If you or a loved one has been diagnosed with Alzheimer’s disease or a related dementia, it may be difficult to think beyond the day to day. However, taking steps now can help prepare for a smoother tomorrow with your geriatric care manager.
Over time, the symptoms of Alzheimer’s and related dementias will make it difficult to think clearly. Planning as early as possible enables you to make decisions and communicate those decisions to the right people.
Below are important legal documents to consider, and resources and tips that can help with planning ahead for health care, financial, long-term care, and end-of-life decisions.
Health Care Planning
Advance directives are legal documents that outline your preferences and apply only if you are unable to make decisions. For health care planning, they communicate a person’s wishes ahead of time. Doctors and other providers follow these directives for your medical treatment. There are two main documents that are part of an advance directive:
- A living will lets doctors know how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment.
- A durable power of attorney for health care names someone as a “proxy” to make medical decisions for you when you are not able.
If advance directives are not in place and a patient can no longer speak for him or herself, someone else will need to make medical decisions on their behalf. Talk to your family, friends, and health care providers about what types of care you would want. It can also be helpful to talk with your doctor about common problems associated with your condition.
For example, in the later stages of Alzheimer’s disease, people may have trouble swallowing, which can bring food or liquid into the lungs and cause pneumonia. Doctors may recommend a feeding tube connected from the nose to the stomach for nutrition, a ventilator to help with breathing, and antibiotics to fight the lung infection to help with recovery. However, some people may want to focus on comfort rather than recovery if the illness occurs near the end of life.
Medical decisions to consider when planning ahead include:
- A do not intubate (DNI) order, which lets medical staff in a hospital or nursing facility know that you do not want to be put on a breathing machine.
- A do not resuscitate (DNR) order, which tells health care professionals not to perform CPR (cardiopulmonary resuscitation) or other life-support procedures in case the heart or breathing stops.
- Other types of medical orders, which inform health care professionals about your preferences for life-sustaining and life-supporting treatment measures during a medical emergency. These have various names but are commonly called POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) forms.
- Organ and tissue donation, which allows healthy organs or other body parts from a person who has died to be transplanted into people who need them.
- Brain donation for scientific research, which helps researchers better understand how Alzheimer’s and related dementias affect the brain and how they might be better treated and prevented.
