Dementia is perhaps the most feared diagnosis and is certainly one of the cruelest. It robs you of yourself.

Advance Directive instructions and a supportive surrogate/proxy (for our purposes, we will refer to this person simply as surrogate) for healthcare decisions are the best defense in protecting your medical treatment preferences should you become incompetent.

But as our recent FEN magazine discussed, hydration and food provided by hand are not currently considered medical treatments. They are basic comfort care such as bathing and may continue to be offered to you, despite your written instructions.

FEN has prepared a Supplemental Advance Directive for Dementia Care (SADD), which strengthens the language concerning your instruction to withhold all food and liquid. If you are interested in finding out more about the SADD and obtaining a copy you can use, click here. More information about initiatives relating to this SADD will be sent by email to all FEN members.

Note: This SADD has been developed by our Final Exit Network attorney, based on his study of applicable law, court rulings and other organizations' Advance Directives. We feel it provides the best legal basis for having your directions followed or litigating if they are not honored.

But law is always evolving. Our attorney will continue to review new laws and rulings that are relevant. You can help us by letting us know of any suggestions you have for revision, or by sharing any experiences positive or negative with use of this document, or similar ones, by anyone you know. Please send them to fenattorney@gmail.com.

Should any revisions be needed, the revised form will be posted on our website as well as our magazine, with an explanation of the changes.

We welcome and value your feedback.


The US Centers for Disease Control and Prevention asks that no large gatherings take place for the next eight weeks. Such gatherings can contribute to the spread of the COVID-19 virus via travelers who attend these events and introduce it to new communities. This affects FEN's Exit Guide Services as well as our Speakers Bureau. FEN has developed "My Choices If I Become Sick in the COVID Pandemic" to help you think about and share your wishes with loved ones during the pandemic.

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We Support the Human Right To a death with dignity

We hold that mentally competent adults who suffer from a terminal illness, intractable physical pain, chronic or progressive physical disabilities, or who face loss of autonomy and selfhood through dementia, have a basic human right to choose to end their lives when they judge their quality of life to be unacceptable.

Every 65 seconds someone in the U.S. develops Alzheimer's
15 new cases of ALS diagnosed each day in U.S.
New cases of dementia worldwide each year

How We Can Help

Our services are free and are offered nationwide. Our guides travel to you and educate you on personal choices.


We believe no one should suffer a traumatic death, and we will do our best - within the limits of each state's laws - to educate you on your alternatives.


Our guides travel to you and educate you on your personal choices. You must, however, be able to competently choose, as well as be able to effect your exit.


Our Exit Guide Service responds to phone requests for information within 48 hours.

Finding Hope in Something Hopeless

I am occasionally asked to talk with Final Exit Network clients or family members who have questions about religion or spirituality. They sometimes seek help in coming to terms with their faith tradition’s opposition to self-deliverance. Usually, clients have already reconciled the apparent conflict for themselves, but a family member may be struggling to understand…

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