How can I plan for the future?
Dementia affects people differently. One person may begin to lose the ability to handle money at an early stage, while another person may keep these skills much longer. So how do you plan for these changes?
Why is it important to plan ahead?
It can be confronting to think about the future and the changes you or your loved one with dementia might experience. But whether it happens quickly, or takes longer, dementia is a degenerative condition and a person with dementia will eventually be unable to make decisions about their financial and legal matters.
Planning ahead can make it easier for families and carers to manage the affairs of a person with dementia. It may also mean that the person with dementia can participate in the planning and make sure that their wishes are carried out in the way that they would like.
If you can, starting this process early may mean the person with dementia can participate in the discussion and is legally competent to sign any documents.
Rodney and his wife Kath had always been conscious of having plans in place for the future. Rodney said that having conversations about financial and legal matters early and before Kath’s dementia deteriorated, has helped him know what she would want now.
“You don’t think a dementia diagnosis will be in your future but having plans in place about the future in case something happens is important. My wife doesn’t have capacity now to discuss financial things, so I’ve had to make decisions myself,” Rodney said.
“Although I have found it to be quite a lonely venture as we would have discussed the options together, it has helped that we already had discussions about the future before her diagnosis.”
Where do I start?
There are a few things to get in order as soon as possible and ideally when the person with dementia still has the capacity to be involved.
Bank accounts
If a bank account is in joint names, the partner of the person with dementia can continue to operate it without any change in arrangements. However, problems can occur if the person with dementia uses the account inappropriately or has accounts in their name only. To avoid these difficulties the person with dementia can give authority, while legally competent, for another person to operate the account. It is important to remember this authority will be invalid if completed when the person is no longer legally competent. If they are unwilling to agree to a change of arrangement it may be helpful to consult the bank manager about a possible solution.
Enduring Power of Attorney
In most Australian States and Territories, a person can sign a document called an enduring power of attorney if they are legally competent at the time of signing. An enduring power of attorney is a legal arrangement that enables a nominated person to look after the financial affairs of another person should they become unable to do so. Many people have enduring powers of attorney regardless of any illness or diagnosis.
An ordinary, or general, power of attorney is also available but is only valid while a person is legally competent. An enduring power of attorney continues until the person’s death, unless revoked.
One of the benefits of having an enduring power of attorney is that it allows the person with dementia to choose someone to act on their behalf in legal and financial matters when they are no longer able to do so themselves.
You might also consider enduring powers of attorney medical and enduring power of guardianship as well as a financial enduring power of attorney. Each of these allows you to decide who can make decisions on your behalf, when you are no longer able to do so for yourself.
Will
A will gives instructions as to how the estate of a deceased person should be distributed.
A will is only legal if the person understands its implications, so it is essential that if the person with dementia wishes to make, or update their will, they do so while they are still competent to sign.
How can a person living with dementia let their family and friends know how they want to be cared for?
While you have capacity, only you can make decisions about your health. By law, health care professionals must get your consent before any proposed treatment.
If a person with dementia loses the legal capacity to make decisions about their medical treatment, someone else needs to make those decisions for them. A person can appoint a medical treatment decision maker with authority or an enduring guardian to make medical treatment decisions on their behalf. Otherwise, the person responsible for making medical treatment decisions on your behalf will be, in order: your current partner (husband, wife, de-facto partner), a primary carer (not a paid service provider), a relative (child, parent or sibling) or close friend.
You can use an advance care directive (also called an advance care plan or a living will) which is a written record expressing your wishes about medical treatment.
Val lives with dementia and has made her wishes clear to her family and her GP.
“It’s really, really important while you still have the cognitive capacity to get your living will in place, how you want to be treated in your end days,” Val said.
“My active direction is that when I can’t put a cup to my lip myself – palliation needs to start and my GP is on side and my guardians are on side.
“It’s so that you have that level of control while you have the capacity, and it can be referred to and it can be revised, and it can be changed."
How can I get help?
Planning ahead can be overwhelming, but we are here to help. If you need support, or just someone to talk to, the National Dementia Helpline is available 24 hours a day, seven days a week, 365 days a year on 1800 100 500.
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What changes can I expect? Dementia affects people in different ways and at different times. So, what changes can you expect if you are caring for someone, especially in the later stages of dementia?
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