Considering Legal and Financial Planning When Diagnosed with Dementia.

In this post, I will discuss the importance of legal and financial planning after a dementia diagnosis.

Unfortunately, many people do not have their finances or legal documents after a diagnosis of dementia, placing them at risk for exploitation or risk of not having their wishes carried out. Consider taking care of these things when you don't have a disease like dementia that can impair your thinking, and you can make clear decisions.

A person with dementia may lose the ability to think clearly, as their disease progresses. Managing finances or making decisions about health will become problematic. Consider reading the GeriAcademy post on stages of dementia.

Because state laws vary, I recommend considering obtaining an elder law attorney to assist with with financial planning.

Health Care Planning

Health care planning and advance directives are documents that a person completes stating their health care wishes. They need to be completed when a person is still able to make sound medical decisions. I think that any adult should have advance directives regardless of age or disease process. I have an advance care directive and a living will. If a young, healthy person were to get into a car accident and were in a coma, someone would need to make decisions on their behalf. We should not leave the people we love with the burden of making decisions on our behalf. The best gift we can give a loved one is to have our wishes documented.

Advance, health care directives, include documents such as a durable power of attorney for health care, a living will, and a do not resuscitate order.

A durable power of attorney for health care is a document that designates a person to make health care decisions when a person is no longer able to do so. A person assigned to make health care decisions is also called a health care power of attorney. A person appointed as a durable power of attorney only makes decisions when their loved one can no longer make medical decisions due to advanced disease.

A health care power of attorney does not need to be a spouse or a child; it can be anyone that a person trusts and chooses. My recommendation is that a healthcare power of attorney be an individual willing to carry out the person's wishes, even if those wishes do not align with theirs.

A Living Will is a document that records a person's wishes near the end of their life. For example, a living will state that a person does not want a feeding tube or a ventilator. Or it discusses no advanced life-saving measures if it is known that the person is likely at the end of their life.

A do not resuscitate order (DNR) instructs health care providers not to perform cardiopulmonary resuscitation (CPR). CPR is conducted if a person's heart stops or they stop breathing. It is the process of doing chest compressions and providing breaths to a person to keep oxygen flowing to their body to save their life. Patients with severe dementia are generally incredibly frail, tend not to have a good outcome, and poor quality of life if they survive CPR. Unfortunately, many individuals with advanced dementia and frailty do not survive CPR. Every individual should talk about resuscitation with their doctor in every stage of life. I make it a point to speak to my patients about DNR orders and provide education on CPR.

Your primary care provider can generally help you with discussing and planning advance health care directives. I have this discussion with my patients routinely.

Financial Planning

Advance financial directives are also crucial to complete! An attorney that practices elder law is generally an excellent source to help navigate a person's financial directives. I also recommend that financial directives be completed and revised throughout a person's adult life, regardless of health status or disease. It is important to at least complete financial directives in the early stages of a dementia diagnosis. Patients with more advanced disease no longer have the capacity to make financial decisions.

Some of the documents that an individual should consider completing include;

A financially durable power of attorney, just like a health care durable power of attorney, designates a person to make financial decisions on their behalf.

Attorneys can also help individuals set up a will to indicate how they want to distribute their assets to their loved ones. Or a living trust which designates a person to distribute money and property to the person who has dementia.

My take

I have seen individuals with dementia in the past that have lost their savings due to exploitation. A person with dementia may not be processing information at the mental age of an adult; this can place them at risk. It is crucial to help a loved one stay as independent as possible, but avoiding the process of putting finances in order can be catastrophic.

Suppose there are signs that a person with dementia is having money problems. In that case, loved ones can start setting up automatic bill pay, putting the person's number on the national do not call registry, or placing fraud alerts on credit cards and bank cards. A person with dementia may have money troubles, including forgetting to pay bills, spending more money than usual, donating large sums of money, and overspending on credit cards.

I cannot stress how important it is to address health care and financial advance directives early in the disease course. Patients with mild dementia are generally aware that they may be having difficulty with finances and more willing to allow loved ones to step in to assist. In my experience, patients with moderate or more advanced dementia may be more resistant to allowing loved ones to help them. This resistance can cause problems because loved ones may need to prove that the person with dementia no longer has the capacity to understand how to care for themselves. Proving that a loved one no longer has capacity can take time and can be difficult.

Conclusion

I hope you found this post helpful. Consider reading other posts from GeriAcademy.