Two of my six aunts died from Alzheimer disease (AD). They didn’t live nearby, so when I saw them every few months, the deterioration from the illness was evident. Both showed the same behavioral trends: some mild forgetfulness and repetitive questioning at first, then what seemed a prolonged period of incessant questions and bewilderment and anxiety over not understanding where they were or why they were there, who others were. Wandering outside at all hours, agitation and resistance to hygiene, eventually disappearing into a nonverbal, nonresponsive state.

It was painful to watch these formerly active, smart, and vibrant women decline in such a way. The most painful part was when they still understood that they were becoming confused and how frightened that made them.

Now there are alternatives available for those who don’t want to go down that road—but they are hard to come by, especially if you live in the United States.

People with dementia face particularly high hurdles.

A special feature in the March issue, “Medical Aid in Dying: What Every Nurse Needs to Know,” covers medical aid in dying and the nurse’s appropriate role in many end-of-life circumstances, including the ethically and logistically challenging situations of those with dementia who seek some agency over how they die […]