'I secretly wish. . .' Caregivers' expression of wish for death of persons with severe dementia.

This study investigates the prevalence, stability, and factors associated with caregivers' wish for the death of persons with severe dementia (PwSD) over a two-year period in Singapore. Among 215 primary informal caregivers surveyed every four months, 43% expressed this wish at least once, with 11% consistently doing so. The wish was primarily linked to caregivers’ perceptions of PwSDs’ poor well-being—including low quality of life, high functional dependency, eating difficulties, and suffering—and to caregivers’ understanding of dementia as a terminal illness. Caregivers emotionally close to PwSDs were less likely to express this wish, which was also associated with higher psychological distress. The findings highlight the need for enhanced caregiver support, palliative care integration, and sensitive communication about dementia’s terminal nature to address both caregiver and patient well-being.