End-of-Life Decision Making for Alzheimer’s Disease Across Cultures

This chapter discusses a range of policy and ethical issues dealing with end-of-life decision making for Alzheimer’s patients. It analyzes issues including: palliative care; advance directives; withholding or withdrawing artificial hydration and feeding, antibiotics, and other care; and physician-assisted suicide. Caring for someone with AD at the end of life raises unique challenges because, in contrast to cancer and other advanced chronic diseases, a person with AD at some stage will lose cognitive abilities, function, and capacity. Therefore, they will be unable to make decisions about their care and treatment or express their needs and wishes for a protracted period as death approaches. This chapter also reviews the wide variation of end-of-life policies across cultures and within the United States.