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TEN THINGS TO KNOW ABOUT DEMENTIA DIRECTIVES

by: Begley Law Group

  1. What is a Dementia Directive?  A Dementia Directive indicates what form of treatment the individual prefers for each level of Dementia or that they want their Health Care Representative to make those decisions.  All adults should sign a Dementia Directive, especially those with a family history of Dementia.  The Dementia Directive should be signed by clients over age 50 even if the client has an Advance Directive.  The standard Advance Directive addresses acute or terminal end-of-life crises.  Dementia Directives deal with gradual declines in mental status.
  2. What is Dementia?  Dementia is a decline in mental ability sufficient to affect one’s personal life caused by underlying brain damage.
  3. Statistics.  One in ten older adults have some form of Dementia.  As life expectancies are increasing, it is likely that this percentage will increase over time.  Approximately two-thirds of individuals affected are women, and the lifetime risk is about one in five for women and one in ten for men at age 45.  Approximately 5% of people aged 65 to 74, 13% of those aged 75 to 84, and 33% of those aged 85 and older have Alzheimer’s Dementia.  Black and Hispanic older adults are more likely to slowly develop Dementia compared to their White peers. 
  4. Symptoms. Symptoms of Dementia are:
    1. Memory loss
      1. Struggling to remember recently learned information
      1. Repeating questions
      1. Frequently misplacing items
      1. Getting lost in familiar neighborhoods
      1. Forgetting the current date or season.
      1. Difficulty managing a household budget, following a recipe, or executing a sequence of steps.
      1. Difficulty judging distances, determining color or contrast, or navigating stairs safely.
    1. Impaired reasoning
    1. Starts mild then worsens over time
  5. Common Types.  Common types of Dementia include:
    1. Alzheimer’s Disease.  Between 60% to 80% of Americans with Dementia have Alzheimer’s disease.
    1. Vascular Dementia.  Vascular Dementia is caused by damaged blood vessels.
    1. Lewy Body Dementia.  Lewy Body Dementia is caused by abnormal deposits of protein alpha-synuclein.
    1. Frontal Lobe Dementia.  Frontal Lobe Dementia is characterized by the breakdown of nerve cells in the frontal and temporal lobes impacting personality and language.
  6. Lifestyle Issues that Increase the Risk of Dementia.
    1. Gaining weight
    1. Rising blood sugar
    1. Failure to exercise
    1. Failure to eat at least one-third of daily calories as fat
    1. Being Vitamin D deficient
    1. Too much alcohol consumption
    1. Too much consumption of diet drinks
    1. Living in crowded cities
    1. Staying single too long, causing social isolation
    1. Failing to complete secondary education
    1. Hearing loss
    1. Depression
    1. Traumatic Brain Injury
    1. Diabetes
    1. Smoking
    1. Hypertension
    1. Obesity
    1. Social isolation
    1. Air pollution
    1. Untreated visual loss
  7. Combination.  A Dementia Directive could be combined with an Advance Directive, but the better practice is to prepare and sign a special Dementia Directive to accompany the Advance Directive but as a separate document. 
  8. Levels of Care.  Levels of care should be included for different levels of Dementia.
  9. Stages of Dementia.  There are three levels of Dementia.
    1. Mild Dementia
    1. Moderate Dementia
    1. Severe Dementia
  10. Filing of Dementia Directive.  The Dementia Directive should be filed with the individual’s primary care physician.
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