Autonomy, competence and advance directives: The physician proposes, the patient with dementia disposes?

At the beginning of the twenty-first century, dementia has become a widely feared and common disease. It is a disease that primarily affects older people. While around 6.3 per cent of people aged 55-plus suffer from dementia, this percentage rises to 43.2 per cent for people aged 95-plus and it is easy to understand why older people fear this. This fear is heightened by the fact that the disease process is often insidious, gradually sneaking up and taking over the people in question. Some persons with dementia, in the early stages of their disease, feel that they start to lose a grip on their inner self and that feeling can sometimes be associated with a dreadful fear. But in many cases they are not fully aware of their decline and do not even deny it, gradually slipping into the changed mental state that is called dementia. At present there is no way of curing, preventing or predicting dementia, so older people have no option other than to learn to live with the fear of dementia, because if dementia is your lot in life you cannot escape it, or can you?.