Complete Estate Planning: Advance Directives for People with Dementia

In November of last year, the Washington Post ran an opinion piece by an ER doctor titled “Doctors are torturing dementia patients at the end of their life”.  Read the article here

The doctor’s experience and perspective are not unusual. As Jane Brody of the New York Times summarized “Advanced dementia, including Alzheimer’s disease, is the sixth leading cause of death overall in the United States. It is the fifth leading cause for people over 65, and the third for those over 85. And once the disease approaches its terminal stages, patients are unable to communicate their desires for or against life-prolonging therapies, some of which can actually make their last days more painful and hasten their demise.” Read more here

The treatment options and goals of care for an older person with dementia can be complex and confusing.

Medical professionals can do a lot to keep an older adult alive for a long time while doing little to improve their quality of life. This often creates a painful dilemma for family members faced with making medical decisions on behalf of a family member who can no longer make a decision on their own.


In January, we posted about the need for advance directives as part of a complete estate plan. The doctor in this opinion piece also encourages the completion of advance directives.


“[They] can avoid my patient’s fate by documenting, executing and fortifying their end-of-life wishes. Advance directives are the tool to do so. They are yes-or-no documents outlining end-of-life health-care wishes, such as preferences for comfort care only.”


He also goes on to share the importance of choosing a healthcare agent that is able and willing to “aggressively” follow your wishes. It is true that a person’s healthcare agent may be in conflict with the medical professionals when it comes to end of life wishes.

Advance directives for individuals living with dementia should be well-thought-out, accurate, and properly executed.

They should also be regularly reviewed with the health care agents and primary care physician. The more these issues are discussed and reinforced, the more likely a person’s wishes will be followed.


Many dementia advocates also encourage the use of special instructions for those living with dementia. Read this piece on the Conversation Project’s blog and Paula Span’s piece “One Day Your Mind May Fade. At Least You’ll Have a Plan.”

This is never an easy topic to discuss, but it is so important. A person living with dementia will one day lose the ability to make their own healthcare decisions. It is best to be prepared.

The team at Hurley Elder Care Law is experienced and equipped to help lead families through these tough conversations as they work to create a complete estate plan. To learn more or to get started with your complete estate plan, contact Hurley Elder Care Law at (404) 843-0121 or through our website for a complimentary phone consultation.


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