Dementia - early planning

Dementia affects people differently#

Dementia does not progress in the same way for everyone. One person may begin to lose the ability to handle money or make sound decisions quite early, while another may keep these skills for much longer. Over time, however, the abilities of a person with dementia will decline, and eventually they will no longer be able to make their own decisions about financial and legal matters.

Planning ahead can make it much easier for families and carers to manage these affairs later on. It can also mean that the person with dementia is able to take part in the planning themselves, so that their own wishes are understood and carried out.

Wherever possible, seek advice while the person with dementia can still take part in the discussion and is legally able to sign documents.

Planning ahead for medical treatment#

If a person with dementia loses the legal capacity to make decisions about their own medical care, someone else will need to make those decisions for them. Many legal systems allow a person, while they are still able, to appoint someone they trust to make these decisions on their behalf. If no such arrangement has been made, there is usually a legal process by which a court or tribunal can appoint someone to take on that role.

Recording your wishes ahead of time helps the people close to you understand what matters to you about the level of healthcare and quality of life you want. There are generally two ways to plan ahead for medical decisions:

• Appoint a decision maker. This allows the person with dementia to name another person to act on their behalf for decisions about medical treatment.
• Create an advance care directive. This is a document that sets out a person’s wishes about medical treatment, and may include specific instructions about the kind of care they would or would not want in certain situations.

These documents may go by different names depending on where you live, but their purpose is much the same. Useful steps include making sure the person with dementia has the chance to appoint a decision maker or create a directive while they are still able to, keeping copies of any documents, and making sure family members know where they are kept.

People who can help with planning for medical treatment include a lawyer, a legal advice service, and any public guardian or advocate service available in your area.

Money matters and dementia#

If a bank account is held in joint names, the partner of the person with dementia can usually keep operating it without any change. Problems are more likely if the person with dementia uses an account inappropriately, or holds accounts, credit cards or other arrangements in their name only.

To avoid these difficulties, the person with dementia can, while they are still legally able, give authority for another person to operate the account. It is important to remember that this kind of ordinary authority becomes invalid once the person is no longer legally competent.

If the person is unwilling to agree to a change, it can help to talk to the bank about possible solutions. Planning ahead here means arranging how and when the person with dementia will access their finances. A bank, an accredited financial adviser, an accountant or a lawyer can all help with money matters.

Enduring power of attorney#

In many legal systems a person who is legally competent can sign a document, often called an enduring power of attorney, that lets a nominated person look after their financial affairs if they later become unable to do so themselves. Many people set these up regardless of any illness or diagnosis.

An ordinary or general power of attorney is also available, but it is only valid while the person remains legally competent. An enduring power of attorney is different: it continues to apply even after the person can no longer manage their own affairs, and remains in force until their death unless it is revoked. That is what makes it especially useful for people with dementia, because it lets them choose, in advance, who will act for them in legal and financial matters.

To plan ahead, set up the arrangement while the person still has the capacity to do so, make sure family members know it exists, and keep a record of where the document is kept. A lawyer, a legal advice service, or a public guardian or advocate service can help.

Wills#

A will sets out how a person’s estate should be distributed after their death. A will is only valid if the person making it understands what it means. It is essential that, if a person with dementia makes or updates their will, they do so while they are still competent to sign. Make sure the will is up to date, that you know who the executor is, and that you know where the will is kept. A lawyer or legal advice service can assist.

Guardianship and administration#

Many places have a board or tribunal that can appoint a guardian or an administrator for a person who is no longer able to make decisions for themselves. If there are difficulties dealing with the person’s affairs, or if there is conflict within the family about what is in the person’s best interests, an application for the appointment of a guardian or administrator may need to be considered. A lawyer, legal advice service, or dementia support organisation can explain whether such an application is needed and how to go about it.

Key points#

• Dementia affects everyone differently, but the ability to make financial and legal decisions will eventually decline.
• Plan ahead while the person is still legally competent and able to take part.
• Options include appointing a medical decision maker, creating an advance care directive, setting up an enduring power of attorney, and keeping an up-to-date will.
• Keep copies of all documents and make sure family members know where they are kept.

Where to get help#