Ethics & Law · patient case question
Regarding the role of his wife, which statement is NOT true?
Patient case: Elderly man with Alzheimer disease and a symptomatic upper left molar
Patient: Male, 78 years old
Chief complaint: “His tooth has been hurting him and his face is swollen.” Reported by the wife, who accompanies him.
Background: Alzheimer disease, moderate stage. Medication: donepezil. His wife attends every appointment and manages his daily care.
Current findings: Periapical radiograph shows tooth #15 lying on its side (slanted/impacted) with an associated radiolucency. Swelling and pain localised to #15. Patient is pleasantly confused and defers all questions to his wife.
Show answer and explanation
Correct answer: C. Simply by being his spouse, she may legally make all decisions on his behalf
- A. True, PROVIDED she holds that authority. This is exactly what must be verified and documented.
- B. True, and the caregiver is the appropriate recipient of hygiene instruction here.
- C. CORRECT — this is the FALSE statement. Marriage alone does NOT confer blanket legal decision-making authority. That requires a formally established mechanism: guardianship, conservatorship, healthcare proxy or durable power of attorney. Many states do grant a spouse default surrogate status for healthcare decisions, but it is not automatic or unlimited, and it certainly does not extend to 'all legal decisions.'
- D. True. Caregiver involvement is essential to any realistic care plan in dementia.
Note: Note the distinction the exam is testing: being a spouse and being a legally authorised surrogate are two different things. Verify and document which applies.