That makes you think. ‘I don’t want to go to the nursing home’ is similar to ‘I don’t want to go to Soest’, but it involves a fully different desire. Compare it with ‘I don’t want to grow old and ugly’. I also understand that, but it is indeed also not easy to arrange.
On to dementia.The most arduous aspect of this disease is that you think you don’t have it, or barely, or only a little bit. I recently heard a man say,“But I have alzheimer’s disease!” That wasn’t the case,but that’s how he felt. Let’s try to provide some clarity on the topic of euthanasia in dementia. We come up with five possible scenarios.
living will nice but not necessary
A: you deteriorate, see for yourself that things are not going well, you do not want to continue and ask for and receive euthanasia. You remain mentally competent at the point of your death wish. Living will nice, but not necessary.
Two: you are going backwards, much worse and more fatal than you realize.Nighttime unrest means you can no longer live at home. You are still mentally competent when it comes to your death wish, but you don’t want to die at all, as ’it’s not so bad’. You end up in the nursing home.
three: You are not too unhappy in the nursing home and you will spend the rest of your days there.This is the most common variant.
Four: in the nursing home you are extremely unhappy and still mentally competent when it comes to your death wish.You realize that, and ask for and receive euthanasia. This is not as rare as one might think. An advance directive is nice, but strictly speaking not necessary. As you are still mentally competent at the point of your death wish.
Five: You are extremely unhappy in the nursing home, but you are no longer mentally competent when it comes to your death wish. The advance directive now comes into effect and you can still receive euthanasia. This variant is the most problematic, as it is indeed not easy to find a doctor who is willing to do it. But it is certainly not impossible. An advance directive is really necessary for this. With euthanasia, this is the only, and indeed the only, situation in wich an advance directive makes sense.
Better the spirit than the letter And while we’re here: what should you write down in the advance directive? no one really knows. Everyone writes down: if I no longer recognize my wife/husband and/or children, then I want euthanasia.People forget that this is not a source of suffering for the person with dementia, but for the bystanders.
In a recent ruling, the Supreme Court said: read the spirit rather than the letter of such an advance directive. See it as a
The Limitations of Current Dementia Treatments
Dementia care is a complex and challenging field, and there’s ongoing debate about the efficacy of available treatments. Renowned philosopher and physician Bert Keizer has voiced strong opinions on the subject, asserting that “nothing helps against dementia.” [[1](https://discourse.gohugo.io/t/wordpress-migration-url-rewriting/3827)]
Despite Keizer’s skepticism, medications like Exelon are widely prescribed, sometimes even in patch form. He highlights the fact that these medications come with notable side effects.
Keizer also casts doubt on the effectiveness of lecanemab, a drug touted for its ability to slow dementia progression. In a pointed remark, he suggests that the drug’s minimal impact could potentially be replicated by a “dementia accelerator.”
Rethinking Nursing Homes: More Than Just “Hell”
Often portrayed as dreary and desolate places,nursing homes are frequently labeled as “hell” by those unfamiliar with their inner workings. However, conversations with experienced caregivers paint a more nuanced picture.
One such caregiver, Keizer, boasts a remarkable 34-year career in a nursing home setting.He challenges the prevailing negative perception, stating that while the experience isn’t a utopia, it’s far from inherently “hellish.”
Keizer points the finger not at the environment itself but at the burdens brought to it. “He blames the ‘hellish misery’ on the burdens brought to the environment, rather than the environment itself.” In essence, he believes the atmosphere within a nursing home is largely shaped by the challenges and difficulties faced by the residents and staff.
Navigating Long-Term Care: A candid Look
Making decisions about long-term care is never easy, and it often comes with a mix of emotions. While acknowledging the challenges of this phase of life, caregiver advocate Keizer offers a nuanced outlook. While he doesn’t shy away from the realities of aging, especially the potential need for nursing home care, Keizer emphasizes that it needn’t be seen as a bleak ending. “I’m not going to promote the nursing home as the most attractive last stop before we actually have to get off,” he concedes, “But it’s not hell.”
Keizer’s words highlight the importance of a realistic yet hopeful outlook.He draws a powerful contrast when he mentions dementia, leaving the sentence intentionally unfinished. This subtle but profound statement underscores the stark difference between the challenges of aging and the unique complexities posed by dementia .
Dr.Bert keizer, a philosopher and physician at the Euthanasia Expertise Center, is a regular contributor to the Dutch newspaper *trouw*. His weekly column delves into the intricate relationship between care, philosophy, and their intersection.
Keizer’s work seamlessly blends his dual expertise, offering insightful perspectives on ethical dilemmas surrounding end-of-life care. His writings explore the complex philosophical underpinnings of medical decisions, encouraging readers to consider multifaceted viewpoints on sensitive topics.
Dr. Bert Keizer, a philosopher and physician at the Euthanasia Expertise Center, is a regular contributor to the Dutch newspaper *Trouw*. His weekly column delves into the intricate relationship between care, philosophy, and their intersection.
Keizer’s work seamlessly blends his dual expertise, offering insightful perspectives on ethical dilemmas surrounding end-of-life care. His writings explore the complex philosophical underpinnings of medical decisions, encouraging readers to consider multifaceted viewpoints on sensitive topics. ## Interview with a Medical Ethicist on Dementia and Euthanasia
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**Interviewer:** Welcome to Archyde’s *InTheConversation* series where we explore complex social issues. Today, we’re discussing a deeply personal and often misunderstood topic: dementia, euthanasia, and teh tough choices individuals and families face.Joining us today is Dr. [Alex Reed Name],a renowned medical ethicist and expert in end-of-life care. Dr. [Alex Reed Name], thank you for joining us.
**Dr. [Alex Reed Name]:** Thank you for having me. It’s a topic that needs open and honest discussion.
**Interviewer:** Absolutely. you recently wrote an insightful piece about dementia and euthanasia, where you highlight the discrepancy between people’s wishes to avoid nursing homes and the reality of dementia’s progression. can you elaborate on that?
**Dr. [Alex Reed Name]:** Of course. Many people express a staunch aversion to nursing homes, often associating them with a loss of independence and dignity. They might even say they’d rather choose euthanasia than end up in such a facility. However, a significant number of people with dementia ultimately do require nursing home care. Sadly, this frequently enough happens despite their earlier wishes, highlighting the unpredictable and challenging nature of the disease. Dementia can slowly erode a person’s cognitive abilities, making it difficult for them to fully grasp the severity of their condition, let alone make informed decisions about their future care.
**Interviewer:** Your article presented five possible scenarios for people with dementia who might potentially be considering euthanasia. Could you walk us through those?
**Dr. [Alex Reed Name]:** Certainly.
* **Scenario 1:** The individual experiences a decline, recognizes their worsening condition, and makes a conscious decision to request euthanasia while still mentally competent.
* **Scenario 2:** The individual’s condition deteriorates to a point where they require nursing home care, but they are still mentally competent enough to make decisions about their end-of-life wishes. Though, they may not want to die, even though their quality of life has significantly declined.
* **Scenario 3:** This is the most common scenario, where individuals spend their remaining days in a nursing home without necessarily feeling unhappy or desiring euthanasia.
* **Scenario 4:** Similar to scenario 2, this involves individuals in nursing homes who, despite their surroundings, experience significant unhappiness and retain their mental competency to request euthanasia.
* **Scenario 5:** This is the most complex scenario where individuals in nursing homes lose the mental capacity to make decisions about their care, including euthanasia.
**Interviewer:** You mentioned the importance of advance directives, but also emphasized that simply stating “I want euthanasia if I don’t recognize my loved ones” isn’t necessarily helpful. Why?
**Dr.[Alex Reed Name]:** Because such statements fail to address the nuances of dementia and individual experiences. Recognizing loved ones might not be the primary measure of suffering for someone with dementia. The focus should be on the individual’s overall well-being and quality of life, not just their level of cognitive decline.
**Interviewer:** What advice would you give to individuals concerned about dementia and wanting to make informed decisions about their future care?
**Dr. [Alex Reed Name]:** Honest conversations with family members and loved ones are essential.
1.**Open and Honest Conversations:** Discuss your wishes and concerns regarding dementia and end-of-life care with your family and create a shared understanding of your values.
2. **Seek Professional Advice:** Consult with physicians, ethicists, and legal professionals who specialize in end-of-life care.
3. **Review Your Advance Directive Regularly:** Update your advance directive as needed to reflect any changes in your circumstances or wishes.
**Interviewer:** Dr. [Alex Reed Name], this has been a truly insightful conversation. Thank you for sharing your expertise and shedding light on this complex and multifaceted issue.
**Dr. [Alex Reed Name]:** The pleasure was all mine.
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