Planning Ahead: Why Dementia Directives Matter
June marks Alzheimer’s and Brain Awareness Month, a time to spotlight the growing impact of Alzheimer’s disease and the importance of thoughtful planning. As more families face this progressive condition, standard advance directives may not be enough. A dementia-specific directive can offer added clarity and peace of mind.
Advance directives, such as a living will or health care power of attorney, are essential parts of estate planning. They allow individuals to state their medical care preferences and designate someone to make decisions if they’re unable to communicate. However, these documents are often geared toward sudden emergencies or end-of-life care. That framework doesn’t always align with the slow, unpredictable course of Alzheimer’s.
With Alzheimer’s, people may gradually lose the ability to express their wishes, making it difficult for loved ones to know what kind of care the person would want. This creates emotional and ethical challenges for caregivers trying to respect the person’s values.
More than 7 million Americans over age 65 are living with Alzheimer’s today, a number projected to rise to 13 million by 2050. Women face a higher lifetime risk than men, and the disease becomes more common after age 75. The costs, emotional, physical, and financial, are staggering. In 2025, Alzheimer’s care is expected to cost $384 billion, with unpaid caregivers providing the majority of support.
Despite these realities, most adults haven’t completed even a basic advance directive. Research shows fewer than one-third have a living will or have appointed a medical decision-maker.
Recognizing these gaps, physicians and elder law experts have created dementia-specific directives. These documents help individuals state what kind of medical interventions they would or would not want at various stages of cognitive decline: mild, moderate, and severe. For example, a person might want all treatments during the early stage but opt out of aggressive interventions as the disease progresses.
Although not legally binding, dementia directives are powerful communication tools. They offer guidance to families and health care providers and reduce the burden on loved ones forced to make painful decisions without clear direction.
Ideally, dementia directives should be completed while a person is still mentally capable of understanding their options. Once cognitive symptoms appear, it may be too late to complete the document meaningfully.
It’s also essential to discuss your wishes with family members and health care providers and to include these conversations as part of broader estate planning. The directive can be used on its own or attached to a traditional advance directive.
In honor of Alzheimer’s and Brain Awareness Month, consider a dementia directive and reviewing it with your estate planning attorney. Doing so can protect your autonomy and ease the burden on those you love.
If you have questions, give our office a call at (605) 275-5665.
Read more: Why Estate Plans Need Dementia-Specific Advance Directives
