Dementia Directive: An add-on to an Advanced Health Care Directive

An Advance Health Care Directive (AHCD) is an important document that everyone should have.  An AHCD allows someone you appoint to make health care decisions for you when you are not able to do so. Having this document in place can avoid an expensive and time-consuming court proceeding if you become incapacitated and can’t make your own health care decisions. The standard AHCD comes into play in the event of temporary incapacity, such as if you are undergoing a medical procedure under anesthesia and some other condition that requires immediate attention is discovered. In this case, the agent you have appointed can give consent to allow the treatment to be undertaken. 

The other situation that is covered by AHCD is end of life decisions, such as terminal illnesses, irreversible comas, or a persistent vegetative state. The AHCD provides important direction  to your agent to make sure that your wishes are followed if the situation arises.

However, Advance Health Care Directives do not normally cover chronic conditions such as dementia, which includes Alzheimer’s. An advance directive which sets forth your wishes in the event you develop advanced stage of Alzheimer’s or another incurable, advanced dementing disease can be an important guide to ensure that your wishes are followed after you are no longer able to make your wishes known. In the absence of this directive, families have to make decisions based on what they think you would want.

In recent years we have begun to offer to our clients this important additional advance directive. It addresses issues such as feeding, whether you would want to be forced to eat, or have a feeding tube installed, and refusing, or limiting medical treatments, facilitating care which emphasizes your comfort, and directing that your agent determine that any institutional placement would include the facilities agreement to follow your wishes. 

If your estate plan does not include an Advance Directive for care in the event of dementia, consider adding one. Our office will review your existing documents without charge and let you know what changes or additions are recommended.