Considerations for Aging: Dementia Planning

Although it can be difficult to plan for aging, it’s important to give consideration to how you would like to receive care in the event of a dementia diagnosis. According to a recent study, the lifetime risk of dementia at age 70 is 30.8% for men and 37.4% for women1.  Taking steps to create or clarify your plan before a dementia diagnosis occurs is important for your physical, emotional, and financial well-being.

The first consideration when contemplating any medical concern is to review your current estate planning documents to ensure that you’ve selected someone to make health care decisions for you. This designation, called Power of Attorney for Health Care or Health Care Proxy, identifies an individual and gives him or her the legal right to make health care decisions on your behalf. While people often name a spouse, child, or parent, the choice is not limited to blood relatives. It is critically important to review who you’ve named and to make sure that you are still comfortable with that decision. Additionally, we recommend that you have a conversation with the person you’ve named, to let him or her know that they are your Proxy and to discuss your wishes.  Often, people wish to include their final wishes for health care in their estate planning documents, via a document called a Living Will or Health Care Advance Directive.  These documents can include, among other things, your wishes related to end-of-life care, including a Do Not Resuscitate (DNR) order if you wish to have one.

Financially, consideration should be given to acquiring a Long-Term Care Insurance policy if you do not already have one or don’t have enough assets to self-insure. These policies can supplement both traditional health care and retirement savings, serving as a way to partially pay for care in the event of a long-term illness or disability, including a dementia diagnosis. Unlike traditional Medicare, which only covers specific hospital, nursing home, and rehabilitation-related services, Long-Term Care Insurance pays for maintenance related care, including in-home nursing and assisted living facilities, for those who are no longer able to care for themselves. As with most insurance, it is best to purchase these policies well before needing them. Having a long-term care policy can provide peace of mind for you and your caregivers.

Because of the complexity of any dementia diagnosis, it is important to consider how you would like to be treated as the disease progresses. In early stages of the disease, you may be able to carry on with your life with little change. However, as the disease progresses, you will need an increasing amount of physical care and supervision. If it is your desire to be cared for by a spouse or child, it can help to clarify in advance your wishes for your continued care. If you’d like to try to remain at home, it is important to make accommodations for this type of care, such as wheelchair accessibility, safety features, and consideration for receiving skilled in-home nursing. If you’d rather be cared for in an assisted living or nursing home, it can be helpful to visit these facilities with someone you trust and come to a conclusion about which one you’d like to live in.

Lastly, it will be helpful for you to make sure that your important documents and information are organized and in a location where your key caregivers know to look for them. You should include your estate planning documents, list of financial accounts and recent statements, insurance policies, and important bills and account numbers for utilities, home maintenance, outstanding loans, and credit cards. If you’d like someone to be able to access these accounts on your behalf, a list of online accounts and passwords should also be included.

If you’d like to discuss these concerns in more detail, please reach out to your Wealth Advisor.

Additional resources are available from:

The Conversation Project

Dementia Directive

https://link.springer.com/article/10.1007%2Fs13524-017-0598-7