The baby boomer generation is getting on in years now; children born in the latter part of the boom are now in their fifties. As this generation ages, concerns about dementia arise. If there is a history of dementia in your family, you need to be thinking about the legal and financial aspects of what happens when a family member is diagnosed with this disease.
Health Care
It’s important for a dementia patient, while they are still cognizant, to make decisions regarding their long-term health care. Making a living will, and creating a durable power of attorney for health care are two of the first steps you should consider. A living will puts your wishes regarding end-of-life decisions in writing, so everyone involved knows what you would decide, were you able to. A durable power of attorney for health care, or designating a medical advocate, is critical. The changes brought about by the HIPPA standards make it illegal for a physician to discuss your condition and care with anyone but your designated medical advocate. Someone needs legal recognition to advocate for you in terms of what medical practices you receive, including DNR orders.
Financial Concerns
A person diagnosed with dementia should, while they are still able, work with their families and a financial planner to determine the best way to provide long-term care for the dementia patient. A will should be drawn up while the person is still of sound mind. The family needs to decide if the person’s finances need to be placed in a medical trust, or if the person designated as the medical advocate is capable of handling the patient’s money. Long-term care decisions, regarding staying at home or being moved to an assisted living facility or a nursing home need to be thought out and provided for.
Bank accounts need to be considered; should the dementia patient and their spouse separate their accounts, or should they remain as joint? Is the spouse, who has legal precedence in terms of medical advocacy, capable of handling the finances? What are the tax implications of separating a joint account, or keeping it intact? How will the family pay for the dementia patient’s care?
First Steps
When a family member first notices the signs of dementia, they should get the person to a doctor for a diagnosis. Some forms of dementia can be treated – dementia caused by hypothyroidism or a lack of B12 can be treated with medication. Dementia caused by a stroke may be treatable as well. Dementia caused by increased fluid on the brain is also treatable. Should the diagnosis be for a form of dementia not curable, such as Alzheimer’s disease, the patient and the family need to have a family meeting and start the decision process. As long as the patient is able to remain at home, they should; it may require a caregiver’s presence, but home is the best place as long as possible. The spouse of the patient should not be the only caregiver; care giving is an emotionally and physically draining process, and the main caregiver needs a break now and then. This needs to be provided for upfront – either another family member, or arrangements for a paid assistant must be made.
If the patient will have to go into a nursing home, be sure you look at payment options. If there is a binding legal agreement, such as marriage, between the patient and their caregiver, the caregiver may be required to shoulder the burden of paying for a nursing home. To avoid crippling financial responsibilities, a medical trust may need to be established, to pay for the long-term residence.
Make A Plan
A diagnosis of dementia is devastating, both for the patient and for his family. Getting your legal and financial ducks in a row is the first step to coping with this tragedy. Establishing a medical advocate, and a medical trust, will lift financial burdens off the shoulders of the patient and his family, and make the journey down this path slightly less difficult. Planning is your best option to be sure your loved one is cared for properly.