December 19, 2008 In our experience, we have had lower functioning patients that have done well with support. In fact, they have been some of the most rewarding patients to work with ! Every person is evaluated on an individual basis. Strathdee, RD, LD, LMHC Genesis Medical Center, Davenport, IA >>> " susana1021 " <sveldheer@...> 12/19/2008 08:20 AM >>> Recently, our multi-disciplinary team has been discussing a group of patients to try to determine appropriateness for surgery. These patients are low functioning mentally but have a lot of family support. They may have been in special ed. in school or have brain damage with memory problems. Some live independently and others live with their parents or other support people. Some cook their own meals, some are afraid to use the oven. Some have BMIs in the 40's some in the 60's and 70's. In all cases, clearly obesity is impacting their lives negatively. There are several key ethical dilemmas: 1. Do we treat a primary diagnosis of morbid obesity with bariatric surgery? 2. Do we deny treatment knowing that these patients' obesity will eventually be their cause of death? 3. Can they truly consent to this elective procedure and is family support enough to manage them for a lifetime? I was wondering if other programs encountered this dilemma and what they have done. I have done a literature search and not found anything yet on mental development issues and bariatric surgery. Is anyone familiar with literature related to this specifically in bariatrics? Any input would be greatly appreciated. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 19, 2008 Report Share Posted December 19, 2008 I have worked with a handful of low functioning patients and we make sure that the family is in full support, attends all appointments and pre-op classes, and we usually only do the sleeve gastrectomy as there is less risk associated with any non-compliance. Sent via BlackBerry from T-MobileFrom: "susana1021" Date: Fri, 19 Dec 2008 14:20:57 -0000< >Subject: Mental disabilities Recently, our multi-disciplinary team has been discussing a group of patients to try to determine appropriateness for surgery. These patients are low functioning mentally but have a lot of family support. They may have been in special ed. in school or have brain damage with memory problems. Some live independently and others live with their parents or other support people. Some cook their own meals, some are afraid to use the oven. Some have BMIs in the 40's some in the 60's and 70's. In all cases, clearly obesity is impacting their lives negatively. There are several key ethical dilemmas: 1. Do we treat a primary diagnosis of morbid obesity with bariatric surgery? 2. Do we deny treatment knowing that these patients' obesity will eventually be their cause of death? 3. Can they truly consent to this elective procedure and is family support enough to manage them for a lifetime? I was wondering if other programs encountered this dilemma and what they have done. I have done a literature search and not found anything yet on mental development issues and bariatric surgery. Is anyone familiar with literature related to this specifically in bariatrics? Any input would be greatly appreciated. Quote Link to comment Share on other sites More sharing options...
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