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Comment by RandomThoughts3 | Hacker News Reader

To be honest, my grand parents both died in their nineties and their last two years were really sad. It was not so much the physical decline but the mental one. At the end, while technically alive, so little of who they were as persons remained, they might as well have been dead.

I fully understand someone in their 80s knowing the end is near choosing to leave on their own term.

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My bio father (he was not a part of my life, which is important to note when you get to the end of this comment) lived to 89, for certain values of "lived". He had long ago exhausted his ability to support himself financially, he was blind, deaf, unable to get around town on his own, had substantial age-related mental health issues, as well as a litany of small but significant health issues. I cannot speak for him, but I'd like to think that if I came anywhere close to that existence and I had the option available, I would opt for an end on my terms that respected my dignity and that of my family. As an American, however, I expect to die like he did: poor, mostly alone, and in pain.

My mom died on her own terms in the states at 57 and her doctor gave her the pills to do it at home. It wasn’t as nice as dying in the hospital, but her life quality had been pretty bad for the last decade and doctors will help even in my state where assisted suicide isn’t legal (Washington state rather than Oregon).

How long ago was this? Ever since war on opioids started, doctors have been extremely closely scrutinized by the DEA. Actually helping and even treating patients in some cases is a good way to risk losing your license and livelihood, and possibly your freedom. (and the War on Opioids didn't just apply to opioids, it caused a massive pendulum swing that affects all "controlled substances" not just pain pills, hence why it would be relevant here)

2009, so 15 years ago?

    > As an American, however, I expect to die like he did: poor, mostly alone, and in pain.

All you need is a "beer brewer's kit" - gas bottle, simple plastic bag, and hose from the tank. There is an Aussie guy who explains how it all works on YouTube.

>"I would opt for an end on my terms that respected my dignity and that of my family. As an American, however, I expect to die like he did: poor, mostly alone, and in pain."

I think there is more than enough info about how to end it painlessly should one decide to part. No 3rd parties needed assuming that person is still mentally and physically adequate enough.

That's just it: I wouldn't trust myself to be expert enough to do it properly. That, of all the things I might be asked to experience in life, begs for a knowledgeable, caring expert. You're right, of course, but that raises the endlessly fascinating question of why more people don't make that choice.

It is probably hidden a lot more than we think when old and sick people make that choice. When you're weak enough and want to end your life, it might not be a huge effort, and it might not be noticeable. And health care people probably hide it sometimes to not upset relatives.

When you have young and healthy people, it's not that easy to hide a suicide, because suspicions of murder will naturally arise.

I appreciate you sharing your perspective. I wondered, when you described feeling "really sad" and the sense that people "might as well have been dead," I'm wondering if you're speaking about your own emotional response or trying to convey how the individuals themselves felt about their situation?

Edited to sound less harsh

Well, they experienced extended physical suffering and having the mental acuity of a toddler. Feel free to try to convince me that not being able to recognise your own kids and the person you have been married with for seventy years while gradually fully losing your hearing and sight and not being able to leave a bed is somehow a worthy experience. I personally question if you can even talk of experiencing anything because that would imply there is something left which can meaningfully process experiences. And that’s the part which came after the initial decline when they were just insanely mean to their loved ones all the time.

You do sound harsh by the way.

My grandfather had Alzheimer's, and for years he lived a stressful life. He constantly kept wondering why he's not in his home (he was), as well as some random paranoia, like that I was a thief that had come to steal from him, or that he was elected mayor against his will, etc. It wasn't great for him.

Thank you for clarifying! I've edited my comment to - hopefully - sound less confrontational

My mom is 94 and in reasonably good health for that age. My dad just died after a decade of decline with dementia. My mom often tells me that she just doesn't want to wake up one morning. And she wants to go out while she is still on top. All her friends are gone, husband is gone, she lives but can't do any of her hobbies like gardening anymore. She is tired and there is nothing left in life besides waiting for death. I think it would be good if we had a better culture around dying and let people die in dignity if they don't want to live anymore.

My grandmother was absolutely unambiguous about it. Even when she was still mobile and living at home, she'd say things like "I hope it's my time soon" and "I want to follow your grandfather." Quite happily, too. She didn't seem depressed. Just sick and tired of her friends dying and her own inability to do anything for herself.

If you know an ancestor with Alzheimer's or other generic "you just kinda decline" diseases, they "die" long before their heart stops beating.

I haven't been able to talk to my grandfather, or hear his stories, or learn about him, or share anything with him, or even be a part of his life for at least 5 years now. He will probably be "alive" for another five years. He mostly just coasts through life. He doesn't really get to interact with friends, because the ones that aren't dying, he doesn't remember. When I see him, he asks me about graduating high school, which I did over a decade ago now.

I doubt he would choose to die, but when I get to experience the exact same thing in 40 years, I'm pretty sure I'd rather chew on a 12 gauge. Having a more reliable and less terrifying option is important.

You feel now that you don't want it live like that, but how can you know what you would want, then?

What does it have to do with anything? What I want for my future self now is obviously 1. having the choice and 2. reasonable care so that the choice isn't forced.

(I’m not op) The full quote is

> At the end, while technically alive, so little of who they were as persons remained, they might as well have been dead.

It sounds like there was some severe mental decline. When undergoing this kind of mental decline, does anybody remain happy? That’s meant as a genuine question, not rhetorical. Of course I’ve heard of the cases where people are constantly scared, feel unsafe, confused, etc. But I wonder if there are more peaceful examples that just make “boring” stories, and aren’t recounted.

My mom ran an adult foster care home. Half the population was elderly, half developmentally disabled. I liked helping out with the developmentally disabled folks. They were a handful, but they were basically enjoying life. But the elderly wing was mostly people warehoused and waiting to die. I remember happy moments, but I don't remember anybody who I'd call happy, and quite a lot of them were miserable.

There was one guy, an occasional escapee and reasonably physically healthy for his 80s, who had severe Alzheimer's. He just wanted to go home. All the time, that's what he wanted. I forget the details, but he didn't have a home anymore. Nobody came to visit him. We did our best for him, but what can you do with that?

We did our best for all of them. But I remember one evening over dinner where my mom and my brother and I were talking about getting our medical/legal paperwork in order. My mom said, "If I end up like that, just wheel me out to a field and leave me."

We couldn't, of course. But when her time came, we did move her to hospice as soon as there was no hope of recovery. She lived her life and bravely fought the end of it, but she didn't want to be kept around as a body, a shrine to her former self. A choice I deeply agree with.

My Oma went through Alzheimer's. Sbe went from being a functional adult, to forgetting how to speak English, to mistaking family members, to recognizing no one, to being unable to feed herself over the course of 10 years. But she seemed happy most of the time, usually smiling, would light up when she saw people, she would attempt to sing along to whatever music was playing. So I'd say she remained happy most of the time, which made it much easier to deal with from our end.

I’m sorry for your loss. Her story brings me a lot of comfort, thanks for sharing it.

My mother passed from Alzheimer's. There was a few-month period in the middle-end phase where she no longer had the capacity for long-term fear or existential dread, but was still able to eat food and listen to music. What remained of her was reasonably content until things progressed. Happy? No, not really. But it was a lull in the storm of pain that preceded and followed. A silver lining to the mushroom cloud.

> When undergoing this kind of mental decline, does anybody remain happy?

According to some people I know who work in care homes: yes, some people do. They're confused, have no idea what's going on, but are nevertheless mostly happy.

(but that is in no way to negate the fact that many don't)

Yeah any time I've been to a nursing home they have a lot of activities to keep them stimulated - usually some sort of musical performance every week day (usually by volunteer community groups, sometimes school kids), themed days ( Valentine's Day, farm day, pet day, Easter, Christmas, etc) - even the immobile and mentally-declined still enjoy the music and patting a dog.

FWIW this seems like a reasonable question.

If I start to develop some kind of age-related mental deterioration that is uncurable (eg dementia, alzheimers), I'll probably find a way to exit before I become incapable of making decisions like that independently, because I'm less scared of death than I am of losing myself like that

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