Now and Then
Mr. Hendricks is a 58 year old with early-onset dementia that has progressed rapidly in the last three years. He is living in a continuing care facility with a nephew, Frank, as his substitute decision maker.
Mr. Hendricks has an advance directive, written twenty years ago, which specifies that if he were to develop dementia he wishes to refuse any interventions aimed at cure, including antibiotics for pneumonia, and states that he would find a life with moderate or advanced dementia not worth living. Cold and flu season is coming up, and staff at the continuing care home are wondering what their responsibility is if Mr. Hendricks develops pneumonia as well as whether Mr. Hendricks should receive the annual flu shot. Their concern is amplified because, contrary to Mr. Hendricks’ expectations, he seems to find considerable pleasure in his life with worsening moderate dementia.
Frank, Mr. Hendricks’ nephew, lives two provinces away and says that while they had a loving relationship, he...