Dementia Centred

By Professor June Andrews

August 19th, 2014

Dementia – a suitable case for suicide?

The suicide of Robin Williams, apparently triggered by fear of what disease in older age would do, is big news. It inevitably has wider consequences on what people think and potentially do.

Personally I hate the idea of suicide.  It is so sad and desperate, and it goes against my religious upbringing, even though I’m not very religious now.  My horror is visceral.  So take what I say in that context.

Motivation for suicide

I hate the idea that people kill themselves because of an unwelcome prospect of the care we give for their condition. If care is ineffective and humiliating we need to improve the care because in some cases the problem is not the condition but the poor care provision.

I often hear people saying, “I’d rather die than go in a care home…”  But indignity is not inevitable.  Care providers just need to sharpen up.

In some circumstances people kill themselves to save pain for their families.  In those cases it depends on the family.  If I decided to release mine from that misery would I kill myself after a little ceremony?  It’s maybe a personality thing.  I think not.

Is Dementia different?

On reflection I think that everyone is different and the tragedy of Alzheimer’s is the same tragedy as any other condition that limits life and health – not particularly worse. 

I actually don’t fear dementia like some people do, because I’m prepared for it.  I want to make it to 90 and by then I have a 50% chance of having it as a female.  I can imagine having my thoughts limited to a loop of familiar music, a comfy little bedroom and waiting for meals.  (Some busy days I look forward to it…!) 

My family are well instructed so they will be able to avoid precipitating the worst sort of disturbing behaviour that I might show.  They can afford to keep me fed and safe after I stop being economically productive; unable to babysit or cook.

Sadness

Of course if I do get it, I won’t be doing cartwheels of joy.  It will be really sad; like many aspects of ageing are sad.  I know it’s not normal ageing but a disease.  However, it does not hurt as much as pancreatic cancer or cause nightmare breathing difficulties like emphysema. 

So if fate dishes me up this disease, I don’t think it would be the one most likely to make me suicidal.

Impact of Suicide

Who knows what a suicide because of Alzheimer’s does to put pressure on people who are struggling on with life with dementia?   Does it strengthen the argument for euthanasia?   

A public suicide by a known name might provide some people with clear evidence that people with dementia don’t value life.  It is a short step from “They don’t value life….” to “They can’t value life….” and then to “They don’t deserve to live”. 

A public suicide related to a particular disease is like laying a landmine…you can’t be sure who is going to step on it or what the result will be.  What might have been interpreted as an action of calm and rational “control” starts to look more like an act of uncontrolled rage. 

And rage is OK.  Like anyone else, the suicide is entitled to rage.  But it’s not a thoughtful comment on how other people should respond to Alzheimer’s.

More from Dementia Centred
13th Mar
By
Ike Kamphof
13th Mar
By
Henriette Laidlaw