NHDD 2023: Start planning today! Vermont Advance Directive Week: April 9-16 | National Health Care Decisions Day: April 16
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Alzheimer’s disease and other forms of dementia affect millions of people every year. It is a progressive, terminal disease that starts with mental decline (mild memory loss, confusion, inability to problem-solve, etc.), and advances to a point where individuals become unable to speak and walk, and are dependent on others for assistance with eating, dressing, bathing and toileting.
People with advancing dementia lose the ability to make decisions for themselves and their loved ones will need to make medical decisions for them at some point.
Used with permission from Adrienne Doucette & Denise Weeks. Adrienne Doucette is a companion to those with dementia, a hospice volunteer, and a passionate advocate for end-of-life planning. Denise Weeks is a caregiver, a trained advance care planning facilitator, and the author of Mantra: Repetition in the Land of Alzheimer’s.
Vermont does not have a specific dementia directive. Rather, a dementia directive can be integrated into a Vermont Advance Directive to address specific preferences regarding this disease by adding a statement “see attached dementia directive”.
The following forms have been used by people seeking to communicate specific preferences regarding dementia/Alzheimer’s.
Note: See FAQ on adding a personal statement or additional pages to a Vermont Advance Directive.
For a person seeking to document goals for care at each stage of the disease – mild, moderate and severe – and indicate the level of treatment they would want.Access Form
Enables you to appoint a health care agent, provide detailed instructions about your care, and includes provisions for those with mental health and/or psychiatric considerations.Download Form
For a person to seeking to document their wishes about when to stop providing assistance with oral feeding and fluids due to advance dementia.Access Form
For a person seeking to document the circumstances under which they would or would not want oral food and fluids to be provided due to dementia or Alzheimer’s.Access Form
Designed to supplement a standard advance directive to provide guidance to your caregivers about the care you would like to receive should you develop dementia.Access Form