End Stage Dementia and Entropy Definition of Suffering

Objectives: A new definition of human suffering and satisfaction according to the entropy hypothesis may fa- cilitate comprehension of health, disease and the aging process. Methods: A cohort study of 71 patients (28 females, 43 males), with very advanced dementia, who died in our ward dur- ing the study period. The intense suffering level of end-stage dementia patients was evaluated by the Mini-Suffering State Examination (MSSE) scale. Results: Suffering level in end-stage dementia has a significant correlation with short survival, advancing age, more se- vere illness, malnutrition, the existence of decubitus ulcers, and the administration of medications. Established correla- tions could be explained by the enhanced level of the patients' body entropy. Discussion: Suffering and satisfaction are functional levels of human entropy. An elevated level of human entropy is a measure of disorder, a process of aging and torment of the patient. a perceived threat to the integrity of the self, perceived help- lessness in the face of that threat, and exhaustion of psycho- social and personal resources of coping. The model proposed by Cherny, Coyle, Foley (10) described suffering as an aver- sive experience, characterized by the perception of personal distress which is generated by adverse factors that undermine quality-of-life. Cherny (11) proposed the triangular model of suffering and taxonomy of factors, prevalence of distress experienced by patients, their families, and their attending health care professionals.