Voluntary Stopping Eating and Drinking – Health Care Directive Options


Hi there! Bridget Mackay at the offices of Bridget Mackay in Petaluma, California practicing the area of estate planning and elder law. And I want to talk to you today about not so the right to die covered, I’ve that and other blogs and I suggest you look at it because California passed that law in 2016. But more so the fact that that law does not really cover folks who have a degenerating memory disease like Alzheimer’s or dementia. Alzheimer’s which is the most common form of dementia. Particularly in late stage, it’s not going to help folks who have those diseases, this right to die act.

However there has been a new sort of rising, taking control of quality of life and how we die amongst that crowd in the use of their health care directives. And the, specifically, the ability to be, you know, have food and hydration. So, oftentimes people in late stage dementia have trouble eating. Either they can’t do it themselves and they needed to be hand fed or they don’t remember to eat or know that they need to eat. And other times they’re swallow reflex starts to deteriorate. So, there is some aspiration and pneumonia and all of those issues.

So, some folks and their health care directives are even making specialized directives or approaching things called “voluntary stopping of eating and drinking” (VSED) and they want to address it specifically in their health care directives. Why is this a way to control quality of life when you’re in late stages of dementia? Well, because you can say in your directive to what degree you want to have food and hydration. Clearly you can you can regulate it. So, for some folks have said if it appears that I’m wanting to eat and receptive to it and when I do eat I’m enjoying it, continued if hand assist feed me when I get to that stage. Others are saying I don’t want any food or hydration even if I would open my mouth as the fork came towards me when I’m in those late stages. If I can’t do it myself, that’s the more extreme end of it.

Some of the directives also include the idea of artificial hydration and food. And so far, you know, the less controversial pieces that most medical professions are not recommending tube feeding for people in late stage dimensive dementia or Alzheimer’s. So that sort of off the table. The more controversial piece is not having anything at all. That if I, even if I may open my mouth to receive food. If I’m not asking for it or not wanting it, then don’t give it to me being the more controversial.

You may want to look into that with your estate planning attorney. See if you want to do this planning now because it’s critical that you do it now. You can’t do it later, obviously. Make some of those choices. Be advised however that if you choose the more extreme stage whereas no artificial or no hand feeding or hydration that you may run up against some medical professionals who will not allow it. May be more difficult to enforce on your agents end.

So, those are some thoughts around your health care directive and those diseases of aging, especially late stage Alzheimer’s and dementia.

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