4 Vital Planning Considerations With A Diagnosis of Dementia

By Valerie Feurich, PAC Team Member

Have you or a person in your care recently been diagnosed with Lewy Body, Alzheimers, or another form of dementia? If yes, you’ll want to consider putting a series of legal, financial, and medical documents in place to reduce your risk of stress or actions being taken that you or the person would not want.

Please note that this blog is not legal or financial advice and we recommend consulting an Elder Law Attorney in your area to ensure all documents are correctly executed.

That being said, here are a few things you’ll want to consider putting into place as soon as possible:

Health Care Planning

Dementia is a progressive condition and the affected person will require more care over time. Having?Advance Directives?to document your preferences and wishes will help you and everyone involved.

Consider implementing these documents:

• Living will?– a document that describes when and how a person would like to receive end-of-life care
• Durable power of attorney for health care, including a HIPAA Waiver?(be sure to give a copy to the person named on the document as well as to health care providers)

It’s critical to talk about and decide which type of care a person would like. As dementia progresses, different problems may arise that could trigger medical interventions.

As an example, when swallowing issues arise, the chance for aspiration pneumonia increases as food or liquids may accidentally enter the lungs. Medical professionals may recommend placing a feeding tube and using anti-biotics, but your preference may be to focus on comfort over a cure toward the end of life.

Other medical decisions include, but are not limited to:

• Do Not Intubate (DNI)?order?(let’s medical personnel know you don’t want to be placed on a breathing machine)
• Do Not Resuscitate (DNR) order?(instructs medical personnel to not use CPR or other life-support procedures should your heart or breathing stop)
• Physician Orders for Life-Sustaining Treatments (POLST)?or?Medical Orders for Life-Sustaining Treatments (MOLST)?(Inform medical personnel about your wishes for life-sustaining and life-supporting procedures during medical emergencies)

Financial Planning

If you or a person in your care has been diagnosed with dementia, making financial preparations is another critical aspect of successful planning.

Advance directives for financial planning, which communicate your or the person’s financial wishes, have to be completed while the person still has legal capacity to make decisions. The documents commonly completed are:

• A?will?(determines how a person’s belongings, such as property, money, or other assets will be distributed upon their death. May also include end-of-life and/or burial arrangements)
• A?durable power of attorney for finances?(determines who can make financial decisions when the person is no longer able to make them on their own)
• A?living trust?(empowers a person, a trustee, to make financial and property decisions on a person’s behalf when they’re no longer able to make those decisions themselves)

While there are templates available, you may want to consider hiring an Elder Law Attorney to help guide you through this process. You can find an Elder Law Attorney near you on the web, through your local library, or local bar association.

If you do not have the funds to hire an attorney, your local?Area Agency on Aging (AAA)?may be able to assist you. You may also be able to find free or reduced cost legal support at www.LawHelp.org.

To ease the process, consider bringing these types of documents to your appointment with the Elder Law Attorney:

• An itemized list of assets, such as bank accounts, property, vehicles, etc. If possible, add their current value to each item.
• Copies of recent tax returns
• Copies of real estate deeds
• Copies of all estate planning documents, such as power of attorneys, wills, and trusts
• Life insurance policies and their cash values
• Health insurance policies
• Long-term care insurance policies
• A list of contact information for involved parties, such as family members, caregivers, or financial planners

Long-Term Care Planning

People are often surprised how expensive long-term care can be.

If a person has been diagnosed with a form of dementia, consider planning early for your later long-term care needs. Nurses, Social Workers, or Geriatric Case Managers can be helpful in long-term care planning. A written care plan, a living document that can be adjusted as needed, can be a very helpful document to have in place throughout this journey.

Long-term care can be provided in a home or outside community, such as Assisted Living or a Skilled Nursing.

While planning, think about where the person can live comfortable and safely as the dementia progresses. Be sure to get information about the costs and services of communities in the person’s desired area, as they can be surprising.

End of Life Planning

At the time of this writing, there is no cure for dementia, and all dementias are terminal. As you think about end-of-life decisions, think about whether life extending medical treatments or quality of life are more important to you or the person in your care.

Starting discussions with family members early and getting necessary decisions made and documents finalized can significantly reduce stress as the condition progresses or the end of life approaches.

Be sure to update documents as situations change, store them all in one place, and share their location with a person you trust. You may want to give your physician or attorney permission to share information with other caregivers. Be sure to also place copies of all health care directives in various medical files.

Conclusion

A diagnosis of dementia can leave you feeling lost and unsure what to do. While the person may continue living a meaningful life with the condition, all dementias are progressive and the person’s needs for support will likely increase over time.

While every person’s journey of dementia is different, planning ahead and putting legal, financial, and medical safeguards into place, can help ease your path.

For more assistance in dementia care matters, consider?signing up for a free 30-minute consultation with a PAC Consultant . While they can’t offer legal, financial, or medical advice, having someone by your side to support and guide you on this journey can offer feelings of greater clarity, acceptance, and peace of mind.

Sources used in the writing of this article:

• https://www.nia.nih.gov/health/legal-and-financial-planning-people-alzheimers
• https://www.alz.org/help-support/caregiving/financial-legal-planning/planning-ahead-for-legal-matters
• https://www.alzheimers.gov/life-with-dementia/planning-for-future
• https://www.alzheimers.net/how-to-ensure-legal-protection-for-a-loved-one-with-dementia
• https://www.dementia.org/legal-documents-and-dementia