The Journal of Post-Acute and Long-Term Care Medicine recently published information regarding SED by AD. The article is interesting and highlights what many of us already know from experience, a growing number of people in the United States suffer with “dementia worry”.  A U.S. survey found that the percentage of respondents concerned about developing dementia increased from 20% in 2006 to 31% in 2010.

Some people commit suicide soon after getting a dementia diagnosis and even more tragic are murders and suicides by a spouse caring for a person with dementia. Suicides also occur in long-term care facilities. In fact, a recent Kaiser Health News investigation found that several hundred older Americans are killing themselves in nursing homes and assisted living communities every year.

To overcome the problem with traditional advance directives, Pope, Terman and others proposed that advance directives could also direct caregivers to discontinue help with eating and drinking at a certain stage of dementia when the person can no longer eat and drink independently (SED by AD). However the Ethics Committee of AMDA, the Society for Post-Acute and Long-Term Care Medicine prepared a White Paper, now Society policy since March 2019, recommending universal rejection of AD for SED in nursing facilities and assisted living facilities.

Maybe it is time that you review your current policy and educate yourself and your staff on SED by AD and advance care planning and review the white paper referenced above.