Vidyya Medical News Service
Volume 6 Issue 256 Published - 14:00 UTC 08:00 EST 12-Sep-2004 Next Update - 14:00 UTC 08:00 EST 13-Sep-2004
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Information for patients: Advanced medical directives

It's hard to face losing a loved one, especially during the long, steady decline of a disease like Alzheimer's. But, says Dr. Judith Salerno, deputy director of NIA, "If we start planning for illness before it occurs, we will take some stigma away from how we choose to live with the disease."

Many people complete an advance medical directive to state their wishes for end-of-life care, in case they become unable to make these decisions themselves. With this document, an individual can designate someone to take appropriate actions and make decisions, and guide family members in the event that they must choose, for example, whether or not to withdraw life support in a hopeless situation.

Dr. Virginia Tilden, in a study funded by NIH's National Institute of Nursing Research at the Oregon Health Sciences University, found that end-of-life decisions are especially difficult and stressful for family members in the absence of guidance from the patient. Having an advance directive in place helps family members and other caregivers lower their level of stress and achieve a sense of acceptance and calm from "doing the right thing."

Patients in the early stages of Alzheimer's disease or facing a terminal illness should consider placing an advance directive in their records while they can still think and communicate clearly. However, only about 50% of Alzheimer's disease patients have an advance directive. Without one, the healthcare team must often intervene to help family members arrive at a consensus, preserve the patient's dignity and quality of life, and begin the healing for those left behind. By providing a way for patients to express their wishes, advance directives can ease the stress and anxiety surrounding the sensitive decisions of end-of-life care.

For more information on advance directives from NIH's National Cancer Institute, visit or call the Cancer Information Service:

Toll-free: 1-800-4-CANCER (1-800-422-6237)

TTY (for deaf and hard of hearing callers): 1-800-332-8615

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