Advance Directives in Dementia Care by Mary Bates, MS, CT, CDP

Understanding Dementia

April 16 is National Health Care Decisions Day, which highlights the importance of advanced health care planning, such as having a Living Will and a Durable Power of Attorney for Health Care.

Advance Directives help loved ones and medical personnel make important decisions during a medical crisis. Having an Advance Directive in place ensures that your wishes regarding your health care is carried out, even when you’re unable to make your wishes known. Documenting your preferences regarding treatment and care at the end of life eliminates the guesswork for family and friends in trying to determine what your wishes may have been.

The past year was an extraordinary wake-up call for everyone. No one can predict when unexpected medical situations will happen, making it more imperative than ever for all adults to complete an Advance Directive.

While Standard Advance Directives are useful for most medical issues, they ordinarily don’t cover dementia. And yet dementia is the most common problem that we face as we age.

While not everyone will develop dementia as they age, many will, so it is critically important to ask yourself, “What kind of medical care would I want or not want if I were to develop worsening dementia?”

Questions to consider could include: “Would I want to live as long as possible?” “Would I want my heart shocked to re-start it?” “Would I want to be placed on a breathing machine?” “Would I want to be hospitalized — or would I want to remain at home or in memory care even if I were very ill?” “Would I want to receive only comfort-focused care with an eye towards relieving suffering such as pain, anxiety or breathlessness?”

Even with early cognitive impairment, you may lose the ability to participate in or complete complex planning about future medical decisions. Therefore, the best time to complete a Dementia Specific Advance Directive would be before you develop signs of dementia. Ideally, the Dementia Directive can be completed by anyone before dementia occurs, as a supplement to a Standard Advance Directive.

A Dementia Specific Advance Directive may actually improve your care in the later stages of the disease, as family and health care providers know your specific wishes and will tailor their care for you according to your instructions.

• For help in completing an Advance Directive, please contact Mary Bates, MS, CT, CDP at Summit by Morrison at (603) 837-3500 or mary.bates@summitbymorrison.org.

Mary Bates, MS, CT is a Certified Dementia Practitioner. She is the Assisted Living and Memory Care Director of Summit by Morrison, a senior living community offering independent living, assisted living, memory care, and respite care.

Through this column, Mary will share the experience, knowledge, and resources she and her team rely on, anticipating that it will be useful for anyone living with, caring for, or coming into contact with a person with dementia. Send your questions to Understanding Dementia at Summit, 56 Summit Drive, Whitefield, NH 03598 or email mary.bates@summitbymorrison.org.