How Dementia Directives Clarify Care for Loved Ones

Alzheimer’s is one of the most common diseases people face in their 70s and 80s. As symptoms worsen, an individual can no longer make decisions for themselves and families must make choices for them. One of the best ways to retain control is to share your directives with the people who would care for you. Advanced directives include what you want for medical care to maintain your comfort and dignity in the event dementia symptoms worsen.

What Is Dementia?

People who develop Alzheimer’s and other forms of dementia lose their memory and the ability to understand what is going on around them over a period of 5-20 years. Familiar faces become unrecognizable and patients eventually need help cleaning themselves after going to the bathroom. Some become irritable and aggressive toward the people they love which can make caring for them difficult.

Over time, people lose the ability to eat, speak, and walk, and eventually die from the disease or complicating health issues. The average length of time it takes dementia to become severe is about eight years.

Expressing Your Wishes

Dementia is a difficult road to walk for families and the patients experiencing the disease. As people lose their ability to make decisions for themselves, their family needs to make medical decisions for them. Giving families members advanced directives about the kind of care you want can help ease the burden and put you in control of your care.

Dementia Directives

Stage One: Mild Dementia

During this stage, people lose the ability to remember recent events. Routine tasks such as cooking become more difficult and driving becomes more dangerous.

If you had mild dementia, which option would you want to be the goal of your care?

  1. Live as long as I can. I want all efforts to prolong my life, including efforts to restart my heart if it stops beating.
  2. Receive treatments to prolong my life, but don’t shock my heart or put me on a breathing machine if my heart stops beating. If this happens, allow me to die peacefully. If I took a sudden turn for the worse, my dementia could likely worsen and this wouldn’t be an acceptable quality of life for me.
  3. Only receive care where I live. If I became ill, I do not want to go to the hospital. If antibiotics would help me live longer, I want them provided where I am living. If I got worse, I do not want to go to an emergency room or hospital. I would want to die peacefully and avoid the risks and trauma of being in a hospital.
  4. Only receive comfort-oriented care focused on relieving suffering (pain, anxiety, breathlessness). I do not want any care to keep me alive longer.

Stage Two: Moderate Dementia

In this stage, people lose the ability to have conversations and understand what’s going on around them. They often require daily assistance with dressing and even toileting.

If you had moderate dementia, which option would you want to be the goal of your care?

  1. Live as long as I can. I want all efforts to prolong my life, including efforts to restart my heart if it stops beating.
  2. Receive treatments to prolong my life, but don’t shock my heart or put me on a breathing machine if my heart stops beating. If this happens, allow me to die peacefully. If I took a sudden turn for the worse, my dementia could likely worsen and this wouldn’t be an acceptable quality of life for me.
  3. Only receive care where I live. If I became ill, I do not want to go to the hospital. If antibiotics would help me live longer, I want them provided where I am living. If I got worse, I do not want to go to an emergency room or hospital. I would want to die peacefully and avoid the risks and trauma of being in a hospital.
  4. Only receive comfort-oriented care focused on relieving suffering (pain, anxiety, breathlessness). I do not want any care to keep me alive longer.

Stage Three: Severe Dementia

During this stage, people can no longer recognize family or loved ones. They may be disruptive, yell, and be awake through the night. Patients are easily agitated, angry, and even violent.

If you had severe dementia, which option would you want to be the goal of your care?

  1. Live as long as I can. I want all efforts to prolong my life, including efforts to restart my heart if it stops beating.
  2. Receive treatments to prolong my life, but don’t shock my heart or put me on a breathing machine if my heart stops beating. If this happens, allow me to die peacefully. If I took a sudden turn for the worse, my dementia could likely worsen and this wouldn’t be an acceptable quality of life for me.
  3. Only receive care where I live. If I became ill, I do not want to go to the hospital. If antibiotics would help me live longer, I want them provided where I am living. If I got worse, I do not want to go to an emergency room or hospital. I would want to die peacefully and avoid the risks and trauma of being in a hospital.
  4. Only receive comfort-oriented care focused on relieving suffering (pain, anxiety, breathlessness). I do not want any care to keep me alive longer.

After deciding what you want for care, discuss your advanced directives with your family and your durable power of attorney for health care. Include your directives in a living will and give copies of your decisions to family members, doctors, and other health care providers.

At LTC Consumer, we help individuals and families prepare for the future with Long Term Care Insurance. Contact us today to learn more about coverage options.