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Legal Issues

Along with treatment decisions and financial planning, there are legal issues that people with Alzheimer's disease and their families will face along the way. Although it can be difficult to face these issues -- such as establishing power of attorney or creating a will -- it's important to handle them early on. Making sure family affairs are in order can give everyone a little peace of mind.

Power of Attorney

Because Alzheimer's patients usually lose the ability to manage their own affairs, experts suggest that it is critical that caregivers obtain power of attorney for their loved one. In this legal process, a person authorizes a trusted family member or friend to make legal decisions for him or her.

Most powers of attorney are "durable," meaning thay are valid even after the person with Alzheimer's is no longer competent.

A general, durable power of attorney names the person or persons authorized to make choices and decisions on behalf of an individual when that person is mentally incapacitated. The extent of this power is determined by individual preference when writing the document.

Some people choose to establish separate powers of attorney for finance and for health care. The two people named would play different roles, one making financial decisions, and the other handling health care issues.

The person with the power of attorney for health care, for example, would make choices regarding organ donation, treatment changes and continuation of life support, if not already outlined in an advanced directive (see description below). The person with this power of attorney also has access to the medical records of the person with Alzheimer's. The person with power of attorney for finances usually has access to the individual's bank accounts and ensures that medical bills are paid.

If the power of attorney is not designated before an individual is unable to make competent choices, the family member or friend who wants the role is required to establish guardianship in court, which can be a lengthy and costly process for the family.




How is Competency Defined?

The idea of competency is ill-defined, even in U.S. courts. Physicians, psychiatrists and other providers have various tools, such as the Hopkins Competency Assessment Test, which they can use to assess competency. If people with Alzheimer's want to avoid such assessments, they can simply talk to their families about when they'd like others to start making decisions for them. Again, it's important to talk about these issues early. After Alzheimer's symptoms become more serious, those with the disease sometimes insist they are able to make decisions when they are not truly capable.

What is an Advanced Directive?

Advanced directives are also called living wills, and they can take the guesswork out of the health care choices that families must make when their loved one has Alzheimer's disease. Advanced directives can allow the following:

  • Outline the individual's wishes regarding life support, resuscitation, nutritional support and other procedures that will lengthen his or her life
  • Specify the role of the power of attorney for health care
  • State the person's wishes regarding his or her death

Do I Really Need a Will or a Trust?

A will reduces stress and grief for families. For those with Alzheimer's disease, it's important to update a will or living trust as soon as possible after diagnosis. Talk to an attorney or financial advisor about how to write a will. A will should specify how assets will be divided, what provisions should be made for minor children and how funds will be made available for funeral arrangements.

Establishing a living trust is also a possibility. These trusts, which are typically set up at a bank or credit union, outline the individual's assets and designate a trustee to manage the estate. A living trust is different from a will because it allows the trustee access to the funds before the person's death. In some cases, a living trust can serve as a substitute for a will.

When making decisions about trusts and a will, it's best to talk to a financial advisor who understands the intricacies of both and can help a family fully explore their options.