Alzheimer's Blog


Advanced directives are also known as a Living Will or Healthcare Power of Attorney (HCPOA).  Both of these legal documents allow a person to assign another person to make medical decisions for them if they are incapacitated and/or are facing an end of life situation. A person with Alzheimer’s or dementia is usually unable or will eventually be unable to make medical decisions for themselves.  It is a good idea to get these documents in place in the earliest stages of the disease.   If these legal documents are not in place before a diagnosis, a hearing may be required to have a judge declare your loved one “incompetent”.  This can be very lengthy and difficult for both the caregiver and patient.

Alzheimer’s can render a person literally unable to verbalize their wishes and these documents ensure the voice of your loved one will be heard by doctors when deciding what kind of medical treatment will be administered or withheld.

This is a very difficult subject to discuss with anyone at anytime, but especially a person with dementia.  The person that is assigned to be the HCPOA should be a trusted friend or family member, who has the patient’s best interest at heart.

Also, be aware that your Living Will and HPOA are only legal if they are in accordance with your own state law.  It is recommended that you seek the advice of an Eldercare attorney, but if you are unable to afford one, many senior service agencies or area agencies on aging have volunteers who can work with you and your loved one to be sure your loved ones wishes are clear and legal.

Involve your family and doctors in discussions with your loved one regarding their Living Will and HPOA.  Try to use examples of other people’s specific medical conditions and ask your loved one how they would want to handle the situation if it was facing them.  It may make your loved one not upset at the prospect of facing life-and-death scenarios themselves.

There are many things that a Living Will may consider for your loved one if their death is impending.  Consider if they would want:

1) To be hospitalized
2) To be put on a respirator
3) To have CPR performed
4) To have surgery
5) To have blood transfusions
6) To have a feeding tube
7) To have medicine administered
8) To be resuscitated

The main difference between these two documents is simple.  The Living Will goes into effect if your loved one is facing an illness where death is certain.

The Healthcare Power of Attorney (or Healthcare Proxy) is a document, which allows the assignee to make medical decisions for their loved one, even if the loved one is not facing death.  The HPOA becomes in effect when your loved one is considered incompetent.  An Alzheimer’s diagnosis is generally sufficient in most states.

The HPOA allows the proxy to make decisions regarding home health care, admission or transfer to and from hospitals or nursing homes, etc.  It also allows them to gain access to their loved one’s medical records and talk with doctors on their behalf.

People who should have copies of Advanced Directives:

1) All doctors involved in your loved one’s care
2) The person designated as the HPOA
3) The hospital where your loved one is treated
4) Your Eldercare attorney
5) A trusted family friend who could find it in case of emergency

Disclaimer: This information is not intended as legal advice.  Please consult with an Eldercare Attorney in your state for specific information.