Advance Directive for Living with Dementia

You can include anything that might help others know how to give you the care you need and make decisions for you when you can’t make them for yourself. This could be:

• Who you want to provide care for you in your home.
• Where you want to live if you can’t live at home anymore.
• Your cultural, religious, and gender preferences about your care.
• What to do if you become combative or abusive because of dementia.
• Preferences for financing your care.
• Preferences about future intimate relationships for yourself and/or your spouse or partner.
• When you should stop driving. 

This Advance Directive doesn't address your preferences for end-of-life care. For that, you need to make a Health Care Directive (living will) to document your wishes and a Power of Attorney that names someone to make decisions for you when you can’t make them for yourself.

It is a legal advance directive under Washington state law. Medical, long-term and other providers are usually legally required to follow your advance directives. There are exceptions. 

Even if you live outside Washington state, this advance directive provides valuable guidance to your loved ones and caregivers.

It’s best to sign your directive in front of a notary. 

If you can’t find a notary, you can sign in front of 2 qualified witnesses. The form says who qualifies.

Give copies to any medical providers, loved ones, and people involved in providing your care or making decisions for you. If you have any Powers of Attorney, give copies to them.

The best way to make sure your wishes will be honored is to talk with your medical team, your care facility, your caregivers, and your loved ones about this Advance Directive. Ask them to honor your choices and decisions.

This Advance Directive is about living with dementia, but we have other directives you can use to plan for your end of life care. (See Related links below.)

The Dementia Action Collaborative's Dementia Legal Planning Toolkit can help you make important financial and health care decisions and give you a place to write them down.

Long-term care is expensive. You can pay for it with your own savings, long-term care insurance, and/or public assistance from Medicaid. We strongly recommend you seek help from an experienced elder law attorney to plan how to finance your care. The Washington Academy of Elder Law Attorneys has a directory.