Take into Consideration: Planning for the Long Term

Much of Dementia care boils down to anticipating and planning for challenges you will face.

As a first step, the person or persons responsible for a loved one's care must have the legal rights to do so. Legal permission involves becoming the designated power of attorney (POA), or under certain circumstances, the conservator and guardian.

The amount and type of long term care your loved one needs is one of the first decisions you and your family will make.

Concerning home care, who will be the primary caregiver? What happens if it becomes neither realistic nor safe to shoulder caregiving responsibilities alone? Is the next step hiring a paid caregiver? Is the paid caregiver one that you hire or one contracted through a home care service? What are the criteria that make it necessary to transition your loved-one from home to an assisted living facility?

Some individuals fervently believe they will be his or her loved one’s caregiver throughout the illness. However, as is often the case, circumstances change. Therefore, you must anticipate and plan for modifications in the type and amount of care your loved one may eventually need. 

Research the options before you need them!

Contact your friends to discover if they know of a reliable caregiver or affordable homecare support. Look into non-profit organizations that provide various types of home care services. Visit assisted living facilities, speak with the director, ask about the services included in their monthly fees, view their inspection reports, and tour the facility. Learn the differences between a continuum of care, independent living, assisted living, and memory or dementia care. Become familiar with the steps you must take before you can place your loved one in an assisted living facility.

It may be months or even years before you come to this cross-road. However, doing your homework will minimize the time and stress of needing to take, often on short notice, this big step.

Developing the “what, if then, or buts” of medical care is another feature of a long-term care plan. Will your loved-one receive care from his or her family doctor or a Dementia care specialist? Research palliative and hospice care to be sure that preconceived ideas do not color your views. Learn about the purposes for palliative and hospice care, the best time to initiate them, and how they impact quality-of-life and end-of-life care. These last decisions are prone to family conflict and long-lasting feelings of ill-will.

A long term care plan includes funeral arrangements as well as various estate considerations. It’s not ghoulish to plan for the funeral. Cremation, embalming with or without embalming fluid, and burial location – are a few of many examples of the difficult and emotional decisions families make.

Prepare yourself for the eventual transition from caregiver to the representative of the estate. What are the responsibilities and the steps you must take to close the estate?

A long term care plan helps families navigate the challenges that dementia care present. Be sure to frequently review, update, and revise your loved one’s long term care plan.

Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

It's Not Bad Luck

Believing it may bring bad luck, many people resist getting their legal and financial affairs in order for as long as possible. However, it’s not having taken care of these matters that will bring bad luck to you and your immediate family. And, as with all complicated family transactions, communication is the key to success (hopefully) without stress.

The power of attorney (POA) is a legal document where you designate a person - family member, friend, or another individual such as a lawyer, the right to act in your behalf. As is true for many legal procedures, the details vary from state to state. However, granting a POA to a designated individual involves a lawyer, a witness, and a notary.

While your doctor appreciates hearing your concerns, he cannot respond to comments or discuss a loved-one’s condition without having a copy of the health POA on file. This document assures the doctor, as well as other healthcare providers, that the named individual has the authorization to receive confidential information and to make medical decisions on your behalf.

A second POA document gives a designated person permission to sign checks, deposit or withdraw money from your bank accounts, or interact with businesses on your behalf. Similar to the medical POA, the banks and businesses must have a copy of the POA on file before there can be an exchange of information or documents. It is best to designate the same person on both POA documents.

Only people who are demonstrably competent to make well-founded decisions may sign POA papers. If this is not the case, a family member, may feel it is necessary to file a request with the courts to become your guardian and conservator – a lengthy, expensive, and emotionally exhausting process. People who have early-stage dementia usually have the capacity to make decisions and therefore are capable to sign power of attorney papers.

With regard to personal finances, it is important to develop a comprehensive plan that both conforms to applicable state and federal regulations as well as parallels the stipulations of your POA documents. The comprehensive plan makes it possible for a family, or another designated person, to manage your finances in the case of infirmity. Upon death, your designee has immediate access to your accounts and thereby makes it possible for him to pay bills as well as to meet other expenses.

A similar plan should be applied to the management of any stocks, bonds, and certificates of deposit you may have. Trusts and annuities are other areas for exploration as are life and long-term care insurance policies.

Most people do not have the time, inclination, or the skills to develop a comprehensive plan to protect their savings and other assets

You can accomplish some of these tasks, such as opening joint bank and checking accounts with the help of a bank associate. However, it’s imperative that you confer with the professionals who specialize in developing an individualized, comprehensive, and long term plan to create income should you become infirm as well as to supplement your social security or disability benefits. Other facets of your individualized financial plan include strategies to protect your assets, and eventually, your estate. Some of the professionals you may need to see include an estate lawyer, an accountant, a financial advisor, and an insurance underwriter.

Yes, it is true. Neglecting to care of these legal and financial matters long before needed guarantees a future of insurmountable difficulties for you and your loved-ones.

Source: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org