An advance directive specifies your preferences for medical treatment when you cannot speak for yourself (Advance Directives). As some illnesses progress, it becomes harder to clearly express your wishes or carry out choices you made earlier. Planning ahead can make an enormous difference for the people who may need to make decisions on your behalf.
These tools are designed to help you put your preferences in writing while you still can, and to give your loved ones, health care agent, and clinicians clearer guidance.
Dementia Directives
Alzheimer’s and other dementias create especially difficult situations because once the disease is advanced, a person can no longer reliably express their wishes.
Several excellent dementia-specific directives have been developed that help you think through and clearly express your preferences, and not just for medical treatment. They may include such considerations as where you’d prefer to live if your home is no longer a safe or feasible option, how you’d want your care to adapt as your affliction deepens, financing your care, even future intimate relationships for yourself or your current spouse/partner.
👉 Northwest Justice Project Advance Directive for Living with Dementia
This innovative directive was developed the Northwest Justice Project in Washington State. It is available for download.
👉 The Dartmouth Dementia Directive
This supplement to a traditional advance directive was developed by clinicians at Dartmouth Hitchcock Medical Center in Hanover, NH. It is also available for download.
👉 Compassion & Choices — Dementia Values Tool
This directive can be downloaded, or worked through online. The online version includes helpful links for explanations and more information.
👉 The Conversation Project has also created a guide for people providing care for people with dementia.
VSED Directive
Voluntarily Stopping Eating and Drinking is getting attention as an end-of-life option, especially in state where medical aid in dying is not available, or when patients would not qualify for MAiD.
Some people consider VSED when their illness is not expected to cause death within six months, as with many forms of dementia, or when they are facing intolerable suffering and hospice or palliative care no longer meet their goals. In these situations, VSED may be one option people consider when they want some say over how the final stage of life unfolds. To learn more, please see our VSED page.
A VSED Directive can help make a person’s wishes clear and provide guidance for healthcare providers and family members whose understanding and support are essential if VSED is chosen.
This Directive was developed in Washington State but as an addendum to one’s New Hampshire Advance Directive, provides legal guidance for your healthcare proxy when the time comes when you can no longer speak for yourself.