This article discusses the particular problem that arises for people with Alzheimer’s disease, for their family and for their caregivers concerning advance directives on the intensity of care at the end-of-life. Various European legislation surrounding the prior expression of end-of-life persons’ wishes are briefly presented as are the procedures for appointing a third party to express this will. Some examples chosen in Europe of approaches specifically adapted for people with cognitive disorders are discussed, distinguishing conceptual and pragmatic approaches.