Dementia Addition to Living Will

  Time For An Update?     With all of the information now available, is it time to update the standard form of a living will?     In January of this year an article in the New York Times started me on this road.  “Complexities of Choosing An End Game For Dementia” was written due to Jerome Medalie, a lawyer, who took dementia into consideration when writing his health care directives.  His motto is, “If I’m not me, I don’t want to be.”     As we all know, this disease can cause a prolonged period of complete incapacity, years in a state of lingering death.  While the current state-sanctioned and offered Living Will forms are fine for what they cover.  However, dementia affects 30 percent of us over the age of 85.  In its late stages it is hardest on our loved ones.  Many are now in search of a new “End Game,” and additional instructions are necessary.      Language would be needed to specify an irreversible and substantial loss of cognitive as well as physical abilities.  This should be followed by examples of what you feel would create a situation where you would have no quality of life, i.e. be unable to recognize or interact with your loved ones, have a complete lack of awareness of your surroundings, and/or not be able to participate in your own care.      To the extent that the law allows, you would be authorizing your health care provider and agent to follow your wishes to withhold or withdraw life support systems such as cardiopulmonary resuscitation, artificial respiration, and means of providing nutrition and hydration.      Our knowledge of this particular affliction gives us an opportunity to expand the current Living Will form.   We can specify what we would deem to be our quality of life issues and end our lives within a framework of our own choosing rather than allowing the disease to dictate.       Until the states’ forms are amended, if this is something you wish to take into account when creating or amending your living will, then legal advice is advisable.       Hopefully, in the not too distant future, all issues will be included to enhance the ability to express our wishes and make our end of life as comfortable and dignified as possible, while at the same time removing the burden from those who love and care for us.                               
Louise Kaminer LCSW                                                                                       
Stamford, CT