Worrying about your health is only part of the emotional stress created by Alzheimer’s disease. Once the reality of having Alzheimer’s begins to set in, you may begin to fret about other more practical matters and your future. Who will make decisions for you when you can no longer make them? Who will care for you when your condition worsens? Where will you live when you can no longer remain at home? How will you finance the cost of your care?
Knowing that you have Alzheimer’s gives you the opportunity to have a say in these major decisions before you lose the ability to make them. Making some important legal, healthcare, and financial decisions can give you great peace of mind and help minimize the financial impact of your condition on your loved ones.
It’s impossible for us to cover all the different legal and financial concerns that may arise in any individual situation. But with help from Manhattan elder law attorney Chfford A. Meirowitz, chairman of the New York County Lawyers Association Elder Law Committee, we can give you some general information and some important topics to contemplate. To obtain more specific information on legal or financial matters, you should contact your local chapter of the Alzheimer’s Association, use the “Resources” section beginning on page 229, or consult a financial professional or an elder law attorney.
LEGAL AFFAIRS
Before you got sick, you were probably accustomed to making decisions, big and small, throughout the day. But when someone has Alzheimer’s, the ability to make intelligent decisions is increasingly compromised as the disease progresses. Over time, you will gradually lose the ability to make decisions about your medical treatment, your living situation, financial affairs, and other major issues.
It’s difficult to know when these cognitive functions disappear, so it’s important to make some decisions while you are in the early stages of Alzheimer’s and still competent. The key is to plan ahead. Competency means that you are fully aware of what you are doing. To ensure that your wishes are respected and that sound decisions are made, you will need advance directives, legal documents that allow you to state your preferences about treatment and care, and financial decision-making. In making some of these decisions, you may want to consult an elder care attorney, a lawyer who specializes in issues affecting the elderly. Here are three decisions that you should make as soon as possible:
Choose a Durable Power of Attorney
The most important advance directive at your disposal is the durable power of attorney. Durable means that the appointed person, also called an agent or attorney in fact, will act on your behalf when you can no longer make any decisions yourself. Unlike a power of attorney, the durable power of attorney (DPA) continues to have authority over your affairs even after you have lost the capacity for sound decision-making. Appointing a power of attorney is not legally adequate for someone who is dealing with dementia.
Choose your DPA carefully. The DPA is typically a trusted family member who knows you quite well—usually a spouse, a child, or a close relative—and who ultimately becomes fully responsible for all decisions regarding your welfare, including medical and financial matters. It is important to note that the laws governing DPAs vary widely from state to state. In New York, for example, a DPA does not cover medical or healthcare decisions. In New York, you need a healthcare proxy and/or a living will to cover your healthcare decision-making. The key is always to appoint someone who you know will act in your best interests.
In the event that you have no one you completely trust to serve as your DPA, you should consult an attorney. A lawyer can help you find someone who can act as your guardian through the courts.
Making Medical Decisions in Advance
Before you got sick, you probably told your doctor whether you wanted certain medical procedures. But in the later stages of Alzheimer’s disease, the ability to make those decisions is severely hampered. That’s where healthcare advanced directives come in. Healthcare advanced directives are simple and important legal documents that permit you to plan in advance of a disability that may render you unable to make medical decisions. There are three basic kinds of healthcare advanced directives:
• A healthcare proxy (HCP) is a legal document in which you appoint an agent to make healthcare decisions for you. The proxy you choose should be someone who would make decisions which are consistent with your wishes should you become incapacitated.
• A living will is a legal document in which you express specific directions as to your wishes with respect to extraordinary measures and life-sustaining procedures such as life support.
You may have strong feelings about the use of artificial life-support systems. Perhaps you believe that you should never be placed on these systems and that death should come naturally. Or maybe you believe the opposite, that everything should be done to keep you alive for as along as possible. In any case, you can make those wishes clear by setdng up a living will. The living will states your choices for future medical decisions and allows you to legally limit or forgo any life-sustaining measures that you don’t want. • A do not resuscitate order is signed by a physician and directs that cardiopulmonary resuscitation (CPR) not be performed in the event it is required.
Planning ahead by executing healthcare advanced directives is imperative to ensuring that a patient’s treatment decisions are followed in the event she becomes unable to express them herself. It is also important to note that you must make your healthcare advanced directives easily accessible to those who may play a role in providing you with care.
Prepare a Will
Many adults today prepare a will once they have children. But if you still haven’t made out a will, you should do so now. A will details how your assets will be distributed after your death as well as who will administer your estate. Without a will, state statutes will determine the distribution of your assets.