Health and Financial Decisions: Why These Can Loom Large After a Dementia Diagnosis
I see the question way too often: "How can I get Power Of Attorney for my dad? He's got advanced Alzheimer's disease and I need to make financial decisions for him. There will be health decisions as well. I can't get him to understand what needs to be done."
The sad part of this question is that this family could have difficulty getting the very documents they need. Once a person is diagnosed with dementia, by definition this person has cognitive problems. When someone is not mentally competent, an attorney will think twice (or more) about drawing up legal documents. Advanced Alzheimer's certainly compromises a person's ability to make the decisions necessary to create legal documents.
What I suggest they do is engage an estate attorney or an elder attorney. Some of these attorney's duties overlap, while some are more specialized, so you may have to interview a few. Ask for guidance. It is possible, with the aid of a the doctor treating the person with Alzheimer's, and records that this person may have left through the years, that an attorney could piece together documents to help the family. Still, even these documents may be challenged in court if someone is determined to do so, simply because it could be proven the parent wasn't competent when the papers were drawn up.
However, I do suggest people try, as these families will need to determine what to do for care as the parent's disease continues to create more brain damage. If there is no dissention within the family about the parent's care issues, things will go more smoothly since most doctors should be consulting the family as the treatment continues. However, if there is dissention in the family, and there often is, it gets more complicated.
Say the son wants the father to be kept alive as long as possible no matter what steps need to be taken. The daughter is sure that the father would rather die when his body gives out and he can't sustain life on his own. Who does the doctor listen to? Sometimes these families end up in court with one adult child trying to get guardianship of the parent. Ugly family battles have started over less.
Even if the family agrees on what should happen to Dad, guardianship may need to be obtained. This must be done through the court system and the family will definitely want an attorney to help them through the process. It can be expensive and drawn out. It is certainly emotionally difficult. However, this may have to be done if an attorney can't help this family get the proper documents because the father can no longer understand what he is doing when he is asked important questions.
So, what do you do if Dad has dementia and you need to get some control of money and health decisions? Dig through Dad's papers to see if he left any kind of living will, as a decade or so ago clinics were giving people forms to fill out and many did just that - and then they put them in a drawer without telling anyone they had done so. Maybe there is a little bit of a road map to follow if you dig deep enough. Talk to close friends and relatives to see if they could testify as to some knowledge of your parent's views on medical issues. If all this fails, you may have to go for a guardianship through the courts.