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Comment by foobarian | Hacker News Reader

Macabre tangent warning. Related to this, and having seen several cases where elderly people had very unhappy end years for various reasons (dementia, incapacity, etc.) I am starting to wonder not for our parents bur for myself - how could I make sure I don't live past the point where I stop adding value and become a drain. It's an interesting engineering problem. Presumably this would be when I lose mental capacity to make certain decisions, so it would need to be some kind of automated dead-man switch type mechanism, that is undetectable so the descendants can have a warm and fuzzy "grandpa went in his sleep" type experience, instead of "grandpa hung himself" or "grandpa pressed the accelerator instead of brake by accident."

Maybe an implant that needs to be re-armed every month or so, and if not it releases some toxin that causes a natural-seeming shutdown. Or ironclad ream of paperwork to make sure plugs get pulled.

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Build strength by middle age, eat nutritious foods, move daily for 30-60 minutes in a large capacity, keep the brain occupied, be social, intermittent fast to remove weight which builds up. They all need to be started earlier in life to create them as muscle memory habits, rather than "motivational habits" in old age.

As one ages, body parts hurt, which demotivates people from moving, which adds weight, etc. Couple that with the potential loneliness and isolation that can cause depression - old age takes more extrinsic and intrinsic motivation than being a youth.

Great advice. You won't have to worry about the things the person you responded to until your 90's rather than your 70's. It's still worth thinking about.

My dad is in his 70's and is dealing with Lewy Body Dementia. It's terrible. If I start showing the symptoms, I'm definitely going to take control of my own death. Quality of life is far more important to me than quantity of life.

Robin Williams got Lewy Body. I guess he decided to take the same door you're looking at. I would too.

He didn't know that, it was diagnosed as Parkinson's. He also had addiction problems, depression and anxiety as well as heart issues.

Generally good advice but intermittent fasting is not recommended for patients suffering from sarcopenia (skeletal muscle wasting). This is a hidden epidemic among the elderly and seriously increases the risk of falls or otherwise losing mobility.

After watching our father die from advanced dementia, my brother established instructions that no one is to feed him. If he can't bring a spoon to his mouth unassisted, he would like to stop eating. He works at a hospital, so I believe that he understands how to do this in a legally binding way.

This tempts me to leave similar instructions if I can't cook for myself.

Will he starve to death?

That's his hope. He doesn't want to live as our father did.

Everyone, regardless of current age or ability, should absolutely have advanced directives in place outlining what they want done (or not done) to prolong their life.

Talk to your doctor about filling out the appropriate paperwork.

Even if you want everything humanly possible done, it's best to document it, and keep that document up to date (check in with your doctor every few years to see if what you want has changed).

I'm 37, and in good health. I have outlined the (pretty limited) scope of advanced care I would want in the event I became incapacitated, and have a designated healthcare proxy that I trust to make decisions consistent with my wishes.

Such advance directives aren't completely legally binding, and rely on family and caregivers respecting his wishes. If your brother is mentally incapacitated and his next-of-kin asks a healthcare facility to put in a feeding tube then they'll probably do it.

This is exactly what I am afraid of.

Also, if he has dementia and is begging and crying to his family for food, they're not going to respect the prior wishes. They're just not.

My father's last intelligible words were "I want a pill." My mother understood this request, but we could not act on it.

A year later he stopped swallowing. My mother polled the family, and the consensus was to try intravenous fluids once, to see if this was temporary. With the fluids it took him a week to die. See how hard it is to even follow someone's last words?

My brother would like to avoid that year.

Assisted suicide is becoming more accepted as an option for the elderly. I suspect that some day it will be as normal our current options for extending life.

I for one would rather die on my own time, surrounded by family when my quality of life declines, rather than clinging on to a miserable existence.

I've had this discussion with friends many times, and I do hope it becomes legal and socially acceptable (I know it is legal in some places, but not widely). I find it ridiculous that we come into this world through no choice of our own, but we can't leave it when and how we want without resorting to some horrific or painful action. Medically assisted suicide should be a basic human right in my opinion.

One unfortunate aspect of this that while some jurisdictions have this available, they are sticky with informed consent on day of.

As a result people will sometimes opt for this months, even years before they really needed to, because of the fear of dementia or similar taking the choice away.

'stop adding value'? WTF.

This is a reasonable concern for oneself, if not a reasonable criticism of others.

Outside of HN that would probably be phrased as 'become a burden on my family'.

So my father-in-law passed away from dementia recently so I've been thinking about this a lot. Some family members could not be arsed (to borrow a phrase) to really care for him over the last several years, and from their viewpoint he was a burden. Some could, though, and to them he wasn't a burden, but a way to express their love. And looking back his long decline of course had a negative effect on a lot of people, but I don't know if it would have been any less negative had he put a bullet in his brain 5 years ago.

I'm sorry about your father in-law.

My dad is going through the same thing right now with Lewy Body Dementia and it's terrible. I've seen enough to know that if it shows up in me, I'm outta here. It might be hard on my family, but I'm not going to endure years of decline where most days I'm terrified from hallucinations which leads to violent outbursts directed at the people trying to help me.

Really, a huge part of my quality of life is knowing that I'm doing stuff that makes the world better in various ways-- offsetting some of the ways I make it worse and the resources I use. When I am not able to do this anymore--- what's the point?

George Eastman (founder of Kodak) left the following note explaining his decision to take his own life (at the age of 77, after several years of failing health and chronic pain).

"To my friends, my work is done – Why wait? GE."

Genuinely curious: Why is your reaction to that "WTF"? I think it's totally valid.

It sounds like something you say about employees, not about family members, and certainly not a way of calculating "self worth".

What you perceive as the value you contribute to the world is the most important way of calculating self worth, is it not? If you felt like you contributed no value any more and were simply a resource drain you certainly would have a low self worth.

Well, for one thing, "adds value" on HN is a pretty loaded term that comes down to "making money for someone else". You're basically saying that when you can't pull any harder, you'll line up behind Boxer at the glue factory so the pigs get one last cent out of your hide.

But lets assume a more charitable definition of 'adds value', then when does that end? I'd argue 'never', but I've also lost a parent and an in-law this year, so maybe that's still a little close for me.

Start wingsuit gliding an the problem will take care of itself

I have seriously thought about leaving a bucket list of expensive & risky stuff for when I'm old (why not take up motor racing, acrobatic flying, sailing around the world at 75?) but whenever I bring this up my gf is horrified.

The trouble with that stuff is you are much more likely to end up an invalid rather than kill yourself. You are then even more of a burden on people around you and less able to control the final outcome.

which is why I suggested things with big motors and high speeds; if things go wrong they go really wrong

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