Dementia Death Quotes

I never understood people who said their greatest fear was public speaking, or spiders, or any of the other minor terrors. How could you fear anything more than death? Everything else offered moments of escape: a paralyzed man could still read Dickens; a man in the grips of dementia might have flashes of the must absurd beauty.

the shorter your sleep, the shorter your life. The leading causes of disease and death in developed nations—diseases that are crippling health-care systems, such as heart disease, obesity, dementia, diabetes, and cancer—all have recognized causal links to a lack of sleep.

This birth thing. And this death thing. Each one had it's turn. We entered alone and we left alone. And most of us lived lonely and frightened and incomplete lives. An incomparable sadness descended up on me. Seeing all that life that must die. Seeing all that life that would first turn to hate, to dementia, to neuroses, to stupidity, to fear, to murder, to nothing - nothing in life and nothing in death.

Age isn't stealing from my grandmother; it's slowly unwinding her.

There are all sorts of losses people suffer - from the small to the large. You can lose your keys, your glasses, your virginity. You can lose your head, you can lose your heart, you can lose your mind. You can relinquish your home to move into assisted living, or have a child move overseas, or see a spouse vanish into dementia. Loss is more than just death, and grief is the gray shape-shifter of emotion.

It seemed to him [Otto Kugelblitz] obvious that the human life span runs through the varieties of mental disorder as understood in his day—the solipsism of infancy, the sexual hysterias of adolescence and entry-level adulthood, the paranoia of middle age, the dementia of late life ... all working up to death, which at last turns out to be "sanity.

There are all sorts of losses people suffer—from the small to the large. You can lose your keys, your glasses, your virginity. You can lose your head, you can lose your heart, you can lose your mind. You can relinquish your home to move into assisted living, or have a child move overseas, or see a spouse vanish into dementia. Loss is more than just death, and grief is the gray shape-shifter of emotion.

There are all sorts of losses people suffer- from the small to the large. You can lose your car keys, your glasses, your virginity. You can lose your head, you can lose your heart, you can lose your mind. You can relinquish your home to move into assisted living, or have a child move overseas, or see a spouse vanish into dementia. Loss is more than just death, and grief is the gray shape-shifter of emotion.

It doesn’t upset me to think about dying. What upsets me is the idea of John being alone after his spell passes. The idea of one of us without the other. (p.127)

We must make haste then, not only because we are daily nearer death, but also because the conception of things and the understanding of them cease first.

Once the disease completely removes the person you once knew, all that is left is a hull of someone you once knew. That’s the first death. You know the second death will come. You just don’t know when. JR Whitsell - That Moment In Time--Two: What If We Helped?

My #love stories have happy endings, because I stop the tales before dejection, dementia, and death occur.

I am not entitled to life without death. I embrace sacred life. I embrace sacred death. I embrace the growing and crumbling in between.

My #love stories have happy endings, because I stop the tales before dejection, dementia, and death occur.


We are everywhere and nowhere.

To mourn someone who is still alive brings a particular, complicated pain. And often it brings guilt; to mourn someone who has not yet died is to consign them to a kind of death.

The symptoms syphilis engendered worsened over time. In addition to the unsightly skin ulcers that pockmarked the body in the later stages of the disease, many victims endured paralysis, blindness, dementia, and “saddle nose,” a grotesque deformity that occurs when the bridge of the nose caves into the face. (Syphilis was so common that “no nose clubs” sprang up all over London. One newspaper reported that “an eccentric gentleman, having taken a fancy to see a large party of noseless persons, invited every one thus afflicted, whom he met in the streets, to dine on a certain day at a tavern, where he formed them into a brotherhood.” The man, who assumed the alias of Mr. Crampton for these clandestine parties, entertained his noseless friends every month for a year until his death, at which time the group “unhappily dissolved.”)

We know that media vita in morte sumus or, “in the midst of life we are in death.” We begin dying the day we are born, after all. But because of advances in medical science, the majority of Americans will spend the later years of their life actively dying. The fastest-growing segment of the US population is over eighty-five, what I would call the aggressively elderly. If you reach eighty-five, not only is there a strong chance you are living with some form of dementia or terminal disease, but statistics show that you have a 50-50 chance of ending up in a nursing home, raising the question of whether a good life is measured in quality or quantity. This slow decline differs sharply from times past, when people tended to die quickly, often in a single day. Postmortem daguerreotypes from the 1800s picture fresh, young, almost lifelike corpses, many of them victims of scarlet fever or diphtheria. In 1899, a mere 4 percent of the US population was over sixty-five—forget making it to eighty-five. Now, many will know that death is coming during months or years of deterioration. Medicine has given us the “opportunity”—loosely defined—to sit at our own wakes.

…wondering, not for the first time, if there was a kind of dark bliss built into dementia: an immunity from death and abandonment, a way of fixing a point in time so that nothing can change, nothing can be rewritten, no one can leave.

And in time we may remember, collecting every little memory, all the bits and pieces, into a larger memory, rebuilding a great layered and labyrinthine, now imagined, international hotel of many rooms, the urban experiment of a homeless community built to house the needs of temporary lives. And for what? To resist death and dementia. To haunt a disappearing landscape. To forever embed this geography with our visions and voices. To kiss the past and you good-bye, leaving the indelible spit of our DNA on still moist lips. Sweet. Sour. Salty. Bitter.

What made Olive the saddest about the Gardners was that everyone wanted to be enshrined in someone’s memory. It was the only way of living on after death, really: in the minds of loved ones. Memories were the only things that made aging bearable, a way of reverting to better, simpler days.

Did I not give you this mini birth and death of sun everyday on the large screen of sky? And did I not make both the birth and death of the sun beautiful? Did I not give you the beautiful birthing and beautiful dying of the sun so that every day you could practice embracing the beauty of life and the beauty of death?

When a fine old carpet is eaten by mice, the colors and patterns of what's left behind do not change,' wrote my neighbor and friend, the poet Jane Hirschfield, after she visited an old friend suffering from Alzheimer's disease in a nursing home. And so it was with my father. His mind did not melt evenly into undistinguishable lumps, like a dissolving sand castle. It was ravaged selectively, like Tintern Abbey, the Cistercian monastery in northern Wales suppressed in 1531 by King Henry VIII in his split with the Church of Rome. Tintern was turned over to a nobleman, its stained-glass windows smashed, its roof tiles taken up and relaid in village houses. Holy artifacts were sold to passing tourists. Religious statues turned up in nearby gardens. At least one interior wall was dismantled to build a pigsty. I've seen photographs of the remains that inspired Wordsworth: a Gothic skeleton, soaring and roofless, in a green hilly landscape. Grass grows in the transept. The vanished roof lets in light. The delicate stone tracery of its slim, arched quatrefoil windows opens onto green pastures where black-and-white cows graze. Its shape is beautiful, formal, and mysterious. After he developed dementia, my father was no longer useful to anybody. But in the shelter of his broken walls, my mother learned to balance her checkbook, and my heart melted and opened. Never would I wish upon my father the misery of his final years. But he was sacred in his ruin, and I took from it the shards that still sustain me.

Fiona couldn't summon a smile. His grandfather sighed. 'If you insist on pity, then really you must pity yourself. Your head is still very empty.' Fionn frowned, indignation jostling the urge to cry fro a precious, fleeting second. His grandfather chuckled. 'Start filling it up, lad. That is your greatest responsibility. To live a life of breathless wonder, so that when it begins to fade from you, you will feel the shadow of its happiness still inside you and the blissful sense that you laughed the loudest, loved the deepest, and lived fearlessly, even as the specifics of it all melt away.

When Franklin D. Roosevelt signed the Social Security Act in 1935, old age was defined as sixty-five years, yet estimated life expectancy in the United States at the time was sixty-one years for males and sixty-four years for females.62 A senior citizen today, however, can expect to live eighteen to twenty years longer. The downside is that he or she also should expect to die more slowly. The two most common causes of death in 1935 America were respiratory diseases (pneumonia and influenza) and infectious diarrhea, both of which kill rapidly. In contrast, the two most common causes of death in 2007 America were heart disease and cancer (each accounted for about 25 percent of total deaths). Some heart attack victims die within minutes or hours, but most elderly people with heart disease survive for years while coping with complications such as high blood pressure, congestive heart failure, general weakness, and peripheral vascular disease. Many cancer patients also remain alive for several years following their diagnosis because of chemo-therapy, radiation, surgery, and other treatments. In addition, many of the other leading causes of death today are chronic illnesses such as asthma, Alzheimer’s, type 2 diabetes, and kidney disease, and there has been an upsurge in the occurrence of nonfatal but chronic illnesses such as osteoarthritis, gout, dementia, and hearing loss.63 Altogether, the growing prevalence of chronic illness among middle-aged and elderly individuals is contributing to a health-care crisis because the children born during the post–World War II baby boom are now entering old age, and an unprecedented percentage of them are suffering from lingering, disabling, and costly diseases. The term epidemiologists coined for this phenomenon is the “extension of morbidity.

How often are people told they’ve brought a condition like depression upon themselves? It’s all part of mercury’s blame-the-victim game. Those depressive symptoms are the mercury speaking for the patient without her or his consent. Sometimes mercury moves past the hostage phase and takes someone out, resulting in death by Alzheimer’s, Parkinson’s, dementia, or stroke. It’s that serious. Mercury has injured or killed well over a billion people. No one likes Alzheimer’s; it’s a frightening, terrible disease. Yet it’s rapidly becoming common—and it’s 100 percent mercury-caused. You heard that here first: Mercury is 100 percent responsible for Alzheimer’s disease. You will never in your lifetime hear the truth about that anywhere else.

The percentage of people reporting contact with the dead in surveys ranges anywhere from 42 to 72 percent. Widows having contact with their deceased husbands can go as high as 92 percent.1 If the surveys had included children and deathbed encounters, which are extremely common, the percentages would have been even heftier. A whopping 75 percent of parents who lost a child had an encounter within a year of the child’s death.2 But a sad 75 percent of all those who had encounters reported not mentioning them to anyone for fear of ridicule.3 It’s hard to believe that a society can deny the validity of an experience shared by so large a proportion of its population. But we do. Many organized and not-so-organized religions go so far as to condemn communication with the dead, a position that at least admits contact is possible. Until recently, near-death experiencers have suffered great distress from disbelief and derision, silenced by those they were expected to trust most, their families and physicians. The same holds for people on the verge of death, since the phenomena they typically experience, such as visits from the dead and visions of the other side, are treated as symptoms of dementia. All these people are between a rock and a hard place.

Archaic societies have lasted so long because they know nothing of the desire to innovate, to grovel before ever-new simulacra. If you change images with each generation, you cannot anticipate historical longevity. Classical Greece and modern Europe typify civilisations stricken by a precocious death, following a greed for metamorphosis and an excessive consumption of gods, and of the surrogates for gods. Ancient China and Egypt wallowed for millennia in a magnificent sclerosis. As did African societies, before contact with the West. They too are threatened, because they have adopted another rhythm. Having lost the monopoly on stagnation, they grow increasingly frantic and will inevitably topple like their models, like those feverish civilisations incapable of lasting more than a dozen centuries. In the future, the peoples who accede to hegemony will enjoy it even less: history in slow motion has inexorably been replaced by history out of breath. Who can help regretting the pharaohs and their Chinese colleagues? Institutions, societies, civilisations differ in duration and significance, yet all are subject to one and the same law, which decrees that the invincible impulse, the factor of their rise, must sag and settle after a certain time, this decadence corresponding to a slackening of that energiser which is . . . delirium. Compared with periods of expansion, of dementia really, those of decline seem sane and are so, are too much so—which makes them almost as deadly as the others. A nation that has fulfilled itself, that has expended its talents and exploited the last resources of its genius, expiates such success by producing nothing thereafter. It has done its duty, it aspires to vegetate, but to its cost it will not have the latitude to do so. When the Romans—or what remained of them—sought repose, the Barbarians got under way, en masse. We read in a history of the invasions that the German tribes serving in the Empire’s army and administration assumed Latin names until the middle of the fifth century. After which, Germanic names became a requirement. Exhausted, in retreat on every front, the masters were no longer feared, no longer respected. What was the use of bearing their names? “A fatal somnolence reigned everywhere,” observed Salvian, bittersweet censor of the ancient deliquescence in its final stages.

What is it that makes a person the very person that she is, herself alone and not another, an integrity of identity that persists over time, undergoing changes and yet still continuing to be—until she does not continue any longer, at least not unproblematically? I stare at the picture of a small child at a summer’s picnic, clutching her big sister’s hand with one tiny hand while in the other she has a precarious hold on a big slice of watermelon that she appears to be struggling to have intersect with the small o of her mouth. That child is me. But why is she me? I have no memory at all of that summer’s day, no privileged knowledge of whether that child succeeded in getting the watermelon into her mouth. It’s true that a smooth series of contiguous physical events can be traced from her body to mine, so that we would want to say that her body is mine; and perhaps bodily identity is all that our personal identity consists in. But bodily persistence over time, too, presents philosophical dilemmas. The series of contiguous physical events has rendered the child’s body so different from the one I glance down on at this moment; the very atoms that composed her body no longer compose mine. And if our bodies are dissimilar, our points of view are even more so. Mine would be as inaccessible to her—just let her try to figure out [Spinoza’s] Ethics—as hers is now to me. Her thought processes, prelinguistic, would largely elude me. Yet she is me, that tiny determined thing in the frilly white pinafore. She has continued to exist, survived her childhood illnesses, the near-drowning in a rip current on Rockaway Beach at the age of twelve, other dramas. There are presumably adventures that she—that is that I—can’t undergo and still continue to be herself. Would I then be someone else or would I just no longer be? Were I to lose all sense of myself—were schizophrenia or demonic possession, a coma or progressive dementia to remove me from myself—would it be I who would be undergoing those trials, or would I have quit the premises? Would there then be someone else, or would there be no one? Is death one of those adventures from which I can’t emerge as myself? The sister whose hand I am clutching in the picture is dead. I wonder every day whether she still exists. A person whom one has loved seems altogether too significant a thing to simply vanish altogether from the world. A person whom one loves is a world, just as one knows oneself to be a world. How can worlds like these simply cease altogether? But if my sister does exist, then what is she, and what makes that thing that she now is identical with the beautiful girl laughing at her little sister on that forgotten day? In this passage from Betraying Spinoza, the philosopher and novelist Rebecca Newberger Goldstein (to whom I am married) explains the philosophical puzzle of personal identity, one of the problems that engaged the Dutch-Jewish thinker who is the subject of her book.5 Like her fellow humanist Dawkins, Goldstein analyzes the vertiginous enigma of existence and death, but their styles could not be more different—a reminder of the diverse ways that the resources of language can be deployed to illuminate a topic.

As the body and mind deteriorate, the dying are not less themselves. Dementia steals the faculties for expressing the self—language, memory, personality—but the self remains, albeit largely inaccessible to others. The experience of actually being with the demented and dying is one of watching someone move farther and farther away, out of earshot and eventually out of sight. It’s wrong to think, “Because I cannot access something, it does not exist.” Being with someone who is near death undermines such nonsense. If people are as much themselves when there is no chance of further accomplishment, activity, or self-expression, then the fact that the unborn may grow up to great accomplishment, activity, or self-expression is irrelevant. That a precious child with Down syndrome may some day compete in the Special Olympics is irrelevant. Another precious child with a different genetic abnormality will spend all his days in a state that most of us will inhabit only at the end of our lives, if ever: incapable of communication, incontinent, compromised in language, memory, intellect, and personality. The compassion we show to the dying is not earned by the things they “used to be” any more than it should be earned by the things that the unborn might become. We will all end up in a state of total incapacity and inaccessibility, some for a long time and some only briefly.

There has been very good news lately that coconut oil can help Alzheimer's patients and patients with Parkinson's Disease, and patients that suffer from dementia. Alzheimer's patients brains cannot metabolize sugar the way it used to. Insulin helps the brain take up sugars from the blood, however insulin isn't very helpful. Generally, brain cells simply starve to death over time. Insulin stimulates brain cells to take sugar and metabolize it for energy. Insulin is also important

Some of these kids are just plain trouble.” Grant glanced over at the boys sitting in the glass-walled box. Mac had been like that, all anger and confusion. He’d been in juvie too, arrested for possession after falling into a gang. Grant was gone. Mom was sick. Dad was a mess. Looking back, Grant wondered if dementia was beginning to take hold back then and no one recognized the symptoms. Lee had been the one who’d coped with Mac’s drug and delinquency problems, and Mom’s deathbed talk had snapped her youngest out of it. A program like this might have helped his brother. “Who knows what those boys have had to deal with in their lives.” Corey’s eyes turned somber. “We’re all sorry about Kate.” Reminded of Kate’s death, Grant’s chest deflated. “And thanks for the help,” Corey said. “These boys can be a handful.” “Is your son on the team?” “No.” Corey nodded toward the rink. A pretty blond teenager executed a spinning jump on the ice. Corey beamed. “That’s my daughter, Regan. She’s on the junior figure skating team with Josh’s daughter, the one in black. The hockey team has the next slot of ice time.” “The girls look very talented.” Even with an ex-skater for a sister-in-law, Grant knew next to nothing about figure skating. He should have paid attention. He should have known Kate better. Josh stood taller. “They are. The team went to the sectional championships last fall. Next year, they’ll make nationals, right, Victor?” Josh gestured toward the coach in the black parka, who had deposited the offenders in the penalty box and was walking back to them. “Victor coaches our daughters.” Joining them, Victor offered a hand. He was a head shorter than Grant, maybe fifty years old or so, with a fit body and salt-and-pepper hair cut as short and sharp as his black eyes. “Victor Church.

Medicine and society have entered into a folie a deaux regarding medicine's importance in gigantic population ills. We believe that genetics and pills and enzymes bring us health. We wait for the dementia cure (the obesity cure, the diabetes cure) rather than changing our society to decrease incidence and severity. We slash social welfare programs and access to GPs and ignore the downstream effect this will have on future generations. To reduce non-communicable disease, the actions we need to take are societal: make it easier for people to move and eat well, strengthen education, promote community participation and meaningful work. Our collective delusion is that we can have all the benefits such a society would bring without the structural supports necessary to bring it into being, that we can attain health by inventing and buying drugs. It is hard to know which is the more utopian vision: magic pills or a society serious about prevention.

Last Comforts” was born when one nagging question kept arising early in my journey as a hospice volunteer. Why were people coming into hospice care so late in the course of their illness? That question led to many others that rippled out beyond hospice care. Are there better alternatives to conventional skilled nursing home operations? How are physicians and nurses educated about advanced illness and end-of-life care? What are more effective ways of providing dementia care? What are the unique challenges of minority and LGBT people? What is the role of popular media in our death-denying culture? What has been the impact of public policy decisions about palliative and hospice care? The book is part memoir of lessons learned throughout my experiences with patients and families as a hospice volunteer; part spotlight on the remarkable pathfinders and innovative programs in palliative and late-life care; and part call to action. I encourage readers – particularly my fellow baby boomers -- not only to make their wishes and goals clear to friends and family, but also to become advocates for better care in the broader community.

The breakthrough study was done by Dr. Peter Elwood and a team from the Cochrane Institute of Primary Care and Public Health, Cardiff University, United Kingdom, and released in December 2013. For thirty years, these researchers followed 2,235 men living in Caerphilly, Wales, aged 45 to 59, and observed the impact of five activities on their health and on whether they developed dementia or cognitive decline, heart disease, cancer, or early death. The Cardiff study was meticulous, examining the men at intervals over the thirty years, and if they showed signs of cognitive decline or dementia, they were sent for detailed clinical assessments of high quality. It overcame study design problems from eleven previous studies (discussed in the endnotes). Results showed that if the men did four or five of the following behaviors, their risk for cognitive (mental) decline and dementia (including Alzheimer’s) fell by 60 percent:

Contents Beginnings 1. Facing Up 2. Getting Older 3. The Brain, the Mind and the Self 4. Memory and Forgetting 5. The Diagnosis 6. Shame 7. The Carers 8. Connecting through the Arts 9. Home 10. The Later Stages 11. Hospitals 12. At the End 13. Saying Goodbye 14. Death

Syphilis is caused by a spiral bacterium (aka a spirochete) known as Treponema pallidum. The bacterium is usually acquired during sexual contact, whereupon it corkscrews its way across mucous membranes, multiplies in the blood and lymph nodes, and, if a patient is especially unlucky, gets into the central nervous system, including the brain, causing personality change, psychosis, depression, dementia, and death. That’s in the absence of antibiotic treatment, anyway; modern antibiotics cure syphilis easily. But there were no modern antibiotics in 1917, and the early chemical treatment known as Salvarsan (containing arsenic) didn’t work well against late-stage syphilis in the nervous system. Wagner-Juaregg solved that problem after noting that Treponema pallidum didn’t survive in a test tube at temperatures much above 98.6 degrees Fahrenheit. Raise the blood temperature of the infected person a few degrees, he realized, and you might cook the bacterium to death. So he began inoculating patients with Plasmodium vivax. He would allow them to cycle through three or four spikes of fever, delivering potent if not terminal setbacks to the Treponema, and then dose them with quinine, bringing the plasmodium under control. “The effect was remarkable; the downward progression of late-stage syphilis was stopped,” by one account, from the late Robert S. Desowitz, who was a prominent parasitologist himself as well as a lively writer. “Institutions for malaria therapy rapidly proliferated throughout Europe and the technique was taken up in several centers in the United States. In this way, tens of thousands of syphilitics were saved from a sure and agonizing death”—saved by malaria.

One of the symptoms of senile dementia is suspicion and the other is paranoia.

Broadly speaking, the more often a cause shows up on a death certificate, the more attention society gives to fighting it. This is why heart disease, type 2 diabetes, and dementia are major focuses of research and interventionary medical care, while aging is not, even though aging is the greatest cause of all those diseases.

Widening the lens of focus, there are more than twenty large-scale epidemiological studies that have tracked millions of people over many decades, all of which report the same clear relationship: the shorter your sleep, the shorter your life. The leading causes of disease and death in developed nations—diseases that are crippling health-care systems, such as heart disease, obesity, dementia, diabetes, and cancer—all have recognized causal links to a lack of sleep.

Faced with the Führer, Hácha caved in. He declared that the situation was very clear and that all resistance was madness. But it’s already two a.m., and he has only four hours to prevent the Czech people from defending themselves. According to Hitler, the German military machine is already on the march (true) and nothing can stop it (at least, no one seems very keen to try). Hácha must sign the surrender immediately and inform Prague. The choice Hitler is offering could not be simpler: either peace now, followed by a long collaboration between the two nations, or the total annihilation of Czechoslovakia. President Hácha, terrified, is left in a room with Göring and Ribbentrop. He sits at a table, the document before him. All he has to do now is sign it. The pen is in his hand, but his hand is trembling. The pen keeps stopping before it can touch the paper. In the absence of the Führer, who rarely stays to oversee such formalities, Hácha gets jumpy. “I can’t sign this,” he says. “If I sign the surrender, my people will curse me forever.” This is perfectly true. So Göring and Ribbentrop have to convince Hácha that it’s too late to turn back. This leads to a farcical scene where, according to witnesses, the two Nazi ministers literally chase Hácha around the table, repeatedly putting the pen back in his hand and ordering him to sign the bloody thing. At the same time, Göring yells continuously: if Hácha continues to refuse, half of Prague will be destroyed within two hours by the German air force … and that’s just for starters! Hundreds of bombers are waiting for the order to take off, and they will receive that order at 6:00 a.m. if the surrender is not signed. At this crucial moment, Hácha goes dizzy and faints. Now it’s the two Nazis who are terrified, standing there over his inert body. He absolutely must be revived: if he dies, Hitler will be accused of murdering him in his own office. Thankfully, there is an expert injecter in the house: Dr. Morell, who will later inject Hitler with amphetamines several times a day until his death—a medical regime that probably had some link with the Führer’s growing dementia. So Morell suddenly appears and sticks a syringe into Hácha, who wakes up. A telephone is shoved into his hand. Given the urgency of the situation, the paperwork can wait. Ribbentrop has taken care to install a special direct line to Prague. Gathering what is left of his strength, Hácha informs the Czech cabinet in Prague of what is happening in Berlin, and advises them to surrender. He is given another injection and taken back to see the Führer, who presents him once again with that wretched document. It is nearly four a.m. Hácha signs. “I have sacrificed the state in order to save the nation,” he believes. The imbecile. It’s as if Chamberlain’s stupidity was contagious …

The losses caused by dementia aren’t as clear as a loss by death. When someone dies, we know when it happened. We know how it happened. We take part in certain rituals to mark the event. Our sorrow is understood by others who offer condolences and support. Those things don’t happen with the slow but inevitable losses of dementia. What we experience is called ambiguous loss. Ambiguous loss and the subsequent grief can come from two scenarios. Either someone is physically absent but emotionally present or they’re physically present but emotionally absent. They’re here, but they aren’t here.

I had been on the doctor yo-yo for many years regarding fatigue and strange illnesses, but this was sickness on steroids! It was far worse than anything I had seen before. I knew what Dementia was and I knew the end result was not pretty. I had seen my elderly grandfather die from it, but he developed it at a far older age. From being diagnosed to death only took a few years. I started to contemplate that I may not make it to fifty years of age.

The health of your body has a direct impact on the health of your brain. In fact, there are only three degrees of separation between sitting too much and dementia. You sit for long periods of time. Your body goes into hibernation mode, depressing your metabolism and increasing your blood pressure, blood sugar, and weight.7 Your high blood pressure damages your heart and its vessels. The small vessels that feed your brain get blocked, putting you at risk of small vessel disease. Without adequate blood supply, the brain’s white matter starves to death.8 White matter acts like a telephone wire that connects brain regions so they can talk to each other. When your white matter is damaged, the communication between those brain regions breaks down just like it did in that telephone game we played as kids; in the end, the message is all mixed up and everyone is confused. It was funny back then, but it’s not funny now. The white matter damage shows up like bright lights on your brain scan called white matter hyperintensities. The scary part is that your brain could be lit up like a Christmas tree but clinically silent, meaning that you may have no noticeable symptoms until it’s too

Your extensive white matter damage causes faster cognitive decline and puts you at risk for dementia, stroke, and even death.10 White matter hyperintensities are part of the main pathology for vascular dementia, the second leading cause of dementia.

Your attitude toward other people can have a big effect on your health. Being lonely increases the risk of everything from heart attacks to dementia, depression and death, whereas people who are satisfied with their social lives sleep better, age more slowly and respond better to vaccines. The effect is so strong that curing loneliness is as good for your health as giving up smoking, according to John Cacioppo of the University of Chicago, Illinois, who has spent his career studying the effects of social isolation.

In the Netherlands, where euthanasia now accounts for more than 4 percent of total deaths in the country, the law goes further. There, a patient with very advanced dementia can be euthanized at an agreed-upon moment, if he has left written instructions in an advance healthcare directive—and if he appears, to his physician, to be “suffering unbearably” at the time of his death. The moment might vary from patient to patient: when he has lost the ability to speak, say, or when he does not recognize his wife. Dutch doctors are allowed to euthanize a patient by injection, even if he is “no longer able to communicate.” According to the Dutch euthanasia review committee’s code of practice guide, a doctor in this situation must “interpret the patient’s behavior and utterances” and watch for any physical signs “that the patient no longer wishes his life to be terminated.

Nevertheless, by the 1980s and ’90s it was clear that immortality was not in fact around the corner and the assurances of the medical profession grew somewhat more modest. Most researchers no longer spoke of curing old age, but, instead, of “compressing” it: of shortening the natural period of ache and pain and disability and dementia that precedes active dying. The idea was that instead of experiencing long stretches of senescence, we could mobilize the forces of science and medicine to let us live our best lives until—snap. Our abrupt end. There was, Nuland wrote, “a nice Victorian reticence in denying the probability of a miserable prelude to mortality.” Today, even this compression of morbidity seems illusory. In truth, increases in life expectancy have been accompanied by more years of age-induced disability. Aging has slowed down, rather than sped up. Still, and in spite of evidence to the contrary, the heady promise of a curtailed old age endures in the popular imagination. “Compression of morbidity is a quintessentially American idea,” the physician and bioethicist Ezekiel Emanuel wrote, in a viral 2014 Atlantic essay called “Why I Hope to Die at 75.” “It promises a kind of fountain of youth until the ever-receding time of death.

....wasn't dementia a fail-safe and soothing oblivion of the machine to its own decay?

Your mother, was she clear in her mind until the end?’ he asked, knowing it was invasive and cruel to do so. Because his mother had died years before her body did, Brunetti was unable to judge which sort of death was worse and for whom. In all these years, although he had asked many people who had lost a parent, he had never had an answer that would decide the case for him.

The mystery of what goes on inside the mind of another person becomes terrifyingly impenetrable in the final stages of dementia; twilight to pitch dark at the vanishing line between life and death.

But for people who are at the end stages of dementia, death should not be fought against. It's a kindness. Let them go.

Dementia is a particularly long farewell to the self. With most illnesses, death comes quite swiftly. With dementia, the flicker with which life ends is excruciatingly slowed.

One quick note: diabetes ranks as only the seventh or eighth leading cause of death in the United States, behind things like kidney disease, accidents, and Alzheimer’s disease. In 2020, a little more than one hundred thousand deaths were attributed to type 2 diabetes, a fraction of the number due to either cardiovascular disease or cancer. By the numbers, it barely qualifies as a Horseman. But I believe that the actual death toll due to type 2 diabetes is much greater and that we undercount its true impact. Patients with diabetes have a much greater risk of cardiovascular disease, as well as cancer and Alzheimer’s disease and other dementias; one could argue that diabetes with related metabolic dysfunction is one thing that all these conditions have in common.

How frightening to know that your brain can betray you this way, that the vessel for our sense of self is often faulty and prone to error. How awful to know that death may come for us over and over, snatching pieces of us little by little until all that is left to take is our body.

Imagine if there was an intervention that didn’t just reduce your risk of the leading killers but also arthritis, dementia, osteoporosis, Parkinson’s disease, and sensory impairments. Because such risks tend to double every seven years, even just slowing aging, such that the average sixty-five-year-old, for example, would have the health profile and disease risk of today’s fifty-eight-year-old, would be expected to cut in half everyone’s risk of death, frailty, and disability.55 This is why I wrote How Not to Age.

Normalcy?” I ask, louder than is probably necessary, surprising myself with the unusual amount of animated expression in my voice. “A regular human being? Jesus, what the fuck is there in that? What does that even mean? Credit card debt, a mortgage, a nagging spouse and bratty kids and a minivan and a fucking family pet? A nine-to-five job that you hate, and that’ll kill you before you ever see your fabled 401k? Cocktail parties and parent-teacher conferences and suburban cul-de-sacs? Monogamous sex, and the obligatory midlife crisis? Potpourri? Wall fixtures? Christmas cards? A welcome mat and a mailbox with your name stenciled on it in fancy lettering? Shitty diapers and foreign nannies and Goodnight Moon? Cramming your face with potato chips while watching primetime television? Antidepressants and crash diets, Coach purses and Italian sunglasses? Boxed wine and light beer and mentholated cigarettes? Pediatrician visits and orthodontist bills and college funds? Book clubs, PTA meetings, labor unions, special interest groups, yoga class, the fucking neighborhood watch? Dinner table gossip and conspiracy theories? How about old age, menopause, saggy tits, and rocking chairs on the porch? Or better yet, leukemia, dementia, emphysema, adult Depends, feeding tubes, oxygen tanks, false teeth, cirrhosis, kidney failure, heart disease, osteoporosis, and dying days spent having your ass wiped by STNAs in a stuffy nursing home reeking of death and disinfectant? Is that the kind of normalcy you lust for so much? All of that—is that worth the title of regular human being? Is it, Helen? Is it?

Humans appear to have evolved to sustain an LDL level of around 25 mg/dL.5055 The average in the Western world is approximately 120 mg/dL. Perhaps it’s no wonder that heart disease is the leading cause of death in higher-income countries, and dementia, according to the World Health Organization, is killer number two.

An 80-year-old is 60 times more likely to die than a 30-year-old—so, too, are they 30 times more likely to get cancer, and 50 times more likely to get heart disease. Having high blood pressure doubles your risk of having a heart attack; being 80 rather than 40 multiplies your risk by ten. Dementia is extremely rare under the age of 60 but, after that, risk doubles every five years—even faster than the rising risk of death. From the perspective of disease risk at least, it’s better to be an overweight, heavy-drinking, chain-smoking 30-year-old than a clean-living 80-year-old.

If long and meandering postmodern zaniness and stale, rip-off modernism are now the Culture, then it is not itself. It has been stricken by dementia. I’m here now to jog its memory one last time and then deliver it to a dignified death.

Rick supposed there were worse ways to go than a fatal heart attack. Anything, surely, would be better than descending into dementia like Ken. The cloudy eyes and unfocused thoughts, the restless twitching of the hands. That was surely a kind of death. It was as if Ken was disappearing almost before their eyes but becoming at the same time deeper and more nuanced.

And I’ll be damned if I’m going to settle for a diet of moose and squirrels when this planet is swarming with tasty humans to consume.” He became agitated now, balling his fists. “I am sick to death of eating moose and squirrel. I hate moose and squirrel!” Without taking her eyes off him, Dementia shouted in the direction of the restroom. “Naomi, come out of there right now!” “Think about it, Dementia,” said Danny, still trying to finesse his way out of this situation. “What are you going to do when the rest of the families want to leave the Colony? Are you going to kill us all? Are you going to kill off the most advanced species to ever walk the earth?” Her response was chilly and unflinching. “Yes. If I have to.” Danny noticed Naomi then, sneaking up behind Dementia with the wine bottle. He

I never understood people who said their greatest fear was public speaking, or spiders, or any of the other minor terrors. How could you fear anything more than death? Everything else offered moments of escape: a paralyzed man could still read Dickens; a man in the grips of dementia might have flashes of the most absurd beauty.

While we, the gardeners of creation blessed Furrow the soil at our saviour’s behest And bury the seeds of our own life’s death And suffer God’s glory to grow