How to Plan for the Legal & Financial Aspects of Alzheimer's

Legal and financial planning are important for everyone, in case of an emergency or even simply for the future, but especially so for those with Alzheimer’s disease and their loved ones. As the disease progresses and cognitive impairment and communication get worse and physical health declines, it’s helpful to know what the individual wanted for themselves and their care, as well as their wishes for financial decisions after they’re gone.

Planning ahead of time, especially prior to any significant cognitive impairment, is crucial to making sure the appropriate decisions are made. Once an individual’s judgment or cognition are impaired, it may affect their capacity to create legal and financial documents and participate in long-term planning. It is best to check with both a doctor and a lawyer to see what is allowed in the state to see if trusted loved ones can assist with planning once the person’s executive functioning and cognition are affected, or if the person was diagnosed with later-stage Alzheimer’s disease.

Legal planning with Alzheimer's

Legal planning for someone with a medical condition often has to do with medical decisions, and involves advance directives. Advance directives in health care are forms that outline and explain the healthcare requests or wishes of an individual.¹ They are used when the individual cannot or are unable to make their own decisions. These documents are generally prepared ahead of time, when the individual is legally of sound mind and is using good judgment and not being coerced or pressured to make certain decisions. Examples of advance directives are a living will and a durable power of attorney for health care. While these can be separate documents, in many states these are combined into one; if an individual does not have them as one document, then be sure that both are drawn up.^1,2

A living will explains the individual’s preferences for medical treatment at end-of-life or if the individual is unconscious and unable to make decisions about treatment, while a durable power of attorney for healthcare names a person (usually called a proxy) to make decisions about healthcare or medical treatment when the individual is not able to do so any longer.¹

Another kind of advance directive is a DNR order, or Do Not Resuscitate order. This is a form that tells medical providers not to do CPR if the person stops breathing or their heart stops. A doctor signs the form and it is placed in the medical chart.

All of these are important and necessary documents for a person with Alzheimer’s to have because as the disease progresses, they will not be able to communicate their wishes about care. Having these documents ensures their wants are in place when the time comes.

Financial planning with Alzheimer's

Even in the early stages of Alzheimer’s disease, an individual’s judgment and planning ability may be impaired, which can have devastating effects financially. Address financial issues as soon as possible and make long-term plans for financial health while the individual can legally make sound decisions. Things to consider include a will, a durable power of attorney for finances, and a living trust.¹

A will outlines how an individual’s assets and estate will be distributed when they die.¹ It can also stipulate arrangements for any minors, gifts, trusts regarding managing the estate, and funeral/burial arrangements.¹ If the person with Alzheimer’s does not have an existing will, once a diagnosis is made, this should be done as quickly as possible. If the person has a will, it should be updated while they still are cognizant enough to legally do so.

A durable power of attorney for finances identifies someone who will make financial decisions for the individual when the person with Alzheimer’s cannot do so for themselves.¹ Having this in place is necessary because without such a person, control of the individual’s finances may be tied up in court.

A living trust is a document with instructions about an individual’s estate and appoints someone to be the trustee. This means the trustee holds the title to the person’s property and funds for any beneficiaries.¹ Once the individual with Alzheimer’s cannot make sound decisions about their financial affairs, the trustee takes over, following the directions in the document. A living trust can include all kinds of property, have detailed instructions for transferring properties, it can help avoid any delays with probate, and can provide instructions about what to do with the properties if all of the beneficiaries have died.¹

After a person has been diagnosed with Alzheimer’s disease, talk with an elder care or elder law attorney about medical and financial legal matters. While healthcare professionals can provide you with guidance and information, they can’t actually assist with legal planning for healthcare decisions. Doing these things as quickly as possible can help ensure things go as smoothly as possible when the time comes to make difficult decisions.

Considerations for those with Alzheimer's who are still working

Although most people are retired by the time they receive an Alzheimer’s disease diagnosis, some individuals may still be working. Whether and how to keep working is also a critical consideration for individuals with early-onset Alzheimer’s disease. Alzheimer’s disease is covered under the Americans with Disability Act. Considerations include whether to keep working, how to inform the employer, and possible reasonable accommodations that can be made to continue working.

Individuals can make reasonable accommodations which are protected under the American with Disabilities Act.³ These accommodations may include memory tools and reminders, help with organizing and planning, and reduced work hours. All of these decisions depend on the stage of Alzheimer’s and demands of the job. For example, an individual may need to resign from a job earlier if the symptoms of the disease make the job unsafe. Prior to making any major changes, it’s helpful to research insurance and health care benefits, as well as employee rights. It may also be helpful to have an advocate with you when talking to an employer, as not everyone is well-informed about the symptoms and progression of Alzheimer’s disease.