Most people in contemporary western societies do not die suddenly, but from organ failure or dementia after a period with declining health due to chronic-progressive disease. With increasing options for care and treatment, decisions about useful or desirable treatment and care are made in the last phase of life of most people. In this chapter, we report on three categories of end-of-life decisions that are made in dementia care. First, decisions primarily aimed at alleviating pain and other symptoms or improving quality of life in other ways, while possible effects on length of life are deemed irrelevant compared to that aim. Second, decisions around life-sustaining treatments or treatments to cure acute or co-morbid conditions which may or may not affect length and quality of life. Examples of such treatments are cardiopulmonary resuscitation, use of antibiotics, and artificial nutrition and hydration. Third, decisions around terminating life, e.g. euthanasia. For all these decisions, we focus on clinical as well as on some societal and ethical perspectives.