Known as an Advance Directive, an Advance Decision is a legally binding document, which outlines what treatment and end-of-life care a person would like to receive in future, when they are no longer able to express or communicate what treatment they would like. It’s important to prepare an Advance Decision, while the person still has capacity. Examples could be expressing a wish to have their organs donated after they die or whether or not they would want to be resuscitated if they were to stop breathing in the later stages of their dementia. Another example could be deciding they would not want antibiotics prescribed if they develop pneumonia during the later stages of their dementia. This may sound morbid, but it’s important to ensure that the person’s wishes are met. The decision must be relevant to the medical circumstances that have arisen and can only be used if the person no longer has capacity.
A person with dementia can write their own Advance Decision but they need to be clear about their wishes and describe specific scenarios like the examples mentioned. It’s worth the person with dementia discussing their advance decision with their GP first and if they are still unsure, or have further questions, they could discuss them with a solicitor, although they don’t have to use one to prepare an advance decision. It’s sensible to inform their GP that they have made one and making sure their GP has a copy. If they write their own Advance Decision, it must include the following information:
- Their name
- Their address
- Their date of birth
- The name, address and telephone number of their GP
- The date and signature
They should arrange for someone over the age of 18 to sign and witness the document. If they choose not to use a solicitor, but they have a solicitor whom they’ve used for other affairs in the past, let their solicitor have a copy. Incidentally, the laws are different in Northern Ireland. For more information, or for a template of an Advance Decision, visit Alzheimer’s Society’s website at https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=354