Choosing The Best Quality of Death

In this article, you’ll read that Jerome Medalie has an advance directive stating that he wants to be able to have his health agent make certain that he is not fed when he can no longer feed himself. It’s unfortunate, but it’s very unclear as to whether this will be upheld in the future based on someone’s Health Directive that is written in the past when they are mentally competent.

Here is a great example of the importance of having end of life conversations and advance directives. But people must know that if they want to be absolutely certain that they don’t have to live into the late stages of dementia, they may have to choose to VSED when they are still mentally competent. These are very difficult life decisions. I know because this is what my husband chose to do, and as his advocate, I made it possible for him to have a good death. His care was overseen by a doctor and caregivers.

We’re all going to die. We each have choice about how and when we die. Let’s start thinking about this when we are healthy and full of life. When preparing for any type of death there are many things to think about. My husband and I went through a lot of medical preparation to achieve the quality of death he deserved and wished for.

Click the photo below for the link to Jerome Medalie’s story as told in the New York Times.




Terminally Ill Couple Choose to VSED Together

Mr. Rudolph, 92, suffered severe pain from spinal stenosis and had a permanent catheter. Mrs. Rudolph, 90, was immobile. Both suffered from the onset of dementia, and they consulted with Compassion & Choices about V.S.E.D.

When Mr. and Mrs. Rudolph said they wanted to VSED in the facility they were living in, the facility said they would not allow this. Most likely, the facility was concerned about legal repercussions. The couple, even though they were outraged that they had to leave the facility, moved to a home. They both died peacefully one day apart and were surrounded by loved ones and family. My husband chose to VSED for the same reasons. He died peacefully and surrounded by loved ones as well.

[pullquote]I’m doing this because I have a disease that will rob me of the ability to make this choice. Since I don’t know about this (i.e. VSED), probably not a lot of people do. And it sounded horrible. Now that I’ve investigated it, it doesn’t sound horrible and I’m going to do it. – Alan[/pullquote]

Voluntarily stopping eating and drinking has become an end of life option for terminally ill patients whose quality of life is dwindling. A version of this has been practiced for decades. People have refused to take medication or to elect not to undergo invasive surgeries. By not eating and drinking patients are choosing not to live into the late stages of disease. Interestingly enough, it is not lack of food that causes a coma before death.  It is not possible to survive when dehydrated. To undergo this process skilled caregivers and support are necessary. My resources page is a great tool if you are looking for more information or resources for VSED and other end of life options.

VSED is a legal option. We all have a right to a good quality of life and a good quality of death. 

Choosing Not To Eat And Drink: Some Terminally Ill Hasten Death

Southeast VSED End-of-Life Choice Conference

The second conference on VSED is happening on April 9th, 2017 in North Carolina. The first national conference on VSED occurred this past October at Seattle University. It was a huge success and it was very much appreciated by the community. It opened up a lot of conversation. I’m glad to see that another conference planned so soon. My upcoming book, “Choosing To Die,” goes into detail about VSED, including the necessary medical and legal preparations. I also include a day by day description of what happened to my husband when he went through the VSED process rather than live into the late stages of Alzheimer’s disease. It took him nine and a half days to die. The book will be available by April 9th on Amazon.

The First National Conference was a huge success and I was honored to be a part of the community that catalyzed this event. This topic is growing and becoming more recognized by the medical and I am proud to see it grow. This website is one of the most in depth resources regarding VSED and I am available for contact with questions regarding any end of life support.

Information and Registration:




Care Giving Supplies

Caregiver_HeartSomeone contacted me because they are the advocate for a loved one who has decided to VSED. They asked for a list of care giving supplies to have on hand to facilitate the process and keep their loved one comfortable. One of my colleagues, who was a caregiver for Alan, put this list together. These are the items we assembled before Alan started. It was important to me that we have everything on hand so full attention could then be given to Alan once he started to VSED. These supplies can be acquired from local medical supply stores, local drugstores and/or on-line. If the person is going to VSED at home and Hospice is involved, Hospice is often able to supply many of these things. Coordinate this list with them before purchasing items or renting equipment independently.

  • A cool mist humidifier will provide moisture in the air and help offset the bodily drying sensations brought on by dehydration
  • Eye drops, lip balm and body lotion administered routinely will soothe eyes, lips and skin.
  • Small one ounce spray bottles, be sure they only spray fine mist, used to quench thirst but providing minimal hydration.
  • Disposable oral swab sticks, the little sponges on a stick. These are good for cleaning the teeth, gums and tongue. It is recommended that they not be used to deliver moisture for two reasons: 1) The sponge can hold a lot of water and offset the goal of not drinking 2) A person might reflexively chomp down on the stick and could potentially bite the sponge portion off, making it become a choking hazard.
  • Tab style adult diapers to be used when a person can no longer get up. These can be used open under the person, or tabbed closed.
  • Bed pan to be used if a person is conscious and needs to eliminate but can no longer get up.
  • Hand held urinal for men, easier than a bed pan if the need to void is felt.
  • Bedside commode useful when a person can no longer get to the bathroom but is able to get up independently or with assist.
  • Hospital Bed helps the caregivers to provide better care as the process continues; the bed can be raised to provide easier care access, lowered so the person can get out more easily, raised and lowered at head and foot to vary body position and prevent pressure sores. The ability to raise the head of the bed, can become important at later stages as breathing and lung clarity changes and is necessary when administering medication.
  • 3 or 4 cloth reusable waterproof pads, also referred to as draw sheets. These come in various sizes and get no smaller than 30” x 34”. They are placed under the person in bed and, besides acting to protect the bed from fluids, they are essential for moving the person easily and comfortably.
  • Disposable waterproof rectangular under pads used on top of draw sheets and also on furniture if person is sitting up out of bed.
  • Gait belt, worn around the person’s waist when they get up. The belt allows a caregiver to hold, guide and stabilize the person without risk of injury that might be caused from holding on to the arm or clothing. If you hire professional caregivers, they will likely bring a gait belt, so check with them before purchasing.
  • A & D Ointment, or some other moisture barrier cream can be helpful in hip creases, inner thighs and buttock region for moisture or friction aggravation.
  • Wash Cloths
  • Hand Towels
  • Baby Wipes
  • Disposable Gloves, available in latex or non-latex.
  • 13 Gallon Kitchen Garbage Bags
  • Baby Monitor, to listen for person’s needs when not in with them.
  • Bell, for person to ring for help.


Summary Shopping List:

From the Drugstore

Eye Drops

Lip Balm

Body Lotion

Small Spray Bottle

Disposable Oral Swab Sticks

Tab Style Diapers

Reusable Waterproof Pads (Draw Sheets)

Disposable Waterproof Rectangular Under Pads

Hand Held Urinal for Men

Bed Pan

A & D Ointment

Baby Wipes

Disposable Gloves

13 Gallon Kitchen Garbage Bags


From Medical Supply Store

Gait Belt

Hospital Bed

Bedside Commode



Cool Mist Humidifier

Wash Cloths

Hand Towels

Baby Monitor