Advance Care Directive

National Health Care Decisions Day is April 16. However, anytime is a good time to create the document or update the document. Assigning an agent to speak for you when you cannot is one of the most important things you can do for yourself and your family.

While I work with and for seniors, truly anyone over 18 years of age should have this document signed and distributed. When my children came of age, I provided them with the forms, helped them complete them and get them notarized. Just as important, we talked about it.

I hear all the time the reasons (shall I say excuses??) for not completing them. “It is too soon” or “I have plenty of time.” But do you really know that?

As a gerontologist and geriatric care manager I have worked with people living with dementia and their families for over 12 years. I worked with these same folks, and the community and other professionals through the Alzheimer’s Association for 21 years.

When a person is diagnosed with dementia and is still in the early stage, that is the time to plan for the future. Unfortunately, Alzheimer’s disease and most other related dementias are progressive. This means the person’s cognitive abilities will decline over time. Memory, judgement, reasoning and foreseeing the consequences of actions or inaction are some of the abilities that decline. When a person progresses to middle stage, the ability to have thoughtful and complex conversations about future care needs and what they want and don’t want at the end of their lives is likely gone.

Therefore, the time to create or update your advance directive and have the discussions with your loved ones about the advance directive is in the earliest stage. This is when the person living with dementia is at their best.

Through the Alzheimer’s Association I facilitated support groups for many years. On a regular basis we discussed the benefits of completing the Advance Directive and having family discussions on the persons wishes. Over the years many, many families thanked us for encouraging them to complete the documents and having conversations. It made those decisions at end of life so much clearer and often resulted in positive outcomes.

There are many resources to obtaining the form for an advanced directive for health care decisions. One excellent source is the conversation project.

Additionally, there are addendums to supplement your advanced directive specifically for people with a dementia diagnosis. Along with your advance directive, these documents will better inform your agent what you would want in each stage of the dementia. Here is one:

I have read that people spend much more time planning their vacations than their retirement and the inevitable changes that come with aging.

Doing what I do and knowing what I know, I created my documents 20 years ago, and with Covid I revisited and updated them. Everyone should and thankfully, it is quite easy. 

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