A living will is a written record of medical treatments a person wants or refuses near the end of life. Alzheimer's caregivers should complete it early and pair it with a durable health-care power of attorney naming a trusted decision-maker. Alzheimer's progressively affects clear thinking, so the person should make and communicate choices as soon as possible after diagnosis. The National Institute on Aging recommends early planning, while the person can still participate meaningfully.
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
- Assemble the right documents
- Record specific treatment choices
- Choose and prepare the health-care agent
- Follow state requirements
- Share, store, and update the plan
Assemble the right documents
A living will covers medical treatment preferences, including whether to receive life-prolonging treatment. It does not appoint a decision-maker or authorize anyone to manage money. Complete these documents together: The health-care agent may need to decide about treatments, care settings, feeding tubes, or do-not-resuscitate orders.
The Alzheimer's Association explains the different roles of these legal documents. Advance directives take effect when the person can no longer make decisions. Until then, the person continues making and communicating personal medical choices.
- A living will stating treatments the person wants or refuses
- A durable health-care power of attorney naming a trusted medical decision-maker
- Any state-required advance-directive forms
- A separate durable financial power of attorney, if someone will manage income, assets, or investments
Record specific treatment choices
Avoid broad instructions such as "do everything" or "no heroic measures" without documenting what those phrases mean. Review each treatment separately: Ask the person's physician to explain the choices in practical terms.
Discuss whether preferences would change with the medical situation, expected burdens, or the possibility of recovery. Late-stage Alzheimer's can involve swallowing problems and pneumonia, making decisions about feeding tubes, antibiotics, and comfort care especially relevant. Record the person's choices before a crisis requires someone else to interpret their wishes.
- Cardiopulmonary resuscitation and a do-not-resuscitate order, or DNR
- Intubation and a do-not-intubate order, or DNI
- Ventilator support
- Feeding tubes
- Antibiotics
Choose and prepare the health-care agent
Select an agent who understands the person's values and is willing to make difficult decisions. The agent should know where the documents are stored and which relatives, physicians, or care teams have copies. Discuss more than individual procedures.
The conversation should also cover preferred care settings, acceptable life-prolonging treatment, feeding support, DNR instructions, and the person's priorities for comfort. A clear directive guides the agent but does not eliminate every judgment call. If the documents do not address a particular situation, the agent may still need to decide on the person's behalf.
Follow state requirements
Living-will and health-care-power-of-attorney rules vary by state. Use the required state forms and follow all instructions for completing and executing them. A physician, hospital, social worker, or attorney can help locate the correct documents and explain local requirements.
MedlinePlus advises using state-specific forms or obtaining qualified guidance. Check every form for missing names, signatures, dates, or required formalities before distributing it. An incomplete document may not provide the clear direction the caregiver expects.
Share, store, and update the plan
Give copies of the completed directives to: Keep the originals accessible rather than in a location caregivers cannot reach during an emergency. If the person changes a preference, replace the old documents and redistribute the revised versions. Ask whether a POLST or MOLST is appropriate.
This clinician-signed medical order records specific life-sustaining treatment preferences, complements an advance directive, and is not available in every state. Do not rely on the living will for financial authority. A separate durable financial power of attorney may be needed and must be created while the person still has legal capacity, according to the National Institute on Aging's planning guidance.
- The named health-care agent
- Close family members involved in care
- The person's physicians
- Hospitals or other providers maintaining medical files
