Dementia and Advance Directives

Many people are making the decision to plan cremation services in Glendale, AZ before they get older and before they develop serious health conditions, including dementia. As part of their planning, these people are also making sure their end of life documents, such as wills or trusts, medical power of attorneys, durable power of attorneys, and advance directives are up to date.

An advance directive is something everyone should have. It includes a living will and any specific medical interventions that a person may want excluded from their medical treatment if they are in a life-threatening situation. A medical power of attorney is also often considered to be part of an advance directive.

A medical power of attorney lets you appoint someone to make medical decisions, in accordance with your living will and any other treatment exclusions in life or death situations, when you are unable to make them yourself.

When people develop dementia, their advance directives become very important. The person who is their medical proxy steps in to make medical decisions that are in line with their wishes and in their best interests.

But this can be a dicey situation in some cases because making medical decisions in someone’s best interests doesn’t always fall into the black and white parameters of living wills and treatment exclusions.

Sometimes, making a medical decision about treatment is obvious. For example, you are the medical proxy for someone who has dementia and suffers from end-stage congestive heart failure. They develop a gallbladder infection. They have a cold clammy sweat. They are nauseated and vomiting. They are in pain.

You take them to the emergency room where the gallbladder infection is diagnosed. A gastroenterologist recommends removing the gallbladder, which means going under general anesthesia. Not only is this likely to worse cognitive function, but with end-stage congestive heart failure, the odds of dying on the operating table are greatly increased.

Therefore, as medical proxy, you would ask the gastroenterologist to treat the gallbladder infection with an alternative method that doesn’t require general anesthesia. They decide to put in a drain that can be used to manually pull off the infection, in conjunction with antibiotics, under twilight anesthesia.

However, there are other times when making the decision about possible life-preserving solutions is more complex for dementia patients. For example, if you are the medical proxy for a dementia patient who has an irregular heartbeat, you are presented by cardiologists with an option for a pacemaker.

While a pacemaker doesn’t technically save a life, which a living will might preclude, it can extend life. Therefore, you are presented with the dilemma of whether you’re going against the wishes of your loved one if you authorize a pacemaker implant to regulate the heartbeat.

The real complicating factor here, however, is whether regulating the rhythm of the heart is in the best interests of someone who is already declining, not just mentally, but also physically, in the throes of dementia.

Does the potential for a little more time to live add any quality to the life of someone with dementia? Will more time bring more decline as the neurological ravages consume more of the brain and further reduce ability and cognition?

In short, advance directives for people with dementia bring a more nuanced question: is it worth it?

For more information about preplanning cremation services in Glendale, AZ, including grief resources, our caring and knowledgeable staff at Simply Cremations & Funeral Arrangements is here to assist you. You can visit our funeral home at 16952 W Bell Rd., Ste 303, Surprise, AZ 85374, or you can call us today at (623) 975-9393.