Dementia-Specific Advance Directives and Health Care Decisions Day

If you’ve provided care for a loved one living with dementia, you know how important it is to tackle the discussion of how medical decisions will be made as cognitive abilities decline – but it can be a challenging conversation. When individuals become unable to make their own decisions, who should take on that role and what steps should be taken?

Increasingly, people who know they may develop dementia are working with attorneys to create dementia-specific advance directives. These legal documents clearly explain the effects of dementia at each stage — mild, moderate and severe — and spell out the medical treatments desired as the condition progresses.

Medical interventions described in the directives include what steps may be taken to keep an individual alive in each stage of dementia.

What About Standard Advance Directives?

Many older adults have signed standard advance directives that name an individual — typically a spouse or other family member — who will make medical decisions in the event that the signer becomes unable. Some experts believe that standard directives constitute adequate consent, but the documents generally focus on people who are expected to live six months or less.

Individuals with dementia can live for many years after diagnosis, and they may pass through various stages of wellness and ability as the condition progresses. The point at which an individual with dementia can no longer make his or her own medical decisions may not become immediately apparent.

In addition, many people with dementia continue to lead full and enjoyable lives even if they are unable to make medical decisions. In that case, a loved one likely would authorize resuscitative measures that the individual might not want in later stages of dementia.

National Healthcare Decisions Day

National Healthcare Decisions Day stresses the importance of considering — in advance — medical treatment that you or a loved one would want in various scenarios. The day, observed this year on April 16, was created to educate and inspire both medical providers and members of the public about the critical role of advance directives in health care planning.

The Conversation Project, an organization that assists people in communicating about end-of-life care, sponsors National Healthcare Decisions Day to help individuals communicate their wishes and ensure that health care providers act accordingly.

The day is observed across the United States with 50 coordinated campaigns designed to bring together individuals and representatives of health care, religion, law and other disciplines. A primary goal for the day is helping individuals understand how to focus on advance health care decisions — by starting a conversation with loved ones.

The Conversation Project offers a “Conversation Starter Kit” to help you and your family members begin talking about end-of-life care.