1. About myself: I seem not to be self-aware. I cannot recall the fundamental values of my life. I cannot recall or appreciate the significance of important events in my life or of emotionally significant relationships. I have no concept of my future. I am not able to plan ahead;

2. Expressing my wishes and promoting my pleasure and decreasing my pain: I cannot communicate any wishes by using words or gestures. I cannot make sounds or movements to indicate "Yes" or "No" in a consistent way. This incapacity puts me at risk to suffer from a variety of symptoms that others may not recognize and thus not treat, including physical pain and other kinds of suffering;

3. Relating to others: I cannot recognize family members or cherished friends. I seem puzzled or I am wrong in identifying them. I utter no words or sounds, or I make no gestures, as they enter or leave my presence. I am unable to pray to, or relate to a Supreme Being (if I believe in one);

4. Dependency and Dignity: I have become totally dependent on others for my basic care; for example, I cannot bathe or dress myself, and/or I am incontinent of urine and/or feces. My social behavior no longer reflects my life-long values, so I have lost my dignity as I previously defined it;

5. My mood, even with treatment: I rarely express joy or pleasure. I am almost always withdrawn, apathetic, despondent or non-responsive. I am often agitated or seem plagued with fear or horror;

6. Burdens versus effectiveness: Maintaining my existence requires almost constant care or intensive medical treatment, and will not be effective to provide improvement or to benefit to my quality of life so that I can live outside an institution or without such treatment or care;

7. Burdens versus benefits: I do not want to prolong the dying of my biologic body if I cannot appreciate any benefit while the burdens to my loved ones require great sacrifices, which may include: depleting my and/or their finances, diverting their attention from other important activities and responsibilities, and causing them to suffer from physical exhaustion or mental depression;

8. Regarding food and fluid: I do not want medically-administered nutrition and hydration, even if there is a risk of contracting pneumonia by aspirating into my lungs what others put into my mouth. After I have lost the mental ability to know how to eat and to drink, I do not want manual assistance IF I seem to have lost enjoyment from tasting and chewing so that it has become necessary to place pureed food at the back of my tongue to initiate a swallowing reflex, OR my actions indicate I am reluctant to eat, OR my trusted physician (AND my proxy, if authorized) believes that I meet a sufficient number of the other seven Criteria of Advanced Dementia to Consider Natural Dying.