DIMENSIONS Spring 1999


Q. I have just been diagnosed with early Alzheimer's Disease. What can I do now to help my children plan for my healthcare in the future?

A. One of our most basic rights is to be able to make decisions about the healthcare we will receive during the last part of our lives. There are legal tools, called Advance Directives, that allow you to make your wishes for treatment known if you become unable to communicate or make decisions. You can play an important part in easing your family's burden by telling them what you would choose when challenged by end-of-life health care decisions, and then preparing for making those choices legally by completing Advance Directives.

The most common Advance Directive is the Living Will, a document directed to physicians and families stating your wish to refuse life-sustaining medical treatment in the event of terminal illness, terminal injury, or becoming permanently unconscious. The Living Will is followed when you are unable to provide instructions at the time a medical decision must be made. It allows a physician to withhold or withdraw life sustaining treatment which would only prolong the process of dying. Additionally, the Living Will allows you to order whether you want to have artificially-provided nutrition and fluids if you are diagnosed to be in a terminal condition or in a permanent unconscious condition. Care to ensure comfort would continue to be provided.

The second form of an advance directive is the Durable Power of Attorney for Healthcare, a document authorizing another person (the designee) to make health-care decisions for you when you are unable to make your own decisions. This document takes effect only when you can no longer make decisions, and goes further than the Living Will in that it allows your designee to make nearly any healthcare decision during your incapacitation. It does not allow the designee to act in other ways such as handling your financial concerns. The designee should be someone who would be able to carry out your wishes and be available in emergencies.

Copies of Advance Directives should be given to your designee, physician, and an additional family member or friend in case of an emergency. A copy should also be attached to your medical chart upon admission to a hospital or nursing facility.

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