An advance directives checklist for Alzheimer's caregivers should document treatment wishes and name someone to make health decisions if the person cannot. An advance directive records those wishes and appoints a health care agent, according to CMS advance-care-planning guidance. Start while the person can understand, choose, and communicate. Alzheimer's progressively impairs clear thinking, so the National Institute on Aging recommends early planning.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Complete the core health-care documents
- Give the agent usable guidance
- Separate medical and financial authority
- Make each document valid and accessible
- Know when a medical order may also help
Complete the core health-care documents
A health care power of attorney names an agent to make medical decisions. A living will states which life-prolonging treatments the person wants or refuses near the end of life.
The Alzheimer's Association explains how these documents serve different purposes. Use this checklist: Choose an agent who understands the person's values and can apply them under pressure. Geographic convenience may help, but reliability and willingness to speak up matter more.
- Name a primary health care agent.
- Name a backup agent in case the first person cannot serve.
- Complete a living will.
- Address preferences about clinicians, treatments, and care settings.
- Discuss late-stage choices, including feeding tubes and do-not-resuscitate instructions.
Give the agent usable guidance
Forms alone cannot describe every situation an agent may face. discuss what matters most to the person, then record enough detail to guide choices when the exact medical circumstances are unknown.
cover questions such as: Avoid vague instructions such as "do everything" or "no extraordinary measures" without further explanation. Ask what those phrases mean to the person and describe the goals behind them.
- Is comfort the priority if recovery becomes unlikely?
- Which treatments would feel too burdensome?
- Are there personal, cultural, or spiritual values that should shape care?
- Where would the person prefer to receive care when choices exist?
- Whom should the agent consult before making a major decision?
Separate medical and financial authority
A health care agent does not automatically have authority over money. The Alzheimer's Association distinguishes a financial power of attorney, which can authorize someone to manage income, assets, and investments while leaving the person's own decisions in place as long as legal capacity remains.
For financial planning: If no power of attorney exists after the person can no longer make decisions, a court may need to appoint a guardian or conservator. The Alzheimer's Association notes that this process can be burdensome and differs by state.
- Name a primary financial agent.
- Name a successor financial agent.
- Clarify which financial responsibilities the agent may handle.
- Give copies to the agent, attorney, and appropriate trusted family members.
- Store the original where it can be found without delay.
Make each document valid and accessible
Advance-directive forms, terminology, witnessing requirements, and legal effect vary by state, CMS cautions. Use the applicable state requirements instead of assuming a generic online form will be legally sufficient.
Before considering the task finished: Tell recipients which version is current. A carefully prepared directive cannot guide care if clinicians or the appointed agent cannot locate it.
- Confirm that every required section is complete.
- Follow the state's signing and witnessing rules.
- Keep the original in a known, accessible location.
- Give copies to the health care agent, backup agent, clinicians, attorney, and trusted family.
- Ask the clinical team to place a copy in the medical record.
Know when a medical order may also help
A POLST is a clinician-signed medical order covering specific life-sustaining treatments for someone who is seriously ill. According to the Alzheimer's Association, it complements an advance directive rather than replacing one, and it is not available in every state.
Medicare permits voluntary advance-care-planning discussions with the patient, caregiver, or surrogate. Part B deductible and coinsurance are waived when qualifying planning occurs with the Annual Wellness Visit, according to CMS guidance on Medicare advance-care planning. Ask the clinician whether that visit can include a planning discussion.
