Lock in preferences while you can

The need to plan for your future is relevant regardless of your health status, but if dementia is being experienced, it may be especially so – with this condition, changes in circumstances may occur more rapidly and unexpectedly.

The key with advance care planning is to do it when there is still the capacity to make decisions about future care.

If the dementia is too advanced, this capacity may be lost, and decisions may be legally void. There is nothing to stop you doing this much earlier in life – anyone over the age of 18 can do so – but most people are not that organised.

Advance care planning involves two processes – creating a document that outlines future wishes about your health care (in Queensland, this is known as an advanced health directive) and creating a document appointing someone to take over decisions about your health and finances if you become incapable of making them yourself (an Enduring Power of Attorney).

Both documents are legally binding and to my mind, both are critical.

One of their main advantages is that they make your wishes clear, so that there can be no dispute or misunderstanding about what you want when you cannot communicate this.

Health decisions in particular may have to be made in emergency situations when loved ones are under a great deal of stress. Having desires known beforehand means that they don’t have to carry the weight of making potentially life-altering decisions.

Also, you may have a number of people in your family who all love you but who have different ideas about what should happen. This may lead to disputes and unnecessary discord even though they all want the best for you.

Again, having something in writing takes away any uncertainty – what happens to you is your choice, and others around you must respect that.

The Enduring Power of Attorney document needs to be discussed with a solicitor. With this, you put in writing who you’d like to take over your health and financial decisions if you become incapable of making them yourself.

Importantly, signing it off, does NOT mean that you immediately hand over the control. The nominated person only acts on your behalf when you are no longer able to decide for yourself.

The advanced health directive should be discussed with, and signed off by, your doctor. I usually suggest this is your GP, as they often know you the best.

Completing this document allows you to write down decisions relating to your health care (not finances) into the future, including what sorts of life-sustaining treatment you may want.

It also allows you to nominate a person (or people) to take over health decisions when you can’t make them. Of course, it is best to discuss this beforehand with the person you are choosing to nominate. You don’t have to nominate anyone if you have already done so by completing an Enduring Power of Attorney.

These legal processes may seem tiresome, but once done give assurance that your wishes will be respected and upheld into the future.

Kailas Roberts is a psychogeriatrician and author of Mind your Brain — The Essential Australian Guide to Dementia now available at all good bookstores and online.
Visit yourbraininmind.com or uqp.com.au