Many people are unprepared to deal with the legal and financial consequences of a serious illness such as Alzheimer’s disease. Legal and medical experts encourage people recently diagnosed with a serious illness—particularly one that is expected to cause declining mental and physical health—to examine and update their financial and health care arrangements as soon as possible. Basic legal and financial instruments, such as a will, a living trust, and advance directives, are available to ensure that the person’s late-stage or end-of-life health care and financial decisionsare carried out.
A complication of diseases such as Alzheimer’s is that the person may lack or gradually lose the ability to think clearly. This change affects his or her ability to participate meaningfully in decision making and makes early legal and financial planning even more important. Although difficult questions often arise, advance planning can help people with Alzheimer’s and their families clarify their wishes and make well-informed decisions about health care and financial arrangements.
When possible, advance planning should take place soon after a diagnosis of early-stage Alzheimer’s disease while the person can participate in discussions. People with early-stage disease are often capable of understanding many aspects and consequences of legal decision making. However, legal and medical experts say that many forms of planning can help the person and his or her family even if the person is diagnosed with later-stage Alzheimer’s.
There are good reasons to retain the services of a lawyer when preparing advance planning documents. For example, a lawyer can help interpret different State laws and suggest ways to ensure that the person’s and family’s wishes are carried out. It’s important to understand that laws vary by State, and changes in situation—for instance, a divorce, relocation, or death in the family—can influence how documents are prepared and maintained.
Advance directives for health care are documents that communicate the health care wishes of a person with Alzheimer’s disease. These decisions are then carried out after the person no longer can make decisions. In most cases, these documents must be prepared while the person is legally able to execute them.
A Living Will records a person’s wishes for medical treatment near the end of life. It may do the following:
- specify the extent of life-sustaining treatment and major health care the person wants
- help a terminal patient die with dignity
- protect the physician or hospital from liability for carrying out the patient’s instructions
- specify how much discretion the person gives to his or her proxy (discussed below) about end-of-life decisions
A Durable Power of Attorney for Health Care designates a person, sometimes called an agent or proxy, to make health care decisions when the person with Alzheimer’s disease no longer can do so. Depending on State laws and the person’s preferences, the proxy might be authorized to:
- refuse or agree to treatments
- change health care providers
- remove the person from an institution
- decide about making organ donations
- decide about starting or continuing life support (if not specified in a living will)
- decide whether the person with Alzheimer’s will end life at home or in a facility
- have access to medical records
A Do Not Resuscitate (DNR) Order instructs health care professionals not to perform cardiopulmonary resuscitation if a person’s heart stops or if he or she stops breathing. A DNR order is signed by a doctor and put in a person’s medical chart.
Advance directives for financial and estate management must be created while the person with Alzheimer’s still can make these decisions (sometimes referred to as “having legal capacity” to make decisions). These directives may include some or all of the following:
A Will indicates how a person’s assets and estate will be distributed upon death. It also can specify:
- arrangements for care of minors
- trusts to manage the estate
- funeral and/or burial arrangements
Medical and legal experts say that the newly diagnosed person with Alzheimer’s and his or her family should move quickly to make or update a will and secure the estate.
A Durable Power of Attorney for Finances names someone to make financial decisions when the person with Alzheimer’s disease no longer can. It can help people with the disease and their families avoid court actions that may take away control of financial affairs.
A Living Trust provides instructions about the person’s estate and appoints someone, called the trustee, to hold title to property and funds for the beneficiaries. The trustee follows these instructions after the person no longer can manage his or her affairs.
The person with Alzheimer’s disease also can name the trustee as the health care proxy through the durable power of attorney for health care.
A living trust can:
- include a wide range of property
- provide a detailed plan for property disposition
- avoid the expense and delay of probate (in which the courts establish the validity of a will)
- state how property should be distributed when the last beneficiary dies and whether the trust should continue to benefit others
Elder Law Attorneys (ELAs)—An ELA helps older people and families:
- interpret State laws
- plan how their wishes will be carried out
- understand their financial options
- learn how to preserve financial assets while caring for a loved one
Health Care Providers—Health care providers cannot act as legal or financial advisors, but they can encourage planning discussions between patients and their families. Qualified clinicians can also guide patients, families, the care team, attorneys, and judges regarding the patient’s ability to make decisions.
Overview of Medical, Legal, and Financial Planning Documents
How It Is Used
|Living Will||Describes and instructs how the person wants end-of-life health care managed|
|Durable Power of Attorney for Health Care||Gives a designated person the authority to make health care decisions on behalf of the person with Alzheimer’s|
|Do Not Resuscitate Form||Instructs health care professionals not to perform CPR in case of stopped heart or stopped breathing|
How It Is Used
|Will||Indicates how a person’s assets and estate will be distributed among beneficiaries after his/her death|
|Durable Power of Attorney for Finances||Gives a designated person the authority to make legal/financial decisions on behalf of the person with Alzheimer’s|
|Living Trust||Gives a designated person (trustee) the authority to hold and distribute property and funds for the person with Alzheimer’s|
Berger Estate & Elder Law, P.A. provides a comprehensive plan for families navigating the devastating effects of Alzheimer’s Disease. We will assist you in meeting your family’s needs to protect quality of life and financial security for the entire family. We will discuss Powers of Attorney and Guardianship, appropriate housing and financial planning to help ensure the best quality of care and life for your family member.
Source: National Institute of Aging