I hear ya! And also believe there should be a pain-free, gentle way to leave this life.

Hi,
I'm sorry you are going through Alzheimer's. That must be hard on you. I understand your concerns. However in considering physician assisted suicide, you may be wasting your money. Only God decides who and when one dies. If it isn't your time, you won't die. That's just the way it is and always has been. I would suggest that you discuss all of this with God and ask for his guidance. Just talk to him like he's your best friend and he is! I will say a prayer for you.
I wish you the best.
PML

There's a lot to unpack in your note, which is deeply heartfelt, so I'm just going to mention a few things.

I have a deep family history of dementia and have been seeing signs of early memory loss myself (heard a terrific talk the other day by a physician who specializes in this problem and is on the cutting edge -- he pointed out that these days, he uses people's self-awareness and the insights of their families as his primary pre-screen for stage 0/1 of dementia, because it's the most reliable very early indicator of someone who has more than just normal age-related cognitive issues of skipped stitches). Until recently, I was exactly where you are in my beliefs.

Now, however, I'm aware that a loss of interest in eating and drinking is normal toward the end, and the primary problem is that medical professionals and caregivers keep trying to override that loss of interest because it feels so cruel, as you put it. In fact, if your body is naturally shutting down, it works if you just let it. This requires, of course, being emphatic with everyone involved about your desires.

Also, we're not likely to solve the assisted dying issue for people with dementia any time soon. The big moral/ethical question is this: Right now, I am comfortable saying that I would like this choice to kick in when a medical professional or two rules that I am in stage X of dementia. But let's say that when I hit stage X, I no longer want to die. Which "me" should rule in that case? The original "me", or the "me" at that time? That's a problem that honestly has me stumped, although I'm working on it.

Secondarily, we are, as a society, not unreasonably tangled up about the whole "suicide" issue, and this isn't going to get fully untangled any time soon. Setting aside the religious and faith-based aspects of the question (and you can't really set those aside, of course, because they contribute to the norms we are talking about), we're stuck on the mental health aspects, including the fact that a reasonable fraction (I haven't looked for the actual statistics) of people who try and fail to commit suicide don't try again. Also, society generally considers that if you have tried (and succeeded or failed), it's a sign of a treatable mental health condition, and it's a slippery slope to facilitate suicide rather than treating the mental health problem if that's what's going on. If you have an untreatable "mental health problem", or if you have tried to treat it and have been unsuccessful, should society acquiesce and facilitate your suicide? It's a huge open question that we're not going to wrestle to the ground any time soon. And dementia "feels" like a mental health problem at a gut level, which I suspect may be part of the problem with end-of-life solutions for it.

The bigger issue, of course, is that medicine is moving too fast for our norms to catch up. As a result, too many of us spend too many years with a poor QUALITY of life, because Western medicine is mostly about QUANTITY of life today. Which is easy to say in the abstract, and really hard and frustrating to deal with when it comes to being one of the people it is happening to.

I know this is not terribly helpful, but it's what I have to contribute. We live in the world we live in, and need to take it into account when exploring solutions.