Dementia and End-of-Life Options
A diagnosis of dementia can bring uncertainty and fear. At Dying With Dignity Victoria, we believe it can also be a powerful moment to take control — to make informed choices, express your values, and ensure your wishes are respected.
Take the first step today. Planning ahead while you still have capacity is one of the most important things you can do.
Understanding Dementia. Dementia is an umbrella term for a group of conditions that cause a progressive decline in memory, thinking, behaviour, and the ability to perform everyday tasks. It occurs when brain cells are damaged or lost, disrupting the connections between them.
Common causes include:
• Alzheimer’s disease — the most common form
• Vascular dementia — often linked to strokes or blood vessel damage
• Lewy body disease
• Frontotemporal dementia
• Alcohol-related dementia, traumatic brain injury, and other rarer conditions
Why Early Planning Matters. In Victoria, the law presumes every adult has decision-making capacity unless there is clear evidence to the contrary. Many people in the early stages of dementia retain full legal capacity for a significant period. This creates a vital window to document your wishes through an Advance Care Directive and appoint a Medical Treatment Decision Maker.
Planning early ensures your voice continues to guide your care, even if decision-making becomes more difficult later.
Dementia, End of Life Planning, and Voluntary Assisted Dying (VAD). Dementia is now the leading cause of death for Australian men and women, and one of the most common topics raised with Dying With Dignity Victoria (DWDV) in relation to end of life choice. DWDV strongly supports personal autonomy, including for people living with dementia.
In April 2023, Dementia Australia released the following policy statement: “Dementia Australia supports the right of every person, including those living with dementia, to exercise choice over end of life care options, which may include VAD measures.”
VAD and Dementia: The Current Situation. No Australian state or territory currently permits VAD for dementia. Only a small number of jurisdictions worldwide, notably the Netherlands, Canada and Belgium allow it, and even there it is used infrequently because obtaining final, contemporaneous consent is highly complex.
In Australia, political interest in expanding VAD laws to include dementia is currently very limited. DWDV anticipates that meaningful reform may still be several years away. Nevertheless, we are actively researching potential legislative models so we are ready when the political climate shifts. We welcome feedback and stories from members and supporters on this complex issue.
How DWDV Supports People With Dementia. DWDV provides practical assistance that includes information on -
• Advance Care Directives
• Medical Treatment Decision Makers
• End of life rights information
• Education and advocacy for expanded end of life choice
Planning early empowers people to maintain control and express their values clearly.
End of Life Option for Dementia (Other Than VAD). For people with dementia who decide they no longer wish to continue living, there is only one legal medical option that currently exists within Australia:
• Voluntary Refusal of Food and Fluid (VRFF) — A legally recognised option for people who retain capacity. Stopping food intake can take weeks; stopping fluids typically leads to death within 10–14 days. VRFF is difficult, requires strong medical and carer support, and must be carefully planned.
Summary. Dementia is a major and growing end of life concern in Australia. While VAD is not currently available for dementia, early planning, clear documentation of wishes, and supportive guidance from DWDV can help people maintain autonomy and dignity. DWDV continues to advocate for future law reform and invites members to contribute their views.
Resources about dementia
Websites
Dementia.org.au
Podcasts
Hold the moment
The dementia podcast
Videos
A changing brain; Teepa Snow
What is dementia?