End of Life Wishes and Cognitive Impairment
End of Life Wishes and cognitive impairment related questions were asked about the most at a recent panel on Medical Ethics. The Partnership for Aging in Palm Beach County, Florida presented a panel to answer survey questions by the group’s members. 
More than half dealt with the ethics for individuals, family members, and medical professionals when end of life or cognitive impairment were involved. So, the main takeaway was; have your legal documents pertaining to your end of life care and wishes in order and updated regularly.
Legal Documents for your Health Related Concerns
You have several options when picking how to state your end of life wishes. Because it is important for your wishes to be recorded in a legal document, consider working with an Elder Law Attorney. Truth is, this isn’t just an ‘older adult’ concern. Eighteen-year-olds are considered adults by the law of the land. Therefore, everyone 18 and older should designate a Power of Attorney and Medical Surrogate. Seniors tend to have medical conditions and falls more frequently. These documents state who will fulfill your wishes and what medical treatments you do or do not want, or for how long. Give this thoughtful gift to loved ones as it takes the guesswork and potential guilt feelings out of the process.
Types of Health Related Documents
- Medical Surrogate
- Medical Power of Attorney
- Living Will (Remember, a Will deals with your belongings, not your medical treatment)
- Five Wishes
- POLST – Physician Orders for Life-Sustaining Treatment
We recommend, depending on your age, you consult with your legal counsel and if over 65, an Elder Law Attorney. The above documents are similar. Some go into greater detail than others and some require just to Notary rather than an Attorney.
Whichever type of Health Related document you choose, it is vital to do them when you have your mental faculties. Alzheimer’s disease and other Dementias is usually a slow process so at the point of diagnosis or concern, is when to create your documents if you haven’t already done so. Cognitive impairment is more of a medical term diagnosed by a physician, typically a neurologist. Capacity is more of a legal term and determined by medical and legal professionals. As stated earlier, as soon as someone becomes an adult, they ought to create their medical documents. Once someone has a moderate to severe degree of cognitive impairment, it is unethical and easily challenged in the court to prepare their legal documents. So, create them early and update them every three years or so.
