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Advance Directives Form (Living Will) (PDF)


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Advance Directives
(eDoc PDF version)

Also known as a "Living Will"

4 pages (form/document)
Downloadable eDoc PDF • 16KB
$5.00 • No shipping charge for downloadable PDF


Wise people think ahead to their inevitable death. Will it be quick and peaceful or painful and prolonged?

You hope for the best outcome, but never know.

As a standby, everybody would be wise have an Advance Directive concerning their end of life care. Such documents are often called 'Living Wills' in everyday parlance.

An Advance Directive helps ensure that your wishes regarding your own end-of-life care are followed, in the event that you are unable to speak for yourself, due to illness or incapacity, such as Alzheimer's Disease.

ERGO offers this important document as a downloadable document (PDF) for $5.00. This particular Advance Directive concerns a person's wishes at the end of life should they become incompetent through senile dementia or Alzheimer's Disease.

Alzheimer's disease now affects 15 million globally, and nearly 5 million people in the United States, and and as many as 16 million Americans are predicted to have the disease by the year 2050. President Reagan suffered from the disease for the last ten years of his life.

Alzheimer's affects about 10 percent of people over the age of 65 and by the age of 85, half the population has it. It is the ninth leading cause of death among those aged 65 and older.

Fatal and incurable, Alzheimer's starts out as vague memory loss and progresses quickly. Patients lose their ability to find their way around, to recognize loved ones and eventually cannot care for themselves. Treatments can help slow the progression of the disease but cannot cure it.

Named after German physician Alois Alzheimer who first described the condition in 1906, it is marked by plaques and tangles around and inside brain cells. Sometimes described as tiny 'Brillo pads', the plaques are made up of a brain protein called beta amyloid. Another protein, called tau, becomes deformed and makes up the tangles inside nerve cells. As the brain cells die, the brain shrinks and loses its wrinkly appearance.

Drawn up by Faye Girsh, EdD, former chief executive of the Hemlock Society USA, the Advance Directive available through ERGO does not claim to be an enforceable legal document. It is an honest expression of a person's wishes while they still have all their marbles. Intelligent, caring people would likely respect it as a human right. Dr. Girsh calls her document "My Last Wishes (in the event of irreversible cognitive decline)" and outlines how you would wish to be treated if a brain affliction ever affected you.