October 2019 – There are now advance directives designed to change as dementia progresses and goals of medical care change.

A simple version that provides good overall guidance is available as a free download from www.dementia-directive.org.

This directive does not address nutrition and feeding, a topic that remains controversial.  Some people are choosing no “medicalized” feeding (no thickened liquids or nutritional shakes) and/or no spoon-feeding.

The developer of this directive advises it be completed before mild cognitive impairment develops.  Even at this stage, people can have difficulty imagining their future selves.

For a more complete discussion of advanced care planning in dementia, visit the End-of-Life Washington website.