When presenting MAID 101 classes, the discussion of dementia inevitably comes up.
Azlheimer’s Association advises that Arizona has the fastest growth rate of for Alzheimer’s disease in the country. As many already know, it presents with a slow progression. People 65+ survive for four to eight years after diagnosis, and some as long as twenty years. Individuals who live from 70 to 80 years of age will spend 40% of this time in the most severe stage.
This news is not good and there is no cure on the horizon, especially with critical research funds being cut at NIH. There is also an unfortunate ‘Catch-22’ with those diagnosed with dementia and MAID. With early diagnosis and the mental capacity to still make medical decisions, there is rarely a 6-month prognosis. And with late-stage dementia when there might actually be a realistic 6-month prognosis, there is no longer the required mental capacity to use the MAID laws. So, unfortunately MAID is usually not an end-of-life choice for those diagnosed with the various forms of dementia.
One possible solution? An advanced directive for dementia that can be completed prior to diagnosis or in very early stages. Even if there is no dementia in the family tree, it can be a comfort to fill this out just in case of this unfortunate diagnosis occurs. Think of this as your competent, healthy self reminding your future self (and your advocate) what you want if you are no longer able to make your own healthcare decisions.
There are many versions of the form including those from Compassion and Choices Dementia Toolkit, Dartmouth Dementia Directive, and https://dementia-directive.org/. These forms give you various other end-of-life choices to approve with your initials such as refusing treatment, antibiotics, and life-saving measures, starting VSED (voluntary stopping eating and drinking) and palliative sedation.
Here is a link to a comprehensive resource and form recently published in the State of Washington that can be used in any state as well, specifically for VSED with dementia:
Advance Directive for Voluntary Stopping of Eating and Drinking(VSED Directive) | WashingtonLawHelp.org | Helpful information about the law in Washington.
As they say in Latin: Estote parati ... be prepared!
