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Why Your Exit Plan Won’t Work against Alzheimer's

Salt Lake City Tribune

Nov. 22, 2019

When I tell people about my mom's Alzheimer's, most people are confident this will never happen to them. Why not?  Because they have an Exit Plan.  The plan is usually an intentional overdose, or something more fanciful like walking into the woods in subzero temperatures.  In Michael Wolff's 2012 essay A Life Worth Ending, the author describes his mother's prolonged suffering from dementia, then reaches a conclusion. "Meanwhile, since, like my mother, I can't count on someone putting a pillow over my head, I'll be trying to work out the timing and details of a do-it-yourself exit strategy. As should we all."

Believing an "exit strategy" will save us from Alzheimer's is not only misguided, but also prevents us from finding a real solution to a global epidemic. We can't dismiss the problem of Alzheimer's with a romantic vision of falling on our swords. Here's why.

1. Most People with Alzheimer's Had an Exit Plan

When I go to my mom's Memory Care facility, I see over sixty people who would have preferred death over their present state.  I know my mom did.  She and my dad told us they were stockpiling pills for just such a scenario.  But things happened.  Dad got cancer when he was still an active 80 year old, and there was hope treatment would be successful.  During the two years of surgeries, radiation, chemotherapy and recovery, it was easy to attribute mom's memory problems to stress.  After he died, mom's brain took a steep plunge and never recovered.

2. Then it's too late.

The conundrum of dementia is you are only capable of suicide in the earliest stage of the disease when symptoms are mild and manageable and quality of life is relatively good   To commit suicide at this point requires a brain hard-wired for it.   If you have not been suicidal in your life, you will not be suicidal at this point, either.  By the time the disease has destroyed your quality of life, it has also taken away the reasoning ability needed to organize a suicide. 

3. Your Advance Directive Will Mean Nothing

Even in states where physician-assisted suicide is legal, there are strict eligibility requirements:  you must be of sound mind, have six months or less to live, and be able to administer it yourself.  Dementia disqualifies you on all counts.  And don't think you can pass the job off to a loved one.  Your directive can be to stop feeding you.  But what if you say you are hungry? What if you reach for a fork, open your mouth?  Will your loved one be able to deny you food?  And if they do, they are breaking the law. Assisted suicide performed by anyone but a physician is illegal in the United States. They will be charged with manslaughter.  They could go to prison. You are placing a terrible burden on those you love.  

We Need to Have a Different Plan

You are right to think Alzheimer's is the worst possible way to end your life's story.  But none of us can rely on an Exit Plan. Unless we come up with a medical solution to Alzheimer's, our generation will join the millions of other Alzheimer's sufferers stuck in the nightmare they thought they could avoid. 

Why Your Exit Plan Won’t Work against Alzheimer's: Work
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