Doctor Develops a Dementia-Specific Advance Directive

If you were diagnosed with dementia, what kind of care would you want to receive? Dr. Barak Gaster has created a dementia-specific advance directive document that addresses that difficult question. The document emphasizes patient education by outlining what patients are likely to experience in each stage of the disease. Journalist Paula Span recently published an article in The New York Times about Dr. Gaster’s innovative work.  

Dr. Gaster discovered in his years of practice that while extra paperwork might be cumbersome for some patients and providers, standard advance directives do not address the way dementia can progress slowly over several years. Preferences can change and patients’ abilities to express those preferences will thus change over time. The document is separated into preferences during 3 distinct stages of the disease: mild, moderate, and severe. Those preferences range from “full efforts to prolong my life” to “comfort-oriented care only.”

Gaster encourages all of his patients over the age of 65 to complete this directive. He feels that it is an effective way to raise awareness and begin a dialogue about a subject that is often hard for patients and families to cope with. Span profiled one individual named Ms. Vandervelde, who appreciated the opportunity to complete the dementia-specific directive. Vandervelde had witnessed the decline her father had experienced while living with dementia. Her experience as a caregiver generated strong opinions about how her own care should be handled in the future if needed. She said, “I was not going to leave that choice to my children if I could spare them that.” Her completion of the brief and simply-worded document left her feeling relieved and empowered.

To read Span’s article, titled “One Day Your Mind May Fade. It Least You’ll have a Plan.” visit To learn more about Dr. Gaster and to download the document he has created, visit

At Weatherby & Associates, PC, we collaborate with our clients and their families by helping them to create a comprehensive plan. We believe that legal planning needs to be updated in conjunction with medical planning. To learn more about our firm’s goal of ensuring that planning is truly personalized, call our office at (860) 769-6938.


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