Strategies for Building Trust with the Caregiver of a Patient with End-Stage Dementia.

This case describes a patient with advanced dementia and an unrealistic spouse, presenting an apparent dilemma about nutrition for physicians. By eliciting the perspective of the caregiver, the physicians can gain insight and rebuild trust that protects the interests of both the patient and the spouse. Their goal needs to shift from resolving the professional ethical dilemma to affirming the immeasurable contribution of the caregiver, acknowledging her journey, asking for her advice, and enabling the work of making meaning in the time available.