Hard to anticipate
K, an 81 year old friend, asked me to help her write her Advance Decision to refuse treatment. K is relatively well, and physically and mentally quite active. When we sat down she was at sixes and sevens as to where she should begin. She just could not grasp the concept of being unable to make her own decisions. It required that we discussed a few different scenarios.
As we had just climbed three flights of narrow stairs to get to the computer room, I asked her what might happen if she fell down the stairs and ended up unconscious with a serious head injury? Her partner also over 80 years of age had had a transitory episode of memory loss and inability to speak. It was only after exploring the consequences of these events that she understood that writing her Advance Decision needed to focus on the possibility of her being in a coma or in a minimally conscious state or otherwise unable to communicate. K was then clear what treatments she would wish to refuse.