Stopping Eating and Drinking by Advance Directives: Choose Your Injustice

Jim, I have a hypothetical case for you. One of my residents with dementia, let’s call him Bill, has an advance directive stating that when he no longer has meaningful social interaction, his caregivers should stop giving him food or water. He is now mostly mute, though rarely he may say a word or two. He still eats reasonably well and seems to enjoy mealtimes, occasionally saying “That’s good” when eating ice cream. His agent with POAHC [power of attorney for health care] is his wife, Alice, who also has advanced dementia and can no longer function as his decision-maker but is more verbal than Bill.