The day-to-day struggles of a degenerative disease are enough to occupy all your time and attention. But when you are diagnosed with a condition like Alzheimer’s disease, just getting through the day is not all you have to face.
It’s also critical to deal with the legal and financial issues that can arise as your condition progresses. Since Alzheimer’s can worsen rapidly and unexpectedly, the Alzheimer’s Association recommends updating your legal and medical planning documents as soon as you are diagnosed.
Start by creating a will. This document outlines what will happen to your assets and property after your death. It can also designate care and financial provisions for minor children, establish gifts for friends and family, create a trust for your property, and outline your preferred funeral arrangements.
If you do not have a legal will on file, most state governments have a system for dividing up personal property that your heirs will have no control over. To make sure that you are complying with all state laws, you may find it helpful to work with an attorney who specializes in estate planning or elder law.
You also need to designate someone with durable power of attorney to make decisions about financial and legal matters once you are no longer able to do so.
This person will be responsible for making decisions about how your money should be spent on care or other expenses, such as travel for your family and caregivers, as your condition worsens; this helps your family avoid legal battles or court orders that could take away control of your finances. The person with power of attorney is usually also responsible for making sure the wishes outlined in your will are honored after your death.
Many people give power of attorney to a spouse, sibling, or close friend. If your first choice is in poor health, elderly, or frequently spends time in another country, you may want to designate a secondary choice as well.
In addition to your standard will, you should also create a living will. This document outlines your wishes regarding decisions such as continued treatment, pain management, life support, and resuscitation. It also enables medical professionals to carry out your instructions without facing liability. Having a living will allows you control over your care and dignity through the end of your life. An advance medical directive further lets you plan ahead for the care you’d want if you could no longer express your wishes.
If you wish, your living will can also contain a DNR, or do not resuscitate order, which instructs doctors not to attempt cardiopulmonary resuscitation if your heart or breathing stop. This order is printed out and put in your medical chart where everyone involved in your care can see it.
The legal rules for living wills can vary from state to state, so it’s best to consult a local lawyer who specializes in end-of-life planning.
Finally, you need to choose a legal healthcare proxy who has durable power of attorney for your care. This person is responsible for making decisions about your care and treatment once you are no longer able to express your own wishes.
Your proxy will be able to refuse or accept treatment on your behalf, move you between healthcare providers or facilities, access your medical records, make decisions about organ donation, and execute the orders in your living will. This could be the same person, or people, with power of attorney over your financial and legal matters.
End of life care can be difficult to think about and discuss with your loved ones. A social worker or geriatric care manager can help you talk through these complex and emotional issues.
Depending on your unique situation, you may need other legal and financial plans in place. For example, if you own your own business or are a partner in one, if you have a large estate, or if you are a beneficiary of a trust, you may need other documents establishing how your property and affairs should be managed.
Consult a lawyer to make sure you have planned for every contingency and protected both yourself and your family from legal and financial uncertainty.
If you can’t afford a lawyer, most states provide samples of their health planning documents, and there are resources available online to guide you through creating a will or designating durable power of attorney. Your state legal aid office or Agency on Aging may also be able to offer advice or legal counsel for free.
July 20, 2016
Janet O’Dell, RN