Emotionally intense content alert. This is not a new theme for this blog, but recent events of people around me caused me to want to say once again that as Baby Boomers, we face two different, yet related issues. First, if your parent/parents or other aged relatives are still living, the time may come when they are simply not the person you knew. Dementia has a heartbreakingly wide range, not all of which is easily categorized. In some cases, dementia can be combined with terrible pain due to an injury or an illness. In either situation, I would strongly urge you to consult with Hospice. If the individual has left a home setting and is in an appropriate care facility, the facility  is usually linked in with Hospice. As I explained in Your Room at the End: Thoughts About Aging We’d Rather Avoid, there may be multiple hospice organizations in your area. If so, you have a choice as to which one to use. When someone reaches the stage of severe dementia, they may well not be able to make personal choices and the chance of improvement is highly unlikely. Although every individual situation has to be properly diagnosed, everyone over the age of about 60 can be defined as being in a terminal state. Severe dementia is not life-threatening, but most of us have become so accustomed to taking routine medications for conditions such as high blood pressure we don’t even think of that as “artificial means”. (We tend to view “artificial means” as only being hooked to a machine.) Making the decision to cease all medications except for sleep and pain can be heartbreaking and create questions and self-doubt.

This leads me to the second issue which is none of us want to believe this will happen to us. It seems too unfair, too unkind, and surely there will be a treatment/cure before then. There is nothing wrong with hoping for that. It is incredibly important, however, to make your wishes known in the event you do suffer severe dementia. The sentiment of, “I won’t care because I won’t know what’s going on”, can be said cavalierly if you’ve never heard the panicked voice or sobs of a parent/elderly relative who suddenly can’t comprehend where they are or why, “they can’t come home.” It is true that in some cases, severe dementia does not cause distress and an individual can comfortably live in a “time or place” they have mentally created, knowing you less as the person you are and more as someone from their past or simply, “a nice young man/woman”. I urge you to have the courage to address this possibility as clearly as you do the eventuality of an illness or injury that leaves you in a coma. If you can no longer make choices for yourself, be certain whoever is in charge (and legally designate someone) knows what you want done.