Can a Living Will Cover Dementia Care Preferences?
We often associate living wills with emergencies like life support and feeding tubes. But what about something more gradual and deeply personal, like dementia? Can a living will cover dementia care preferences? This blog lays it out.
Dementia Care in Advance Directives
A living will is a type of advance directive, which is a legal document that spells out your wishes regarding medical care if you’re unable to communicate. Incorporating dementia care and advanced directives is wise, but it requires a profound understanding of how these legal tools work and where they fall short.
Dementia care in advance directives typically includes directions on life-sustaining treatments, pain management preferences, do-not-resuscitate (DNR) orders, and preferences regarding artificial nutrition or hydration. These directives are powerful when dealing with terminal illness or permanent unconsciousness.
However, dementia doesn’t fit neatly into those categories. It’s progressive, not terminal, in the early stages. It often leaves people conscious but increasingly unable to make decisions. While a living will can document some medical preferences, it may not account for the complexity and duration of dementia care.
The Shortcomings of Traditional Estate Planning
Most living wills are designed for end-of-life decisions, not ongoing cognitive decline. They rarely address nuanced issues and don’t necessarily account for dementia being a long process with evolving healthcare needs. Medical interventions might not be life-sustaining in the traditional sense, but they can drastically affect quality of life.
Moreover, legal definitions may limit scope. Many state forms only take effect if the person is terminally ill or permanently unconscious, which are terms that don’t always apply to dementia in its early stages. It’s important to create documentation that reflects your wishes, so contact an estate planning attorney for help as soon as possible.
How to Include Dementia Care in Advance Directives
Can a living will cover dementia care preferences? Yes, here’s how:
- Customize Your Will
Some states allow you to add specific clauses to a living will to address dementia, including requesting only palliative care or avoiding hospital transfers in advanced cognitive decline. A skilled estate planning attorney can help you incorporate this language into a legal document that meets your state’s requirements.
- Appoint a Durable POA
A durable medical power of attorney (POA) designates someone you trust to make decisions on your behalf if you’re unable to. Unlike a static living will, this person can respond to real-time medical decisions, evolving symptoms, and complex ethical questions.
- Create a Separate Dementia Directive
A dementia directive is an add-on that allows you to articulate how you want to be treated as the disease progresses. This document can guide your proxy, inform your care team, and ensure your wishes are known, even if they aren’t legally binding in all circumstances.
- Plan for Long-Term Care
Advanced directives often focus on medical care, but dementia is expensive. Memory care, long-term facility placement, and in-home care aids involve costs that can add up fast. Work with an estate planning attorney to explore long-term care insurance, Medicaid eligibility, revocable and irrevocable trusts, and powers of attorney for finances.
- Update Regularly
Advanced directives are not one and done because laws change, relationships change, and your health changes. Contact an estate planning attorney every couple of years or after major life events to review the documents and ensure your proxy is still willing and able to serve.
Conclusion
A living will can cover dementia care preferences, but a truly effective plan for cognitive decline requires more than a check box on a medical form. Schedule a consultation with the Nicole Pavlik Law Firm today to discuss your wishes with an experienced estate planning attorney.