Ethical Issue: ECT on down/dementia patient?

I work at a mental health/geriatric unit. Our psychiatrist is an old school, generally lack of communication with nurses, distanced doctor, and, he likes ECT.
I have an-86-year-old lady who was diagnosed with down syndrome/boarderline IQ at age of 40, and now early stage dementia secondary to down syndrome (a particular down syndrome i dont remember the name on top of my head since im pretty new on this unit). I just want to ask here: is it ethical to send a down syndrome & geriatric patient for ECT on regular basis? Would ECT be as effective as it is performed on other types of pscy patients(bipolar, schizo, depression)? For me i dont see behavior issues of this Res that could be particular difficult for the team. However, i did listen to the transportation girl, she mentioned that right after ECT Res became restless(ex, hanging her legs over the bed rails/climbing in the recovery room, and restless could remain for half day after she returns to facility. She usual routine is verbally loud when she wants to be resistant, but i dont even think she realizes how loud she could be.
What do you think?
Who is the person signing the consents for this?

Quote from xtxrnWho is the person signing the consents for this?

Quote from whitebunnyson is the POA

i’ve only been a nurse for just over a year, i do however work in a facility for dementia pts/residents... the way i see it is this, she has down syndrome, she’s 84, and she’s early stage dementia with no behaviour issues except yelling at staff and being resistive to care? i’m not sure i see the point of even doing ect. i could totally understand seeing her more restless after treatments, moving people with dementia around a lot is one of the things that can cause high anxiety as they are not familiar with the surroundings. what exactly are they trying to accomplish? i thought ect treatment was for bipolar / depression.this is really interesting; i hope more people post their thoughts.

Were any other alternative methods tried for this patient? Also does she have any co-morbid psych disorders like Bipolar Disorder or Major Depression? ECT usually isn't the first line of treatment(even for psych disorders...unless a patient personally requests this type of treatment). Usually medication, psychotherapy or both are tried first before turning to ECT. I have never worked on a psych floor..so please correct me if I am wrong, I just got my BA in forensic psychology(so I do know a thing or two about psychiatric illness and it's treatments) before shifting career paths(believe me it took me a long time to actually find this career that I actually like...no LOVE :heartbeat)...and just to change the subject a little...before anyone asks me if I feel bad that I "wasted" my time getting my BA in forensic psychology which is totally unrelated to nursing(I get asked at least once a day LOL). But the answer is NO...education is never a waste(I also got a chance to get my degree from a world renowned criminal justice college in Manhattan which I wouldn't trade for the world) and as the cliche goes..knowledge is power.

What are the ECTs for? There's no purpose for them in someone who has Down's Syndrome or dementia. Maybe the lady has depression, mania, or anxiety? That's what ECTs are used for. If she's been getting the ECTs a long time, maybe the doctor keeps giving them because they keep her depression or mania or anxiety as stable as possible. ECTs often have to be given from time to time, kind of like a booster shot is given to prevent some diseases. Maybe you don't know the whole story.Also, her POA made the decision. I also hope he or she is fully informed about the reason for the ECTs and made the proper choice for the patient's treatment.

if she is gaining no benefit from the ECT and the side effect is that it is exacerbating unruly behavior (which i how I read it, please correct me if I am wrong), then there is no point to putting her through it.

Have you read this patient's history thoroughly and talked to her son? I'd be willing to bet there's a lot more to it than you're aware of, I truly hope that's the case anyway. Perhaps she's relatively stable because of the ECT, not in spite of it. While it sounds awful to be sending an 86 year old for ECT, it's possible that it's been decided to stop it several times in the past with disastrous results. I find it really hard to believe that it's being given for the sort of behaviour described in the OP.I once looked after an 85 year man whose paranoid delusions hadn't been too much of a problem for several years but as what was initially mild dementia progressed, his mental state slowly became more and more unstable. It was horrible watching this frail elderly man truly suffer with a mental illness that gradually became unmanagable. Eventually (and it took a long time) his psychiatrist felt there was nothing left to do but try ECT as this had been effective several times over the years.The ECT did help him. His dementia continued to progress but he didn't have another obvious exacerbation of the schizophrenia that had been a problem on and off for most of his life. Mental illness is so sad and I take my hat off to nurses who work in psych - I love looking after the elderly with dementia but schizophrenia is another thing altogether.It'd be interesting to hear how this ends up if the OP is able to give any more information about the patient's history.

I'm stuck on :1. 86 and Down Syndrome...that's mighty geriatric already! ECT seems cruel. 2. She had a child? Infertility is the rule amongst Down patients although conception not unheard of. Definitely need more info here.

I work on a psych unit and we do ECT on a regular basis. I didn't even know ECT was still done until I got this job, but I have seen amazing results from it.