In any comprehensive estate plan, preparing an advance directive is a good way to ensure that you receive the type of medical care or interventions you want in the even that you become incapacitated or otherwise unable to communicate your wishes. By documenting your preferences ahead of time, you can rest easier with the understanding that, come what may, your wishes will be known and respected. For people who develop dementia or Alzheimer’s, an advance directive becomes important, as these conditions generally lead the individual to suffer mental decline and eventually become unable to articulate their wishes. Unfortunately, many people who develop dementia or Alzheimer’s have no advance directive in place—so, what happens? Let’s take a look at how some states, including Washington, are addressing this issue.
Respecting a Person’s Wishes
An advance directive provides a road map of sorts to articulate a person’s preferences for medical care, should they become unable to express such wishes due to incapacity. Without an advance directive, someone suffering from dementia or Alzheimer’s may have difficulty identifying or articulating their wishes, and this can be concerning for loved ones and care providers. However, many patient advocates suggest that we respect the wishes of our loved ones, even if it takes some time for them to express them clearly. We should be hesitant to assume that a dementia patient is automatically mentally incompetent—there is a legal process that we must follow in order to determine whether this is true. Instead, we should be patient with the individual and invite them to express their wishes on their own timeline. It may be useful to appoint a legal guardian to provide support during this time.
Washington’s Approach
As some aging individuals develop dementia or Alzheimer’s, certain states are implementing new strategies for serving these patients and their families. The Alzheimer’s Disease and Dementia Mental Health Advance Directive is now legal in several states (including Washington), and it allows an individual to document their responses to several questions, such as where they plan to reside, how their finances will be handled, under what circumstances they will stop driving, and other practicalities. This document can be filled out by those who are concerned about developing dementia or Alzheimer’s, or by those who are in the early stages of these conditions. For many who complete this document, the process offers a helpful way to assess your values and your vision for how the rest of your life will unfold. It also encourages family members to think about the role they will play as you age.
Protecting Yourself and Your Loved Ones
Even if the idea of thinking about a future in which you are unable to communicate your wishes is unpleasant, it’s essential to have a clear plan in place for if—or when—the time comes. Documenting your wishes also removes a huge burden from your family members, as you relieve them of the pressure of having to make agonizing decisions on your behalf. Instead, the directive will serve as a guide, so that everyone can feel confident that your wishes are being upheld and honored at all times.
