How does dementia impact end-of-life communication, and which strategies best support patient autonomy?

• A. Dementia does not affect communication; no special strategies are needed.
• B. Language impairment limits dialogue; strategies include early goals-of-care discussions, simple language, visual aids, and engaging surrogates while honoring patient preferences.
• C. Surrogates should always make decisions without patient input.
• D. Only written notes should be used for all decisions.

Answer: (B)