Dementia and euthanasia

[spartan max2]

I was at a training today for my CEUs (continuing education units) for my license. It was about dementia.

Dementia is a catch all term for different types of brain failure, the most common being Alzheimers.

They showed us brain scans showing how every area of the brain has less activity as the condition progresses except for one area, the Amygdala and the brain stem - those areas actually increase in activity! The part involved in fear, threats, and survival. 

So in essence, people with Dementia are very afraid. Most of their challenging behaviors are from being afraid and confused. They die in fear. 

I feel it would be more compassionate for society [to make assisted dying legal] for those with late-stage dementia. 

Edited September 7, 2019 by Saru
Edited title, final sentence due to the sensitive nature of the topic.

[+Desertrat56]

Well, doctors kill cancer patients with overdoses of morphine and it probably happens to people with late stage dementia or alzheimers as well.  At least in the U.S. it does.  I know when my daughter worked in a nursing home for alzheibers patients they would send her home when one of the patients could not get out of bed and sent for the family and the doctor.  I am sure the treatment at that point is the same as for cancer patients like my mother and aunt, who were overdosed on morphine by the nurses who directed us to give them a large dose every hour until they quit breathing.  That is exactly what I think you are talking about.

I don't think they do this for demetia patients until they are unable to eat or sit up, but for cancer patients it depends on the doctor.  My mother was put on huge doses of fentinyl (not sure I spelled that right) until she became comatose (pretty quickly) and then on large doses of morphine every hour.  Before the fentinyl she was able to sit up and talk to us, after the fentinyl she was comatose in 24 hours.  She was still in a lot of pain but unable to move. 

P.S.  I know I did not answer your question because I can't.  It is not a pretty way to die.  There are other quicker ways to end someone's suffering but they are all illegal.  I think morphine should also be illegal as doctors use it too often to make things easier for themselves not the patient.

Edited September 6, 2019 by Desertrat56

[Hankenhunter]

Both my parents suffered horribly and died from this horrible disease. I have made arrangements with my doctor to end my life if I start showing the signs. I just can't in all good conscience, put my kids through what we experienced. I won't go into the details as I don't want to ruin anyones day.

[spartan max2]

1 minute ago, Hankenhunter said:

Both my parents suffered horribly and died from this horrible disease. I have made arrangements with my doctor to end my life if I start showing the signs. I just can't in all good conscience, put my kids through what we experienced. I won't go into the details as I don't want to ruin anyones day.

I can only imagine what that would be like .

I'm sorry. 

[+Desertrat56]

1 minute ago, Hankenhunter said:

Both my parents suffered horribly and died from this horrible disease. I have made arrangements with my doctor to end my life if I start showing the signs. I just can't in all good conscience, put my kids through what we experienced. I won't go into the details as I don't want to ruin anyones day.

I don't trust doctors so I don't have one, I go to urgent care if I need to (rarely).  I told my kids that if I need care they must sell my stuff and put me in a nursing home.  I agree with you.  I don't want anyone else to go through what I did.  I expect to be like my 86 year old aunt who has asked us to take her to the mountains and leave her if she ever gets incapacitated.  (she also said and don't tell my kids because I don't want them to come to see me and find me dead) 

[Hankenhunter]

10 minutes ago, Desertrat56 said:

Well, doctors kill cancer patients with overdoses of morphine and it probably happens to people with late stage dementia or alzheimers as well.  At least in the U.S. it does.  I know when my daughter worked in a nursing home for alzheibers patients they would send her home when one of the patients could not get out of bed and sent for the family and the doctor.  I am sure the treatment at that point is the same as for cancer patients like my mother and aunt, who were overdosed on morphine by the nurses who directed us to give them a large dose every hour until they quit breathing.  That is exactly what I think you are talking about.

I don't think they do this for demetia patients until they are unable to eat or sit up, but for cancer patients it depends on the doctor.  My mother was put on huge doses of fentinyl (not sure I spelled that right) until she became comatose (pretty quickly) and then on large doses of morphine every hour.  Before the fentinyl she was able to sit up and talk to us, after the fentinyl she was comatose in 24 hours.  She was still in a lot of pain but unable to move. 

P.S.  I know I did not answer your question because I can't.  It is not a pretty way to die.  There are other quicker ways to end someone's suffering but they are all illegal.  I think morphine should also be illegal as doctors use it too often to make things easier for themselves not the patient.

You have my condolences and sympathies. Your post touched me deeply. Hopefully, there will be a cure for this horrible malady sooner than later. Regards,

Hank

[+OverSword]

I wouldn't say we should kill them but it should not be illegal to assist them to die if they choose to do so before they are too far gone.

[justin3651]

It sounds reasonable in theory but the devil is in the details. How do we decide? Who decides ultimately? What if family disagrees? What if the family think it's time to put grandma down but the doctor diagrees? 

[+Desertrat56]

3 minutes ago, Hankenhunter said:

You have my condolences and sympathies. Your post touched me deeply. Hopefully, there will be a cure for this horrible malady sooner than later. Regards,

Hank

Thank you.  My condolences to you too.  I also hope for the cure soon.

[HandsomeGorilla]

I sincerely believe that it should be every person's right to not only live life as they please, but to end their life as they please, as well. 

[spartan max2]

4 minutes ago, justin3651 said:

It sounds reasonable in theory but the devil is in the details. How do we decide? Who decides ultimately? What if family disagrees? What if the family think it's time to put grandma down but the doctor diagrees? 

That's a very good point. We would need some kind of concrete way to decide.

[Hankenhunter]

1 minute ago, justin3651 said:

It sounds reasonable in theory but the devil is in the details. How do we decide? Who decides ultimately? What if family disagrees? What if the family think it's time to put grandma down but the doctor diagrees? 

Aye, there's the rub. Communication with loved ones and your physician is paramount. My grown kids understand and support my decision. If it comes to pass, I will have a big going away party, and the next day Poopa will be going to live on the farm.

[lightly]

Your quite a guy "Poopa".  

[papageorge1]

51 minutes ago, spartan max2 said:

I was at a training today for my CEUs (continuing education units) for my license. It was about dementia.

Dementia is a catch all term for different types of brain failure, the most common being Alzheimers.

They showed us brain scans showing how every area of the brain has less activity as the condition progresses except for one area, the Amygdala and the brain stem - those areas actually increase in activity! The part involved in fear, threats, and survival. 

 

So in essence, people with Dementia are very afraid. Most of their challenging behaviors are from being afraid and confused. They die in fear. 

I feel it would be more compassionate for society to kill those with late-stage dementia. 

This is certainly a timely topic for me. My mother died a month ago from late-stage dementia. In our particular case I feel we were very lucky as her final end-stage was fast although in all the disease progressed slowly an inch a day for ten years or so before that. Just in the last few weeks she lost interest in food and seemingly the ability to swallow. This is actually common and they really die of starvation and dehydration and yes this is common as intravenous or tube feeding is never indicated for end-stage dementia (no artificial methods of entering food/fluid is something I strongly agree with). 

Now on to the OP question. I definitely believe that in the end nothing should be done to extend life but only to relieve suffering. Comfort/pain medication should be used liberally. Now on to the tricky question of directly ending life with a certain fatal dose. At what point is it advisable and who decides? This is not even the assisted suicide question as the patient is not mentally competent to make a decision. 

Fortunately for my mom the final decline was so rapid this issue didn't present itself. However I am sympathetic to the cases where somehow the patient gets enough food/water into them to continue on for a long time (years??). I wondered if instructions to not give any food or drink after a doctor determines end-stage is in process is one natural solution the family can consider. The euthanasia option requires a doctor determination and a family decision which may not always be unanimous (that could be ugly). 

All in all I think there is a place for the euthanasia option in some cases.

 

Edited September 6, 2019 by papageorge1

[RAyMO]

My father died very recently from the disease. Despite being very well cared for by the staff at the home, it was distressing to watch his demise over the last months. Weak, frail and unable to comprehend anything around him, I will say nothing more on that. Confused in his final years, not knowing anyone, and really not, imo,  having any quality of life.

Had euthanasia been available as an option I and, I am pretty sure, my siblings would have opted for it, not least because we believe he would have opted for it, had he been able.

But there are indeed questions - what if the option had been available and what if one of my siblings had disagreed - in that case it wouldn't have happened. As a family all care decisions about our parents have and always will require all to agree. Its more complex than that but that's the jist. 

Edited September 6, 2019 by RAyMO

[RAyMO]

5 minutes ago, papageorge1 said:

This is certainly a timely topic for me. My mother died a month ago from late-stage dementia. In our particular case I feel we were very lucky as her final end-stage was fast although in all the disease progressed slowly an inch a day for ten years or so before that. Just in the last few weeks she lost interest in food and seemingly the ability to swallow. This is actually common and they really die of starvation and dehydration and yes this is common as intravenous or tube feeding is never indicated for end-stage dementia (no artificial food/fluids is something I strongly agree with). 

Now on to the OP question. I definitely believe that in the end nothing should be done to extend life but only to relieve suffering. Comfort/pain medication should be used liberally. Now on to the tricky question of directly ending life with a certain fatal dose. At what point is it advisable and who decides? This is not even the assisted suicide question as the patient is not mentally competent to make a decision. 

Fortunately for my mom the final decline was so rapid this issue didn't present itself. However I am sympathetic to the cases where somehow the patient gets enough food/water into them to continue on for a long time (years??). I wondered if instructions to not give any food or drink after a doctor determines end-stage is in process is one natural solution the family can consider. The euthanasia option requires a doctor determination and a family decision which may not always be unanimous (that could be ugly). 

All in all I think there is a place for the euthanasia option in some cases.

 

My thoughts are with you. And I agree with your points.

[RAyMO]

31 minutes ago, Hankenhunter said:

Both my parents suffered horribly and died from this horrible disease. I have made arrangements with my doctor to end my life if I start showing the signs. I just can't in all good conscience, put my kids through what we experienced. I won't go into the details as I don't want to ruin anyones day.

Totally understand where you are coming from.

[Hankenhunter]

2 minutes ago, RAyMO said:

My father died very recently from the disease. Despite being very well cared for by the staff at the home, it was distressing to watch his demise over the last months. Weak, frail and unable to comprehend anything around him, I will say nothing more on that. Confused in his final years, not knowing anyone, and really not, imo,  having any quality of life.

Had euthanasia been available as an option I and am am pretty sure my siblings would have opted for it, not least because we believe he would have opted for it, had he been able.

But there are indeed questions - what if the option had been available and what if one of my siblings had disagreed - in that case it wouldn't have happened. As a family all care decisions about our parents have and always will require all to agree. Its more complex that that but that's the jist. 

Well said. Sorry for your loss. And what you personally went through. The feeling of helplessness is so horrible and draining. Im starting to wonder if there is some environmental factor involved that hasn't been discovered yet. 

[RAyMO]

9 minutes ago, Hankenhunter said:

Well said. Sorry for your loss. And what you personally went through. The feeling of helplessness is so horrible and draining. Im starting to wonder if there is some environmental factor involved that hasn't been discovered yet. 

I am sure over the time you and your family have discussed various possibilities. But your comment reminded me of my uncle. He's in his 80s, still rides a bike, thinks nothing of jumping in a car and driving on a 5 hour journey to visit his sister, my mother, insists on the latest iPhones etc. He looks amazing for his age, I am not sure how many years he was going with his girlfriend before he told her there was  25 years between them . In short he's quite a character.

But he is convinced and sincere when he says its Red Meat!

Not that I believe him - it just came to mind when I read your post.

Edited September 6, 2019 by RAyMO

[+Desertrat56]

17 minutes ago, RAyMO said:

My father died very recently from the disease. Despite being very well cared for by the staff at the home, it was distressing to watch his demise over the last months. Weak, frail and unable to comprehend anything around him, I will say nothing more on that. Confused in his final years, not knowing anyone, and really not, imo,  having any quality of life.

Had euthanasia been available as an option I and, I am pretty sure, my siblings would have opted for it, not least because we believe he would have opted for it, had he been able.

But there are indeed questions - what if the option had been available and what if one of my siblings had disagreed - in that case it wouldn't have happened. As a family all care decisions about our parents have and always will require all to agree. Its more complex than that but that's the jist. 

I'm sorry for your loss and I can relate some but probably more in the next few months.  My dad is declining and living in a nursing home now.  Every time I go to see him he is less and less there.  His dementia is alcohol and drug induced as he was an addict, though strangely has survived 87 years.   Because of his addictions and fears and insanity the family has no say in anything concerning his life.  He set it up that way so he is dependent on an attorney and some company that has  legal responsibility for his medical decisions.  All we can do is visit.

It is becoming something that seems more and more common. (the dementia, not the legal stuff)

 

[RAyMO]

38 minutes ago, Hankenhunter said:

Aye, there's the rub. Communication with loved ones and your physician is paramount. My grown kids understand and support my decision. If it comes to pass, I will have a big going away party, and the next day Poopa will be going to live on the farm

I am sure this topic brings back memories Hankenhunter and I am sorry for your loss.

Hopefully it won't come to it, but the big party idea seems like a good idea. I might steal it.

[darkmoonlady]

If I were diagnosed with dementia or Alzheimers, I would arrange for physician assisted suicide long before I declined too far I didn't have cognitive control. I just watched Still Alice a movie about a woman diagnosed with early onset Alzheimer's and she tried to set up her own suicide but failed because her cognitive abilities went to far down before she could. I'd live a specific time, a short one, enjoy that time and then because I live in a state where it's legal, physician assisted suicide. I have no want to be here beyond a life and mind that are in decline. I think it would be humane as long as prior authorization was made while a person was cognitively able to understand and a date set for time of suicide. 

[RAyMO]

5 minutes ago, Desertrat56 said:

I'm sorry for your loss and I can relate some but probably more in the next few months.  My dad is declining and living in a nursing home now.  Every time I go to see him he is less and less there.  His dementia is alcohol and drug induced as he was an addict, though strangely has survived 87 years.   Because of his addictions and fears and insanity the family has no say in anything concerning his life.  He set it up that way so he is dependent on an attorney and some company that has  legal responsibility for his medical decisions.  All we can do is visit.

It is becoming something that seems more and more common. (the dementia, not the legal stuff)

 

 My thoughts are with you and your family. Perhaps I am wrong but I feel it is very sad you can have no say on his life. But as you said that was his decision.

I doubt this is even relevant, but just in case, one side effect of my fathers illness was that it brought us (my siblings and I) together. Something I cherish and will endeavor to ensure endures.

 

[Imaginarynumber1]

People should be able to make arrangements earlier in life so that if they do suffer some form of dementia, they can still end their life on their own terms. Not just for dementia, either. 

[Imaginarynumber1]

1 hour ago, justin3651 said:

It sounds reasonable in theory but the devil is in the details. How do we decide? Who decides ultimately? What if family disagrees? What if the family think it's time to put grandma down but the doctor diagrees? 

I should be able to craft a legal document that says if i ever suffer from some sort of dementia or brain debilitating illness, that i choose to have my life ended with tyhe assistance of a medical professional rather than suffer. Family be damned. They should have no say in my decision.