Planning Ahead with Alzheimer's: The Best Time to Plant a Tree ...

There is a Chinese proverb that begins by saying the best time to plant a tree is 20 years ago. When a loved one is diagnosed with Alzheimer’s disease or other types of dementia, there are so many questions. Where do you start? There are medical questions and emotional ones. There are practical questions. What can you expect? How much time do you have? Now what?

Creating a care team

I have read the heartbreaking and anguished comments by other family members on the AlzheimersDisease.net Facebook page and website who are dealing with so many issues and are already feeling behind. I think the first question is how involved are you going to be? Who is going to be on the care team, as far as loved ones are concerned? It’s amazing the strength you can gain from resolve. It’s hard when you’re not sure. You don’t have to do it alone, though. You need support. My mom had my family and me to help care for my dad. My mom has us. My brother visits when he can. He can’t right now. He lives out of state. We talk all the time. He told me he’s glad I am there taking care of mom and thanked me. His support means a lot.

My role as a caregiver

My husband and I had to have a long talk about the role we would play. We have had a lot of those talks along the way. If you have a bigger family than I do, communication, no matter how uncomfortable, is key. It’s for love, after all. Healthcare providers are also part of your care team. They can provide guidance. There are good financial advisors, too. This journey won’t be without cost.

My brother and I, after our dad died, were put on my mom’s main bank account in Mississippi. My grandpa’s will had gotten held up for years because of some paperwork issues. We are determined, as a family, not to let it happen again. Mom was good with adding us. I didn’t need it at the time, but it has come in handy lately. I have heard stories of parents with dementia accusing their son or daughter, “this stranger,” of stealing from them. It’s best to deal with finances, and most things, before it gets out of hand.

Legal and financial planning

My mom’s financial advisors that take care of her investments suggested we get a power of attorney and update her will, and ours. They connected us with an attorney that drew up all of the papers. I am the executer of her will. My brother is “first runner up,” as we call it, should I not be able to perform my duties. The power of attorney allows me to make all of the personal and financial decisions if or when she can’t. Her financial advisors have a copy. I can send copies to any institution I need to, so I won’t be locked out of anything concerning her.

Mom’s financial advisors and the attorney all talked about a “Five Year Look-Back Period” for Medicaid, and they mentioned long-term care insurance. Mom has life insurance, but long-term care insurance is different. Her health insurance will pay for short term rehab, but not a long-term stay. If Mom can’t stay home with us anymore (we also had that conversation), how will accommodations be paid for? It can get really expensive. Medicaid doesn’t want seniors liquidating their assets just so they can come in under the asset limit, so there is this look-back period. It’s not 20 years, but rather 30-60 months, depending on your state or the type. Any transactions during those months are up for review, if you are applying for Medicaid.

This journey has many twists and turns, but there is a lot you can do ahead of time. With some planning and difficult conversations, you can enjoy some shade and save yourself some much, much harder conversations later.