The medical decisions you’re most likely to face, explained before you’re in the middle of them.
Understand what to expect for your person living with dementia as they age so you can speak up for what they’d want.
Created by Dr. Brittany Lamb, ER physician since 2014 and former hospice medical director.
Many if not most of the medical decisions you’ll face are foreseeable
Dementia affects more than judgment, insight, and communication.
The brain controls the body too. As dementia progresses, mobility, swallowing, the ability to recognize symptoms, and so many other things are known to happen.
Unfortunately people living with dementia are more likely to come into the ER and stay in the hospital and they can have medical issues just like anyone else.
The things that will come up aren’t random.
You can learn what’s most likely by looking at:
- Your person’s age
- Their other medical conditions
- Their stage of dementia
We can’t predict every outcome, but you can learn how to approach your person’s medical decisions using their values before they come up.
The healthcare system isn’t set up to prepare you for this.
Make Your Plan is what I wish healthcare professionals had time to walk you through before you’re needing to make a decision in the ER, the hospital, or the doctor’s office.
I won’t tell you what you should choose on their behalf. You know your person. What I can do is help you understand what happens medically, what care options mean, and what questions to ask, so the choices you make line up with who your person is.
For most people I recommend using the program in order.
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
But depending on what’s going on for both of you, there are parts I’d especially want you to pay attention to.
Which of these sounds most like your situation right now?
Your person has MCI or is in the early stages
This is the best time to prepare, while your person is likely still able and possibly willing to take part in these conversations.
- Understand when you will need to step in to make their medical decisions, and what is possible to do with their advance directives (Module 1)
- Take care of the time-sensitive steps, like legal and financial planning, and gather their medical history before you need it in the ER (Module 2)
- Learn the three goals of care, and tipping points so you can talk about your person’s values around quality of life and when they’d want their goal of care to change (Module 3)
You’re already deciding and in the thick of it:
ER visits, hospital stays, new medical issues happening
The goal here is to stop treating each medical decision as a brand new crisis.
- Set your person’s current goal of care, so every decision has something to come back to (Module 3)
- Learn the five-step process I teach for making any medical decision, and use the guides for when a hospital stay, surgery, or a new medication is being offered (Module 4)
- Depending on what you’re facing, learn about the issues dementia itself makes more likely, like falls, infections, and delirium (Module 5), and your person’s biggest risks from conditions that come with age or their underlying medical issues (Module 6)
- Know what “code status” means before you’re asked about it at the hospital and how to manage other commonly stressful hospital situations (Module 7)
You’re wondering if the care team is recommending “too much”
or believe your person would want you to focus on their comfort
Medical decisions at this stage often come up quickly and for a lot of people are really hard emotionally. It helps to understand your person’s care options and clear up your questions ahead of time.
- Revisit your person’s goal of care and their tipping points (Module 3)
- Understand what DNR, POLST, and MOLST forms can and can’t do, and how palliative care and hospice differ (Module 8)
- Learn how swallowing problems, weight loss, and dehydration are usually handled, and what the care choices are (Module 5)
- Revisit the conditions most common with age, so you can process what’s most likely for your person and how you’ll handle them with comfort in mind (Module 6)
- Walk through the POLST form for your person’s goal of care (bonus module)
If you put your plan off until your loved one is taken to the ER or hospitalized, it will be way more stressful. Having a plan in place will help you make decisions that are in your loved one’s best interest and align with their wishes.
Pamela, daughter
I feel that if my LOWD was to be taken to the ER that I am better equipped to make an on the spot, immediate decision, according to what my loved one would have made, if they were in their correct mind.
Make Your Plan student
I’m more confident that I can and should take a more active role in guiding and selecting the medical [care] for my person. The goals of care section (Module 3) helped me a lot in that regard.
Make Your Plan student
What you’ll be better prepared to handle
As you work through Make Your Plan, you’ll understand:
- Your role as decision-maker
- Your person’s goal of care
- The medical risks most relevant to your person
- What options may come up
- What questions to ask before making decisions
- How to update the plan as things change
Same program. Two levels of support.
Choose Personalized Support if you want my eyes on your situation.
Independent Study
$397
One-time payment. Payment plan available.
For people who want to work at their own pace and email me questions along the way.
- All 8 modules plus the bonus
- Lifetime access
- Planning spreadsheet and printable guides
- Email access to me for non-urgent questions
Same lessons as Personalized Support.
Personalized Support
$697
One-time payment. Payment plan available.
For people who want my eyes on their situation.
Everything in Independent Study, plus:
- A recorded analysis from me. I review your person’s medical history document and your role as their decision-maker, then record what I’d want you to focus on first, what can wait, and what to prepare for. All tailored to you and your person’s situation.
- More specific email support. Because I know your person’s story, my answers to your questions can be more specific to what you’re facing, months or even years from now.
I am more confident about making medical decisions on my husband’s behalf; decisions that I believe he would have made for himself. I have a treatment plan that can be modified as my husband’s illness progresses and needs change. I feel prepared with customized tools to advocate for my husband with his values and preferences in mind.
Janeen, wife
The Medical Plan – it is now a road map for our family. I am more prepared to make better decisions. When speaking with medical professionals, ‘Goals of Care’ are such powerful words.
Personalized Support student
You may be wondering whether you really need a program for this.
Can’t I just Google my questions, or ask AI?
The hard part isn’t finding information. It’s knowing how it applies to dementia and to your person’s values.
Dementia changes ordinary medical care.
- A simple test or procedure may require sedation.
- A hospital stay can bring on confusion that lasts well after discharge.
- Your person may not be able to tell anyone how they feel or where they’re hurting.
Inside Make Your Plan, I’ve narrowed each common medical situation down to what you need to know to make choices that fit your person’s values.
Make Your Plan is built on:
- More than a decade caring for people living with dementia in the ER
- Educating the people who make medical decisions for them
- It’s also designed to help you make the most of the time you get with your person’s healthcare team. Visits rarely leave room for in-depth, dementia-specific explanations. With this background, you can walk in already understanding the basics and spend that time on the questions that matter most for your person.
I feel I have a place to go look for information and where to find the questions I should be asking. It will make me a better decision maker once I make the time to work through all of it.
Carol H., wife
Here’s what I’ll walk you through, module by module
Your role as their medical decision-maker
What the role really means, when you step in, and what to do with their advance directives. Plus mindset work, including how to consider yourself in all of this.
The steps not to put off
Legal and financial planning, and gathering your person’s medical history with my guidance on what to pay attention to. Knowing their history helps you see what’s most likely to happen to them, and it makes you a stronger communicator with their care team.
Their goal of care, now and later
The three goals of care, how quality of life fits in, and the tipping points that signal a goal may need to change.
Building your person’s plan
How to organize it, the five-step process for any medical decision, guides for common moments like a hospital stay or surgery, and how to update the plan as things change.
Medical issues dementia makes more likely
Falls and fractures, infections, delirium, swallowing problems, dehydration, and behavior changes: what usually happens and what care choices come up. Plus what you can do ahead of time to prevent some of these things.
Emergencies as we age
Stroke, heart conditions, COPD, kidney disease, and more. A start-here lesson helps you pick the ones that apply to your person. You’ll learn how these situations are diagnosed and the care choices that go with each goal of care.
When someone is critically ill
Code status, sepsis, respiratory failure, and what ICU care involves, so these conversations don’t catch you off guard during stressful hospital stays.
Tools to advocate
DNR, POLST, and MOLST forms, palliative care and hospice, medication reviews, and preventing falls and delirium.
Bonus: The POLST form walked through for each of the three goals of care.
A few more details
Short focused video lessons
Most under 15 minutes. About 13 hours in total. You won’t need all of it right away.
Planning spreadsheet
Keep your person’s plan in one place.
Printable guides
Bring them to appointments, ER visits, and care meetings.
Lifetime access
Come back to any lesson when something changes or your person’s goal of care needs to shift.
Email access to me
For course-related and general dementia medical questions. Not for specific medical advice.
Dr. Lamb is no doubt knowledgeable on this topic and also extremely kind. Her advice and directives are easy to receive and don’t feel overwhelming!
Cassi S., daughter
Recognize any of these? There’s a lesson on each one.
Common conditions as people are aging
- TIA (“mini stroke”) and stroke
- Heart failure (CHF)
- Atrial fibrillation
- Pacemakers and defibrillators
- Coronary artery disease (CAD)
See all 13 covered in Module 6
- COPD
- Chronic kidney disease (CKD)
- Gastrointestinal bleeding
- Diverticulitis
- Bowel obstruction
- Syncope (passing out)
- Pulmonary embolism (blood clot in the lungs)
- Aortic aneurysm and dissection
Medical issues dementia makes more likely
- Head injuries
- Hip and pelvic fractures
- Pneumonia
- Urinary tract infections (UTIs)
- When antibiotics don’t work
See all 14 covered in Module 5
- Rib and spine fractures
- Skin injuries
- Skin infections
- Malnutrition and dehydration
- Constipation
- Swallowing problems
- Mobility problems
- Delirium
- Behavior changes
Plus, I’ll walk you through hospital decisions and what you need to know about medical order forms to avoid as much stress as possible.
Common hospital situations
- CPR
- Sepsis (severe infection)
- Intubation and ICU care
See all 7
- Code Status
- Respiratory failure
- Sedation
- Trauma and critical illness
Medical order forms
- DNR
- POLST
- MOLST
Each one includes Video lesson + Printable handout
What you’d want to know before you have to make a decision.
Before you enroll
I want you to know this is right for you
Not sure? Email me at brittanylamb@blambmd.com. I’ll give you an honest answer, even if that means recommending you wait or start somewhere else.
Enrollment is non-refundable because you get instant access to every lesson and download when you join.
Want to add the analysis later? That’s possible. Just shoot me an email when you hit Module 2.
Going through it with someone else? They can join for $97 so you’re not both paying full price. Just email me after you enroll and I’ll get you a custom coupon.
Common questions
My person doesn’t have major medical issues yet. Is it too early?
This is the best time to start preparing. You can do the time-sensitive steps and learn what’s likely ahead without the pressure of a crisis.
My person is already in the middle or late stage. Is it too late?
No. Many if not most of the medical decisions you’ll face are still ahead, and the program helps you prepare for them now while making sure you’re clear on your person’s goal of care and know when it might need to change.
I’m already overwhelmed. How much time does this take?
The lessons are short, most under 15 minutes, and you have lifetime access. Many people take about 8 weeks, one module at a time. You won’t need every lesson inside but it’s there for you as time goes on and as things come up.
Will you tell me what decision to make?
No. You know your person. I’ll help you understand the medical side of things, what the care options mean, and what to ask, so you can choose what fits their values.
Can I email you with questions?
Yes. Both options include email access to me for general dementia education and planning questions related to the program. For decision-making in real time, contact your person’s care team or call 911.
Is this medical advice?
No. This is education. Your person’s own healthcare team is still the right place for decisions about their care. The program helps you get more out of your time with them.
I’m not the official decision-maker. Is this still for me?
It depends on your situation. If you’re helping make decisions alongside your person’s decision-maker, and they’re open to learning with you, you can go through the program together. Email me and I’ll get you a coupon to add a second user for $97, so you don’t pay full price twice.
If learning together isn’t realistic, you’re still welcome to join on your own to learn and prepare.
And if you’d rather start with what I recommend every decision-maker learn, without the deeper dive into dementia-specific medical issues, Medical Decision Making 101 is a 90-minute course that’s a good place to begin.
There’s no need to figure out the medical side as you go
No matter how much you’ve read or how well you know your person, it’s still going to be hard making decisions on their behalf.
Preparing for the medical side of things gives you some control over a part of dementia you can actually do something about. You get to think things through and clear up questions ahead of time instead of reacting in the moment.
This is how you can reduce so much of the second-guessing, regret, and guilt that comes with wondering whether you’re making the right choices.
The next…
- Appointment
- Hospital stay
- Call from the care team
…will come either way.
Preparing now means you’ll meet it already understanding:
- Your person’s risks
- The care options
- What to ask
I’m here to help you prepare, one step at a time.
All my best,
Dr. Lamb