People are always somewhat reluctant to discuss pleasant dementia. What we call pleasant dementia is a condition that affects people who are happy in their everyday lives and who exhibit no objectifiable suffering. They don't necessarily recognize their loved ones or have any idea of the day or date but are happy in the moment. For example, they are happy eating and taking part in small-scale activities. They appear entirely satisfied and happy.
Should we consider that these people are suffering enough to make an advance request? That's a big question.
Some people say they're happy now. However, if they had seen themselves in this condition before they fell ill, they might have decided they wouldn't want to live with that situation. Some feel that, if all they love doing is eating and taking part in small-scale activities at the long-term care centre, that's not a life worth living. It constitutes existential suffering for them and they prefer to receive medical assistance in dying. However, people may also adapt and become happy.
We talked about refusal earlier. It's all the more difficult to administer medical assistance in dying to someone who seems happy and absolutely doesn't remember requesting it several years earlier. That's the problem with pleasant dementia.