You decide to hold an initial meeting with Rose, Jacinta, other family members whom Jacinta feels are appropriate, an Aboriginal interpreter, Aboriginal Mental Health Workers and a member from the renal team.  The diagnosis of mild to moderate intensity dementia is explained to Jacinta and other family members.  While Rose still has some cognitive ability to consider her situation, her wishes should be discussed whether to continue with dialysis in town or to return to her community to spend time with her family prior to dying in her own country. 

You also discuss with Jacinta (who is unusually quiet) and the other family members the issues of power of attorney to discuss ongoing care for Rose in the community and other related matters.  You discuss the treatment for her renal condition as well as medication to control the more symptomatic issues of her dementia, such as the desire to dig up her daughter’s body, as these issues may cause significant distress to the community if she decides to return there.  The use of a cognitive enhancing medication is also discussed.