Planning for Alzheimer’s:
The Legal Document that Empowers AD Patients
My family got the lion’s share of Alzheimer’s Disease.  One by one AD has stolen away the women I love.  And while I find myself missing these great women in my life, I recognize at the same time that years from now Alzheimer’s disease could be my story as well.   In fact, as I write this article (in my early forties), I’m already hyper-sensitive to those moments when I forget a name or something slips my mind.  I feel like I’m on red alert.  

In the award-winning film, Still Alice, Dr. Alice Howland, a fifty-year-old linguistics professor at Columbia University, is diagnosed with early onset familial Alzheimer’s disease.  At one point, her adult daughter asks her something not many folks ever consider asking someone with AD.  “What’s it like?  What does it actually feel like?”  So often books and articles are written to address what it feels like to care for someone with AD.  Only recently has attention been devoted to what it feels like to actually suffer from the disease.   

Alice replies, “It’s not always the same. . . . I have good days and bad days.  On my good days I can almost pass for a normal person.  But on my bad days I feel like I can’t find myself.  I’ve always been so defined by my intellect, my language, my articulation.   And now sometimes I see the words hanging in front of me and I can’t reach them, and I don’t know who I am, and I don’t know what I’m going to lose next.”  

Alzheimer’s goes hand-in-hand with feelings of helplessness, hopelessness, and loss of control.   But even in the face of such a devastating disease, there are things that individuals with Alzheimer’s can do take control of their lives and feel empowered.   Enter, the Mental Health Advance Directive (MHAD).   

Often, advance directives are used as somewhat generic forms that address only artificial life sustaining treatment in the event of incapacity.  What many people, including some attorneys, do not realize is that this document can do so much more.  A mental health advance directive, when drafted conscientiously and with the specific needs of the patient in mind, can be tailored to address a vast array of concerns and fears for the future.  It can assist caregivers and medical professionals in determining the best ways to administer care, can list life values, and can outline preferences for methods of care and treatment as well as other life decisions.  For example, a MHAD enables individuals with Alzheimer’s to articulate their preferences and instructions with regard to:
·      in-home care and out-of-home placements
·      how to address combative or aggressive behaviors
·      financing of care
·      future intimate relationships
·      suspension of driving privileges
·      myriad other fears and concerns for the future  

This document can make a monumental difference in the lives of people suffering from Alzheimer’s.  In the face of a devastating illness, AD individuals can tailor their care to their own individual needs, feel more involved in their personal decision making, and reduce the burden of decision making that might otherwise be shifted to a family member or caregiver.  In many ways, the MHAD can give AD patients their power back.   

When drafting a Mental Health Advance Directive, it is important to work with an attorney who has experience drafting MHADs specifically for Alzheimer’s individuals.  An experienced attorney will know what questions to ask and what life values and preferences to explore in order to draft a comprehensive, effective document.