Advance Care Planning

When caring for someone with Alzheimer's disease it is important to plan ahead. One of the benefits of planning in advance is that the person can participate in the decision-making process and have their wishes known. It often becomes difficult and divisive to make key decisions well after a person has been diagnosed with Alzheimer's disease. Planning in advance will help ease the transition in early retirement, financial planning, healthcare, and safety and security issues.

Five Types of Advance Directives in New York State:

• A Health Care Proxy lets you appoint a healthcare agent -- that is, someone you trust to make health care decisions for you if you are unable to make decisions for yourself.
• A Living Will allows you to leave written instructions that explain your health care wishes, especially about end-of-life care. You cannot use a Living Will to name a health care agent; you must use a Health Care Proxy.
• A Living Will together with a Health Care Proxy lets you state your health care wishes and name a health care agent.
• A Do Not Resuscitate Order (DNR) only lets you express your wish to do without cardiopulmonary resuscitation (CPR) - that is, emergency treatment to restart your heart and lungs if your heartbeat or breathing stops.
• Medical Orders for Life-Sustaining Treatment (MOLST) are one way of documenting a patient's treatment preferences concerning life-sustaining treatment.

A Health Care Agent's Rights and Obligations Under New York's Health Care Proxy Law:

Your Health Care Agent will only have the authority to make decisions related to artificial nutrition and hydration (for example, use of a tube to give you food and water) if you have communicated your wishes to him or her. You may either tell your agent or write about your wishes in your Health Care Proxy form.

Your agent will have the authority to decide whether or not your heartbeat should be restarted through cardiopulmonary resuscitation (CPR) unless you specify in your Health Care Proxy form that your agent cannot make this decision for you.

Once your agent's authority begins, he or she has the right to get your medical information and records to make informed health care decisions for you.

Your agent's decision is final unless an objecting family member or facility obtains a court order overriding the decision or disqualifying the agent.

Your agent is not financially responsible for the cost of your care.

Overall, your agent is required to make health care decisions for you according to your wishes, religious and moral beliefs, and in your best interest.

Continuing Education

• Alzheimer’s Disease and Advance Directives: A Primer for Primary Care Physicians

This webcast raises awareness among healthcare providers, especially primary care physicians about the looming crisis of increasing Alzheimer's disease in this country. It provides critical information and tools to prepare these healthcare providers to have constructive conversations with patients that have remaining capacity about their preferences for medical care in the advance stage of disease. Additional continuing education related to Alzheimer's disease and related dementias is available.