I know a guy who says he will kill himself if he gets dementia.

His dad had it. His mom had it. He says that he refuses to put his family through that. If he starts to have dementia symptoms, he’ll end it.

He knows what end-stage dementia looks like. He knows the pain of having parents who don’t recognize you. He knows how much nursing homes costs.

When he told me of this plan, I wasn’t sure what to say. He thinks that this choice would be generous; it would save his family the emotional and financial struggles of his slow decline. I have nothing brilliant to say when he tells me his plan.

How do you talk to someone who has a well thought-out plan to die by suicide? He’s not speaking on a whim. This isn’t a passing thought. It’s just his plan. He’s not presenting it with a lot of emotion either. He’s very matter-of-fact. It’s almost like he’s telling me about his plans to check out a new coffee shop when it opens.

I know people that have a tremendous quality of life after they start to develop symptoms of dementia. I have friends with dementia who are living fun- and laughter-filled lives. They travel. They go to fabulous restaurants. They go for walks, tell jokes, and watch movies. They do things that bring them joy. They….live. Not just survive. But really live.

I mention this to the guy. He says he knows, but if he waits too long, it’ll be too late. He’ll forget to kill himself. (Yeah, he actually said that.)

There’s an implication here that I am not comfortable with. He is saying a life with dementia isn’t worth living. Maybe, in my mind, I am insulted because I hear him saying that the lives of people with dementia have no worth. Maybe I am somehow taking this personally.

I ask if he’s told his family about his plan. He says he has, and they don’t support him. He thinks that they will understand when the time comes that it’s the right choice.

Is it harder to care for a loved one with dementia or to know they killed themselves so they would not be a burden to you?

He is assuming, of course, that he will be a burden to them. I want to ask if his parents were a burden to him, but I am scared to go there.

Burden is such an awful word, and I use it sparingly. Perhaps because being a burden on someone is one of my biggest fears in life.

If you’ve read the book or watched the movie Still Alice (highly recommended), you might remember that the main character has a plan to die by suicide. She sets up memory tests on her computer, and she tells herself when she can’t pass, it’s time. But she’s waiting too long….she’s unable to understand and execute her own instructions.

Most people with dementia don’t fear death as much as they fear loss of their identity and independence. I’ve read research articles that back this statement (which I can cite upon request) but it’s evident from the conversations I’ve had with friends who live with dementia.

I can’t judge the guy who has a suicide plan. I’m uncomfortable with it, and I don’t know that it will lessen the pain his family will endure if he does have dementia.

But I can’t judge.