When your loved one has been diagnosed with dementia, there are numerous decisions that need to be made quickly. Unfortunately, time is not on your side because your family member’s condition will worsen with the progression of the disease. As a result, you will need to have a series of conversations with your loved one about a variety of topics while they are coming to terms with cognitive changes. It is an incredible burden on the family but one that you must bear to have the proper arrangements in place to look after your loved one both physically and financially.
The most important thing to remember when you have this conversation is that your loved one is struggling with their cognitive decline. They may very well be agitated and, even if they are aware of the conversation, may not want to talk in depth. Much of the success of your conversation will depend on how and when you approach them. You will want to expend a great deal of effort to put them at ease and to make them comfortable so that they will talk to you.
With that in mind, there are many different things to discuss with your loved one. The best thing to do is to separate things into several separate smaller conversations so you will not overwhelm them. Try to keep your conversations limited to one or two topics at once because you will not have many opportunities to learn your loved one’s wishes before the disease progresses.
There are many different things to discuss with your loved one when you find out that they have dementia. Hopefully, you already have a plan in place that will help provide for their care and will address things such as care decisions and finances. If you do, your conversations with your loved one will simply be about confirming that the plan still reflects their wishes. Then, you will also talk about how to plan will be implemented as their condition changes.
The difficult part comes if you do not have an extensive plan in place for senior care. Alternatively, challenges are also presented when the plan that was made is not current and things have changed since the plan was drafted and conceived. Then, you will likely need to make decisions that involve your loved one and will need their consent to many of these choices. This is where it becomes difficult considering their declining capacity.
Thus, the most important part of the conversation is the fact that you have it as soon as you possibly can. Before dementia has progressed, it still is possible to obtain valid consent from their family member. They can still sign a document and the signature would be binding. However, as they lose the ability to understand what they are signing, the less likely it is that the signature would hold up under scrutiny in court.
Here are some of the substantive conversations that you will need to have with your family member. Dementia will be something that drains physically and emotional resources so your family will need a care plan and a financial plan. Your family will need a clear decision path that lays out who is responsible for making choices that pertain to your loved one. If you need help understanding your options and the best way to put them into effect, contact a guardianship and conservatorship attorney for more help.
Your first consideration should be of who will be the person to make the relevant decisions. There will be several different choices that must be made as your loved one’s condition progresses. As you will see below, some of these involve medical care and others involve some of the specifics of their day-to-day life. The thing that is clear is that your family member will no longer have the capacity to make their own decisions.
Therefore, your family will need to designate someone to have the formal power of attorney to make decisions on behalf of your loved one. The last thing that you want is for the court to appoint a guardian because then you will lose some control over the situation. In concert with your loved one, you should select someone who will have the power of attorney. Generally, this person will execute the decisions upon which the family agrees but if the family does not agree, they will have the final say.
These conversations may be the last chance that you will have to formally get your loved one’s healthcare choices down on paper. It could be that they will an advance care directive that includes a do-not-resuscitate order. This will typically include end-of-life care decisions that will govern their care. This does not even have to encompass end-of-life care choices. The living will can also include healthcare preference before your loved one reaches that point. An advance directive can also give a durable power of attorney over health care.
You will need to have conversations about the level of care that your loved one wants as they reach the end of their life. Some people may simply not want aggressive medical care and may just want palliative care to be made comfortable.
This will be your last chance to change the person’s will if necessary. Sometimes, a will is out-of-date and needs to be updated. You can still make some changes after a dementia diagnosis. Of course, the greater the change that is made, the more susceptible the will may be to challenge at a later course in time. But you may still make some amendments to the will at this point provided that your loved one has the capacity to understand what it is that they are signing.
Even if you do make specific changes to a care plan or will, it is very important to know what your family member wants at this point of their life and then make choices in accordance with their wishes. You will need to take the time to make sure that you understand what is important to them and what their priorities are.
Blake Harris is the Managing Attorney at Mile High Estate Planning where he assists clients with Wills and Trusts, Asset Protection, and Probate. Blake has extensive knowledge and experience helping families plan for and manage the transfer of their assets.