I appreciate that you give it to them straight. This is the type of care all people should have access to. If I get diagnosed with dementia, ALS, or terminal cancer let me know ASAP. So I can make appropriate arrangements to be able to travel to a state/ country that allows some sort of end of life care. I’ve watched my mother and both my grandmothers suffer and pass from dementia it’s a a hell of a way to go and so much suffering we are nicer to our animals. I also watched my grandfather pass from ALS and I have an aunt suffering with Parkinson’s. I have no wish to even fight any of these diseases and I’d never want my children to see me suffer or feel like they would have to put their life on hold to take care of me. Each individual person holds the right to know what they can and cannot handle in terms of suffering or fighting a disease. The choice should always be left up to the patient and to have a doctor they can turn to for good counsel. I honestly don’t know how someone in your profession unwinds at the end of the day. I’d be a ball of fried nerves if that was my day to day job.