🎵 “Don’t Fear the Reaper” – EOA MAID, Dementia & the Conversation No One Wants to Have (Blue Öyster Cult)
This is one of the hardest topics I will probably ever write about.
Medical Aid in Dying. I have seen it on my reels lately because a young woman in Canada with EOA I followed made this choice. It was her choice, and her country allowed it.
MAID.
The “I don’t want to live like this” conversation.
The one nobody wants to say out loud.
But in the early stages — Stage 2, Stage 3, MCI — my husband said it over and over:
“Find a state that will Kevorkian me.”
And yes, we Googled.
Because when the person you love is terrified, and they know something is wrong with their brain, and they feel like they are losing themselves one day at a time… you listen.
You may not agree.
You may panic inside.
But you listen.
💬 Disclaimer
I’m not a doctor, lawyer, therapist, or MAID expert. This post discusses difficult end-of-life topics, alzheimer's dementia, depression, anxiety, and suicidal thoughts. It is not medical, legal, or mental health advice. If someone is in immediate danger or talking about harming themselves, call 911 or 988 in the United States. I am not encouraging anything, just explaining what we are going through.
🧠The Thing We Learned Quickly
In the United States, medical aid in dying is not the same as saying:
“I have Alzheimer’s and someday I don’t want this.”
That is not how the law works.
In states where MAID is legal, it usually requires:
Adult patient
Terminal illness
Expected prognosis of six months or less
Mental capacity to make the decision
Ability to make the request personally
Ability to self-administer medication
Multiple doctor confirmations and safeguards
And that is where Dementia and Alzheimer’s become heartbreaking.
Because by the time many people with Alzheimer’s are considered near end-of-life, they may no longer have the capacity required to request it.
And if they still have capacity early on?
They usually are not considered six months from death.
That is the brutal legal gap.
⚠️States Where Medical Aid in Dying Is Authorized
As of 2026, medical aid in dying is authorized in these 13 U.S. jurisdictions, though effective July dates and details matter:
California
Colorado
Delaware
Hawai'i
Illinois
Maine
Montana (authorized via state Supreme Court ruling)
New Jersey
New Mexico
New York
Oregon (no residency required)
Vermont (no residency required)
Washington state
Washington, D.C.
Most states require residency. Oregon and Vermont are exceptions that have removed residency requirements, but that still does not mean dementia automatically qualifies.
Again, this is why you must check current law and speak with professionals.
⚠️Canada and MAID
Canada has MAID, but dementia is complicated there too.
Federally, Canada does not generally allow advance requests for MAID after someone has lost capacity.
Quebec is different. Quebec allows advance requests in certain situations for people diagnosed with a serious and incurable illness, including Alzheimer’s disease and other dementias.
This is a major legal and ethical area, and the rules continue to evolve.
⚠️Sweden vs. Switzerland
This gets confused a lot.
Sweden does not allow active euthanasia or medical aid in dying the way people often think of it.
Switzerland is different.
Switzerland allows assisted suicide under certain conditions, but euthanasia is illegal.
People must generally have decision-making capacity and be able to self-administer.
Organizations in Switzerland have their own screening processes, medical documentation requirements, and capacity evaluations.
So again — dementia creates major barriers because capacity matters.
💡Why This Topic Comes Up So Early
This is what people outside Early Onset Alzheimer’s do not understand.
In early stages, some people KNOW something is wrong.
They may not understand all of it.
But they feel it.
They feel:
The confusion
The word loss
The fear
The anxiety
The loss of control
The humiliation
The future coming toward them
And sometimes that fear comes out as:
“I don’t want to live like this.”
That does not always mean they want to die that day.
Sometimes it means:
“I am terrified.”
💡What If Before Diagnosis, People Were Misdiagnosed?
This is something I think about often.
How many people before the internet and support groups were told they had:
Anxiety
Depression
Bipolar disorder
Stress
Midlife crisis
Anger problems
When really, something neurological was starting?
My husband’s first diagnosis was anxiety and stress.
And I can’t help but wonder how many people knew something was wrong, could not get answers, felt like they were losing their mind, and had nowhere to put that fear.
That thought breaks me.
💡What We Did Instead
When this conversation kept coming up, I redirected us toward help.
Not dismissing him.
Not saying, “Don’t say that.”
Not shaming him.
But trying to say:
“I hear you. I know you are scared. Let’s talk to the doctor. Let’s make sure we are treating the anxiety too.”
For us, Lexapro became part of the conversation.
We had to work with dosing, timing, and side effects.
Morning dosing worked better for us.
Generic caused stomach issues, and name brand worked better in our situation.
That may not be true for everyone.
Keep in mind I am not against a person chosing MAID, I beleive it is a fundamental right, I just know it is not possible to do it legally in the US for his condition, when he had the conversations with us, he was and is still very capable of making this decision, and if he was adament and persistant, I would take him to a Dr. to discuss those options.
But the point is this:
Sometimes the MAID conversation is really an anxiety conversation.
Sometimes it is depression.
Sometimes it is fear.
Sometimes it is the disease.
And sometimes it is all of it.
💡What To Do If Your Loved One Says This
Ensure you have a safe envirnoment at home- hide the car keys, move cars out of garage, remove weapons, remove poisions, lock up medication that could cause harm.
Do not ignore it.
Do not panic and shut it down.
Do not argue law.
Try:
“I hear that you are scared.”
“I’m not going to leave you alone with this.”
“We need to tell the doctor exactly what you are feeling.”
“Let’s talk about what you are afraid of.”
“Are you feeling like you might hurt yourself now?”
If the answer is yes, or you are not sure, get immediate help.
In the U.S., call or text 988.
💡What To Ask the Doctor
Bring it up directly.
Say:
“My spouse is talking about not wanting to live with this disease.”
“He is asking about medical aid in dying.”
“I am concerned about depression, anxiety, and suicide risk.”
“Could medication help?”
“Could counseling help?”
“Could this be related to dementia progression or medication side effects?”
“Do we need a psychiatrist, neurologist, or geriatric behavioral specialist involved?”
This is not the time to protect the doctor from uncomfortable words.
Say the hard thing.
🧠Things That May Help Redirect
Not cure.
Redirect.
Support.
Stabilize.
Antidepressants or anti-anxiety medication when appropriate
Therapy or counseling
Support groups
Routine
Exercise
Reducing fear triggers
Honest but simple conversations
End-of-life planning documents
Dementia values and priorities tools
Palliative care conversations
Compassionate care planning
Sometimes people calm down when they feel heard and when they know there is a plan.
🤔The Hard Truth
There is no easy answer here.
Dementia traps families in a horrible middle space:
Early enough to know.
Too early to qualify.
Late enough to suffer.
Too late to consent.
And that is why this topic is so painful.
💬Final Thought
If your loved one says they do not want to live like this, please hear the fear underneath the words.
They may be asking for control.
They may be asking for comfort.
They may be asking for reassurance.
They may be asking for help.
And as caregivers, all we can do is take the words seriously, bring in medical support, protect them from harm, and keep walking through the impossible one day at a time.
Some information is out there
💬 Disclaimer
I’m not a doctor, lawyer, therapist, or end-of-life specialist. This post is based on personal experience and general information. Medical Aid in Dying laws vary by location and change over time. Dementia, depression, anxiety, and suicidal thoughts require professional support. If you or someone you love may be in immediate danger, call 911 or 988 in the United States.
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