Estate planning and Alzheimer’s

Original article on NIH site: The National Institute on Aging reports many people are unprepared to deal with the legal and financial consequences of a serious illness such as Alzheimer’s disease. Legal and medical experts encourage people recently diagnosed with a serious illness—particularly one that is expected to cause declining mental and physical health—to examine and update their financial and healthcare arrangements as soon as possible. Basic legal and financial documents, such as a will, a living trust, and advance directives, are available to ensure that the person’s late-stage or end-of-life healthcare and financial decisions are carried out.

A complication of diseases such as Alzheimer’s is that the person may lack or gradually lose the ability to think clearly. This change affects his or her ability to make decisions and participate in legal and financial planning.

People with early-stage Alzheimer’s disease can often understand many aspects and consequences of legal decision making. However, legal and medical experts say that many forms of planning can help the person and his or her family even if the person is diagnosed with later-stage Alzheimer’s.

There are good reasons to retain a lawyer when preparing advance planning documents. For example, a lawyer can help interpret different State laws and suggest ways to ensure that the person’s and family’s wishes are carried out. It’s important to understand that laws vary by State, and changes in a person’s situation—for instance, a divorce, relocation, or death in the family can influence how documents are prepared and maintained.

Legal, Financial, and Healthcare Planning Documents

Families beginning the legal planning process should discuss a number of strategies and legal documents. Depending on the family situation and the applicable State laws, a lawyer may introduce some or all of the following terms and documents to assist in this process:

• Documents that communicate the healthcare wishes of someone who can no longer make healthcare decisions
• Documents that communicate the financial management and estate plan wishes of someone who can no longer make financial decisions

Advance Directives for Health Care

Advance directives for health care are documents that communicate the healthcare wishes of a person with Alzheimer’s disease. These decisions are then carried out after the person no longer can make decisions. In most cases, these documents must be prepared while the person is legally able to execute them.

A living will records a person’s wishes for medical treatment near the end of life or if the person is permanently unconscious and cannot make decisions about emergency treatment.

A durable power of attorney for health care designates a person, sometimes called an agent or proxy, to make healthcare decisions when the person with Alzheimer’s disease no longer can do so.

A Do Not Resuscitate Order instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a person’s heart stops or if she or she stops breathing. A DNR order is signed by a doctor and put in a person’s medical chart.

In addition to these, there may be other documents discussing organ and tissue donation, dialysis, and blood transfusions. For more information about advance directives for health care, see Advance Care Planning: Healthcare Directives.