How To Plan For Care During Dementia Onset

Proper estate planning includes a Power of Attorney, Power of Attorney for Health Care and an Advance Directive. So, yes, you can plan now in case you have diminished mental abilities due to dementia, Alzheimer’s Disease, stroke or injury.

Power of Attorney

A power of attorney is a document signed by the principal (you) that allows the agent (spouse, child or other loved one) to conduct business for the principal. The power granted can be expansive or limited. When doing estate planning, I generally favor the expansive version. This is to allow maximum flexibility if needed in case of severe dementia or if nursing home care is needed. An easy way to explain the expansive power is that the agent can do anything for you except: vote, change your Will or get you married. If you are married the agent could file for divorce but if you are competent you could stop it, if you wanted. A power of attorney can be cancelled anytime you wish, as long as you are competent.

A power of attorney can be of great assistance when we get older. It allows the agent to speak to others about business things such as credit card bills, utilities bills, banking issues, insurance, etc. Without a power of attorney anyone trying to assist will be told that it cannot be discussed with you. This is often a way for less scrupulous to dodge explaining why your parent is has a bank draft of $50 per month to them.

A common question is ‘can someone diagnosed with dementia grant (sign) a power of attorney?’ Anyone who has capacity to understand the document can execute one. It is possible even after a diagnosis of dementia or Alzheimer’s.

Power of Attorney for Health Care

A document signed by the principal (you) that allows the agent (spouse, child or other loved one) to receive medical information and make medical decisions if the principal is unable to do so. The agent would only make a decision if you were unable to do so. Probably the more important purpose of the power of attorney for health care is to receive information about you. If you at the hospital due to an accident and unable to speak, the hospital could not provide any information to your family without a written authorization. This would also apply if you had dementia and could not relay information to your family, the medical provider could give them the information.

The reason for separate documents is that it should be clear to medical providers that the document provides the necessary information to allow your agent to make a decision or receive the information. Also, there may be a relative or close friend with medical training that would be good to help you. This could be a person that you would not want making financial decisions or receiving financial information.

A power of attorney for health care can also be granted (signed) by anyone who has capacity to understand the document can execute one. It is possible even after a diagnosis of dementia or Alzheimer’s.

Advance Directive

A document that directs how the patient wants to treated (ventilator, CPR, IV fluids) or not treated in case of a terminal illness or permanent unconsciousness and has lost the ability to communicate. Stated differently, would you want to be kept alive by artificial means if there was no hope for recovery.

Living Will or Natural Death Declaration are different names for an advance directive.

Most everyone that needs a caregiver needs to have a durable power of attorney for financial matters and a healthcare power of attorney for health matters.