Almost every day new research is bringing light to the causes and symptoms of Alzheimer’s disease and Dementia. Yet, so much is still unknown. Recently, physicians at Johns Hopkins School of Medicine published an article on the difference between Alzheimer’s disease (commonly referred to as senility) and adult hydrocephalus—what some refer to as “water on the brain.” Adult hydrocephalus is caused by excess cerebrospinal fluid in the ventricles. The condition produces blockages in the brain that interfere with the body’s normal ability to reabsorb cerebrospinal fluid, causing the brain to swell with the liquid. If the liquid is removed, or drained, the individual will likely see a return of cognitive and memory function. (See article: http://www.hopkinsmedicine.org/mediaII/MNU/2006/Age.html.)
Unfortunately, there is no easy solution for the millions of men and women who are faced with a diagnosis of Alzheimer’s and Dementia. So what is to be done? Practically and legally speaking, much should be done upon receiving such a diagnosis. We have family friends and clients who were diagnosed as young as 55 years old. Rather than take the “wait and see approach,” we recommend that families act quickly and consider the following:
1. Medical Power of Attorney A medical power of attorney (MPOA) gives someone (a responsible adult) the legal right and duty to make medical decisions on your behalf, when you are no longer capable of doing so. There will come a time in most Alzheimer’s patient’s lives where the transfer of decision making is necessary. The decision should be made when the patient is able to choose the surrogate. Many MPOA forms are available at hospitals and online – this should be done immediately, and copies mailed to all family and friends so that the decision is known by all and, hopefully, will be respected by all.
2. Power of Attorney / Will Alzheimer’s knows no boundaries of race, creed or gender. Rich and pooralike will suffer from the disease. Some will need to make financial decisions that effect where their assets will go, and others will need to arrange for care absent significant assets. Giving power of attorney (POA) to a loved one or trusted friend to make these financial decisions on your behalf should you become unable, gives you the power to specify what you want done, in a manner that is legally binding. It is likewise essential that a Will be drafted. We often receive calls from our nursing home clients asking that we draft a Will for a loved one. If they have Dementia and Alzheimer’s, it is often too late to draft a Will. In most states, in order to be binding, the “testator” (or person who is the subject and signor of the Will) must have “mental capacity.” They must know who they are, what assets they have, and to whom they are giving their assets. I have gone to hospitals to draft Wills, met the testator, and been unable to assist the family upon realizing that their loved one lacks mental capacity to tell me about their Will requests. The moral of the story is a simple one – whether you have $10 or $10,000,000 in the bank, have a simple Will drafted while you are able. If you think you cannot afford one, most local bar associations have attorneys that will draft a will pro-bono (or free) for someone who cannot pay.
3. Make arrangements for long-term care Imagine having to decide where your loved one will receive care once their Alzheimer’s disease or Dementia has advanced so much that you are unable to care for them yourself. It is an awful decision making process and one that carries with it great regret and anxiety. We suggest you have the very frank conversation, before the condition advances, about the type of care your loved one wants to receive. Tour facilities, talk to families, research at home care --- and do all of this as soon as possible. When an emergency occurs or you need care immediately, your options will be limited. We often ask clients why they chose a specific facility for their loved one and the most frequent response is simple – “it was the only one that had a bed available.”
4. Investigate state and federal programs to assist with payment Are you eligible for Medicare? Did you know that, at best, it will only pay for 100 days of your care at a nursing home facility? What about Medicaid? Do you qualify? Again – these are resources that need to be investigated long before the call to an Assisted Living or Nursing Home is made. If your loved one has assets, how do you protect those assets? A consultation with an elder-care attorney should provide the insight you need to understand what programs your loved one is eligible for, or on the flip-side, how to manage assets such that the facility cannot take them all.
5. Funeral arrangements Oh boy I know this is a depressing topic – but there is no better way to relieve stress for your family than to plan your own funeral while you are alive. I mean it! Pick the place, the means – the music – do it all! Two hours of planning for yourself could save your family immeasurable cost, anxiety and worry, thus allowing your family to spend time together celebrating your life and mourning your loss…not just signing contracts. I understand that these are not easy decisions to make. But unfortunately, when dealing with an Alzheimer’s and Dementia diagnosis, there are few patient’s who will not experience significant memory and cognitive loss. This will be devastating for all involved but you can help your family by making these difficult decisions with your help and input, rather than asking them to make the decisions alone.