When a loved one is diagnosed with a progressive disease like Alzheimer’s or dementia that is expected to cause declining mental and physical health, there are many important decisions that need to be made quickly – before the disease has had a chance to progress. In addition to deciding about doctors, medical treatments, and therapies, your family member must also make some legal and financial plans for the future. Advance planning is crucial as it allows the person to clearly express their wishes and participate in decision making.
Preparing Documents in Early Stages of Dementia
Senior Couple
People with early-stage dementia are still capable of understanding the aspects and consequences of legal decision making, but as the disease progresses they gradually lose the ability to think clearly. Early legal and financial planning is therefore extremely important – it is highly recommended that the affected person examines and updates their financial and health care arrangements as soon as possible after the diagnosis. Even though difficult issues often arise, advance planning can help people with Alzheimer’s and their families clarify their wishes and make informed decisions about health care and financial arrangements.
If your loved one does not create or update the necessary legal documents before their mental capacity declines, they won’t be able to ensure that their wishes will be carried out if there comes a time when they’re unable to make decisions for themselves. In such a case, the court will take care of essential matters related to your family member’s health care and financial affairs.
Legal and financial planning for Alzheimer’s disease involves three basic factors – planning for health care, planning for overseeing of finances and property, and choosing someone to make decisions on behalf of the affected person. These broad categories include a number of legal documents:
Healthcare Directives: Living Will and Power of Attorney for Health Care
Healthcare directives are documents that communicate the health care wishes of a person with Alzheimer’s disease. They allow the affected individual to outline the type of care they want under various medical scenarios (including life support and end-of-life wishes) and designate a trusted person to make health care decisions for them when they’re no longer able to do so.
1. Living will
A living will (that may also be called physician orders of life sustaining treatment (POLST)) outlines a person’s wishes regarding end-of-life care and medical treatment. It may:
- specify the extent of life-sustaining procedures and treatment the person wants;
- allow health care professionals to stop artificial life-sustaining measures if the patient has a terminal condition;
- protect the physician or hospital from liability for carrying out the patient’s instructions.
A living will shows exactly how much intervention the individual wants, so families don’t need to make painful decisions when a loved one is seriously ill. This is very important for people with a progressive disease, like Alzheimer’s, who may eventually need life-sustaining treatment. With a living will, a person can make specific requests for what should and should not be done, rather than relying on family members to make decisions in an emotionally charged situation.
2. Health Care Power of Attorney
The power of attorney for health care enables a person to appoint someone (called a health care agent or proxy) to make medical decisions on their behalf. This authority is usually given to a spouse or an adult child and can be used when the incapacitated person is either unconscious or can no longer make rational decisions because of diminished cognitive abilities.
Depending on the state laws and the person’s preferences, the proxy may be authorized to make decisions concerning doctors and other health care providers, types of treatments, care facilities, end-of-life care, long-term care insurance, and others.
The living will and the health care power of attorney can be combined in one document.
3. Power of Attorney for Finances
Powers of attorney allow a person (the principal) to name another individual (called an agent) to make financial and other decisions on their behalf when they’re no longer able to do so themselves. The power of attorney does not give the agent the authority to override the decisions of the principal – the principal maintains the right to make their own decisions, as long as they have legal capacity (the ability to understand and appreciate the consequences of one’s actions and to make rational decisions).
A power of attorney for finances enables your loved one to authorize another person (a family member, friend, or professional) to make decisions about their finances and property in areas like banking, investments, assets, sale and purchase of real estate, taxes, etc., when they are no longer deemed capable of doing so. It is essential that the power of attorney includes a durable clause that specifically states the document remains in full force and effect even if your loved one becomes mentally incapacitated, as in the final stages of Alzheimer’s disease.
The agent may be required to provide a periodic accounting to a third party, such as another family member or a lawyer.
If durable powers of attorney are not made before your family member becomes incapacitated, a court will have to establish a guardian (also known as conservator) to make decisions about your loved one’s health care and finances. This process can be very expensive and emotionally taxing, so it’s best to create the necessary document while the Alzheimer’s patient is still capable of handling their affairs. This will ensure that the individual’s estate distribution is made according to their wishes and will help avoid complications and disagreements among family after death.
4. Living Trust
A living trust provides protection and direction. It gives a person the opportunity to pool all their investments, bank accounts, titles of real estate, and other assets into a trust and provide instructions about how these resources should be handled when the individual is no longer able to manage their affairs.
Typically, the estate’s owner is named as the trustee of a living trust, so they maintain control of the property. If the person is diagnosed with a progressive disease like Alzheimer’s or dementia, they also name a successor trustee to manage the estate and its funds if they cannot do so themselves and include detailed instructions on how the money should be used if they’re hospitalized or need long-term care.
If the person becomes incapacitated, the successor trustee assumes the management of the trust for the benefit of the estate’s owner until their death. After the person dies, the trustee distributes the property directly to the beneficiaries named for the trust.
In many states this allows the avoidance of probate (the process in which the courts establish the validity of a will).
5. Last Will and Testament
A standard will is the most common form of end-of-life planning. This document outlines a person’s desires for how their property should be distributed after their death. It designates an executor (the person responsible for managing the estate) and identifies beneficiaries (the people who will get the assets the individual leaves behind – family members, more distant relatives, friends, charities, etc.). A last will can also specify arrangements for care of minors, gifts, and funeral arrangements.
A person must be of sound mind to make a will, so it’s vital to create this document (if one is not already present) as soon as a person is diagnosed with Alzheimer’s. (The will of someone with dementia can be challenged if the disease has progressed, so the earlier this document is made, the better.)
In addition to allowing your loved one to personally choose their heirs, a will makes probate easier and quicker for the family.
If a person doesn’t have a last will and testament when they die, the state will determine how their assets should be distributed.
6. Letter of Instruction
A letter of instruction provides family members with the financial and other information they need if a loved one becomes incapacitated.
This document should list all of the person’s investment accounts, real estate holdings, insurance policies, military benefits, overseas assets, loans, cemetery plot records, etc. It should also provide the location of important documents, the passwords for online accounts, and the contact information of key contacts, such as lawyers, financial advisers, and insurance agents.
The Importance of Preparing Legal Documents for Alzheimer’s Patients Ahead of Time
Various legal and financial documents are needed to safeguard your loved one’s wishes and assist you as you care for them. It’s best to ensure that these documents are taken care of in the earliest stage of the disease possible, as your loved one’s ability to make rational decisions will decline over time and they won’t have the legal capacity to make the necessary documents.
In case your loved one with Alzheimer’s or dementia doesn’t have the required documents in place, the court will have to appoint a guardian to make decisions on their behalf. The person appointed to handle the affairs of your loved one may be unknown to them or to the rest of your family and may not always have your family’s best interests in mind. Besides, finding the right guardian takes time and any delays in important decisions can lead to serious problems for the Alzheimer’s patient.
To avoid such complications and ensure that your loved one gets the best possible care and has their wishes carried out when they become incapacitated and after their death, make sure all the necessary documents are prepared (or updated) as soon as possible after your family member is diagnosed with Alzheimer’s or another form of dementia.
Also, keep in mind that seniors affected by dementia need specialized memory care that family members may not be able to provide. It is recommended to enlist the help of a reliable home care agency, like Assisting Hands, that will provide excellent care to the elderly and ensure their safety and comfort in all stages of the disease.
Alzheimer’s Home Care
At Assisting Hands Home Care, we provide a wide range of quality home care services for senior citizens affected by Alzheimer’s disease and dementia in the Batavia, IL area. Our experienced, compassionate caregivers can help the elderly with all aspects of daily living and handle common symptoms such as confusion and agitation. They will make sure the senior’s living environment is safe and well-maintained, will engage your loved one in mind-stimulating games, conversations, and other memory exercises that help slow the effects of memory loss, will accompany them on walks and escort them to doctor’s appointments, will assist them with their daily routine, and will ensure that they take their medications on time.
If you have a family member in the Batavia, IL area who suffers from Alzheimer’s or dementia, Assisting Hands Home Care is there to help – call us at (630) 332-2203 for more detailed information about our Alzheimer’s and dementia care services and rest assured that your loved one will be safe, comfortable, and well-cared for.
