How Advance Directives Are Used When the Diagnosis is Dementia

7.26.19The progressive nature of dementia makes advance directives necessary to manage the health care needs of the patient.

When adult children suspect that one or both of their parents may be suffering from the early symptoms of dementia, it’s a good idea to sit down with an experienced elder care attorney to start planning for the legal issues that will follow, says The Roanoke Times in the article “What to do in absence of advance directive.” If the parent is unwilling to cooperate, the attorney will be able to refer the family to a social worker or other professional who may be able to assist. In addition, a geriatric evaluation consultation with a board-certified geriatrician will help to clarify the medical issues.

It’s wise for anyone older than 55 to have advance directives in place, should they become incapacitated so a trusted agent can fulfill the patient’s wishes in a dignified manner. Think ahead and plan ahead.

As a family’s planning starts, the issue of competence must be defined. A diagnosis of Alzheimer’s disease doesn’t necessarily indicate incompetence or a lack of capacity. At this point, a patient still has the right to make a decision—despite family members disagreeing with it. A patient’s competency should be evaluated after a number of poor choices or an especially serious choice that puts a patient or others at risk.

An evaluation will determine the patient’s factual understanding of concepts, decision-making and cogent expression of choices, the possible consequences of their choices and reasoning of the decision’s pros and cons. Healthcare professionals make the final determination, and these results are provided to the court.

If a patient passes the evaluation, she is deemed to have the mental capacity to make choices on her own. If she cannot demonstrate competency, an attorney can petition the court for a competency hearing, after which a trustee may be appointed to oversee her affairs.

The time to address these types of issues is before the patient becomes incapacitated. The family should clearly define and explore the topics of living wills, health care proxies, estate planning and powers of attorney now with an experienced Houston elder law attorney.

Having an advance directive and other legal documents prepared can be emotionally difficult for parent and child, as it puts the stamp of reality on an unpleasant truth. However, by putting all of the planning documents in place, the family will be better prepared for the future and the challenges ahead.

Reference: Roanoke Times (June 17, 2019) “What to do in absence of advance directive”

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