If you have an aging parent with dementia, making sure they complete estate planning documents such as powers of attorney could be one of the most important steps you take to protect their wishes as they age. Just over half of adults in the U.S. already have an advanced directive outlining healthcare preferences, according to a 2017 Caring.com study.
And while these are difficult conversations to have with a loved one, the alternative – especially if that loved one develops dementia – is a lengthy, expensive process to establish guardianship so you can make decisions for them. “It’s important to be able to have the power of attorney to be able to ensure that someone knows what your wishes are from a financial standpoint and a medical standpoint,” says Molly Fogel, LCSW, director of educational and social services at the Alzheimer’s Foundation of America.
5 Reasons to do the Paperwork Early
Experts recommend starting this discussion as early as possible. What follows are four main reasons to get started now.
1. Your aging parent is still able to communicate their wishes
“If someone has severe memory loss or severe cognitive impairment, then they lack capacity to execute these documents,” explains Allyson E. Gold, director of the University of Alabama School of Law’s Elder Law Clinic.
If your loved one has been told they have dementia, get an accurate diagnosis, says Fogel. This will allow you and your loved one to have some idea of the course of their dementia – essential information to bring to the table as you all plan for the future.
“A power of attorney document can only be signed by a competent individual. This is why I encourage clients as well as friends and family members to be proactive and to complete these documents before their loved one becomes mentally incapacitated,” explains Nicole T. Rochester, MD, founder and CEO of Your GPS Doc (LLCwww.yourgpsdoc.com). Dr. Rochester was a caregiver for her father, who had vascular dementia. “This probably sounds overwhelming, but the alternative is chaos,” she writes in a post on her blog about POAs .
2. You’ll save time and money
Gold points out that although you can hire a lawyer to draft a will, living will, durable power of attorney, and healthcare power of attorney, in many states you can also do these quickly and cheaply with the help of a law clinic or community group. In contrast, the process to obtain guardianship in order to help care for a parent with dementia must go through the courts – which means you’ll be burning through time and money.
3. Your aging parent preserves their autonomy
“When you do set up a power of attorney it does not mean you are taking away your power to advocate for yourself,” explains Gold. Reassure your loved one that even if they have named a person to act on their behalf, they can still direct the course of care as long as they’re able.
4. These conversations can be time-consuming and involve multiple parties
“In an ideal situation, we want all our families to engage in proper proactive planning,” says eldercare lawyer Wendy Goidel with the Goidel Law Group in Melville, New York.
The sooner you get started, the better chance you’ll have of talking through any big sticking points with your aging loved one or other relatives.
What to know about creating a POA for a parent with dementia
1. Your parent is the client. From a legal perspective, the client is the person who is authorizing the documents. Occasionally, Goidel says, two spouses will be the client.
2. The goal is establishing your loved one’s wishes for an ongoing quality of life. The documents recommended by the Alzheimer’s Association include the following.
- Power of Attorney. This document allows your loved one to name the person who will make decisions for them about legal and financial matters if they are unable to do so.
- Healthcare Power of Attorney. This type of POA specifically allows the person your aging parent chooses to make their health and medical decisions on their behalf when your parent is unable to do so. “This is the most important step anyone can take if they want to direct their care all the way to the end,” says Hattie Bryant, author of "I’ll Have it My Way: Taking Control of End-of-Life Decisions".
- Will. This document explains what your aging loved one wants to happen with their assets and possessions after their death, and names a person to serve as the executor who will carry out those wishes.
- Living Will. This is a document that outlines your aging parent’s wishes for medical care if they cannot make decisions for themselves.
3. Involving all of the players is crucial. Even though your aging parent is the client, Goidel stresses the importance of including as many family members and other service providers in the planning process as possible. Gold also recommends making sure that whoever is named power of attorney be familiar with your aging loved one’s preferences and how to carry them out.
4. Identify your parent’s hopes and needs. In addition to the legally enforceable papers such as a power of attorney, your team could help your aging parent outline all of the elements that they hope to see in place for their future quality of life, Goidel says. For example, she says, you might all discuss when your loved one would like to move to residential care, and how you can choose the best facility. Talking about legal paperwork and your aging parent’s wishes for care can be emotional. If you or your loved ones are having difficulty with the process, Fogel recommends calling the AFA’s free, confidential helpline to talk to licensed social workers at (866) 232-8484.
Although the process can be stressful, Goidel notes that by the end of it, family members and the clients often feel relieved to have a clear understanding of their loved one’s wishes.
“The documents provide peace of mind to everybody and can always be updated, as long as there is enough capacity to do that,” she says.