Planning for Alzheimer’s: Legal Strategies for Cognitive Decline

For families navigating an Alzheimer’s diagnosis, balancing everyday life with the uncertainty of the future is challenging. While focusing only on immediate needs is tempting, planning for the future can make a difference as cognitive abilities decline. Knowing which steps to take and how to protect a loved one’s well-being ensures that their wishes are honored, and their affairs are managed with care.

Why Plan Early for Alzheimer’s?

As Alzheimer’s progresses, symptoms make it increasingly difficult for individuals to manage their own lives. Early planning lets them make decisions while they still have the capacity, allowing their wishes to be documented and shared. Waiting too long to arrange legal matters can leave loved ones feeling lost, especially regarding health care decisions and financial management.

What Health Care Documents Should You Prepare?

Healthcare planning is an essential first step, as it helps outline preferences for future medical care. These preferences are often detailed in a living will and a durable power of attorney for health care.

• Living Will: A living will specifies how someone wants to be treated if, in Pennsylvania, they are permanently unconscious or in an end-stage medical condition where they can no longer communicate their decisions, such as in a permanent coma or suffering from a terminal illness. It tells doctors if someone wishes to avoid specific life-sustaining treatments, like intubation.
• Durable Power of Attorney for Health Care: This document designates a trusted person, sometimes called a “health care agent,” to make medical decisions when the individual cannot. This document is for positive care and positive treatment when your loved one can recover but is not able to make their own health care decisions; for example, due to being sedated during surgery or having lost capacity to understand medical choices.

According to the Alzheimer's Association, having these documents in place helps avoid confusion during crises. If these decisions aren’t documented, family members often have the responsibility to make unguided choices on behalf of the person, which can lead to significant stress and emotional strain.

What Financial Documents Can Protect Assets?

Financial planning is just as important as health care planning. Having documents that define how finances will be handled ensures that a person’s assets are protected and managed according to their wishes.

• Will: A will allows a person to specify how their property and money will be distributed after they pass. It may also provide instructions on guardianship for minors, select gifts and outline funeral arrangements. It is also very important that the declining loved one's family members create their own will that leaves any assets to the declining loved one in trust for the loved one, so that the funds are protected from creditors, nursing homes, etc.
• Durable Power of Attorney for Finances: This document designates someone to handle finances when the individual cannot do so. This can include paying bills, managing investments, overseeing property, and, most importantly, the ability to make unlimited gifts to the individual's heirs to potentially protect assets if the loved one needs skilled care.
• Irrevocable Trust: An irrevocable trust may be recommended in order to preserve assets for the individual's heirs and, in some instances, avoid inheritance tax.

Working with an elder law attorney to draft these documents makes individuals and families feel more secure about their future. However, those with limited resources can explore legal aid offices, nonprofit organizations and state agencies that may offer assistance.

What are Long-Term Care Options?

As Alzheimer’s progresses, long-term care planning becomes crucial. Individuals with cognitive decline may eventually require 24/7 care, whether through in-home assistance or at a facility. Personal care centers, assisted living centers, nursing homes and residential care facilities offer services for those unable to live independently. When planning for long-term care, consider the following:

• Residence Choices: Consider whether the individual will remain at home or transition to a care facility as their needs increase. Early planning can allow for adaptations to make their living space safer or for finding a facility suited to their needs.
• Community Resources and Costs: Research the cost of community resources, like home health aides or adult day care centers. It’s wise to begin saving early, as these services can be costly but invaluable for both individuals with Alzheimer’s and their families.

How Should You Approach End-of-Life Planning?

Since Alzheimer’s has no cure currently, end-of-life planning is essential. Individuals should consider their quality of life as well as treatments that may extend their lives. End-of-life plans often include decisions on whether to pursue aggressive treatments or focus on comfort measures. Family members can confidently make decisions if these wishes are documented.

Others must intervene if someone has not designated a financial or a health care agent. For families, this can be emotionally difficult.

Start Securing Your Future: Plan for Alzheimer’s Today

Facing an Alzheimer’s diagnosis can bring a whirlwind of emotions. However, taking legal steps early can bring clarity and peace of mind to everyone involved. Starting with primary documents—Will, Financial Power of Attorney, Healthcare Power of Attorney and a Living Will—can make a lasting difference in preserving one’s wishes and dignity.

Need Help with Alzheimer’s Planning?

If you or a loved one has received an Alzheimer’s diagnosis, don’t wait to plan for the future. Contact our life care planning team for a consultation to develop a tailored plan that protects you and your family during each stage of cognitive decline. Together, we will make sure your wishes are in good hands.

Key Takeaways

• Plan early: Start legal planning soon after an Alzheimer’s diagnosis to ensure that your wishes are documented.
• Designate trusted decision-makers: Name healthcare and financial Agents to manage critical decisions as needed.
• Outline health preferences: Advance directives/living wills allow you to specify medical treatments you do or do not want.
• Safeguard assets: Use wills and trusts to manage financial assets, so they are distributed according to your wishes.
• Prepare for long-term care: Consider residential options and costs for care as Alzheimer’s progresses to provide needed support.

Reference: Alzheimer’s Association “Planning After a Dementia Diagnosis”