Long-Term Planning

The Alzheimer’s Association cautions: "It's important for everyone to plan for the future, but legal plans are especially important for a person with Alzheimer's disease. The sooner planning starts, the more the person with dementia may be able to participate.”¹

"We have prepared for the worst and now we are planning to live the best. If the worst comes, we are ready for it. If it doesn't, we will have not wasted today worrying about it. “

- Betty Davis

Preparation is key after a dementia diagnosis. It is important to begin necessary steps to ensure long term plans are secure. First, the person living with dementia and caregivers should recognize the current state of legal capacity. Legal capacity is the ability of an individual to make rational decisions and understand consequences.² An individual with dementia should remain involved in all legal decision making and planning for as long as possible. As dementia progresses, legal capacity diminishes until the person living with dementia becomes incapable of rational decision making. It is important to make written formal agreements and legal decisions as soon as possible after diagnosis. With the proper documentation in place, decision preferences can be respected when an individual with dementia can no longer make decisions for themselves.

One of the most important documents to have completed, especially after a diagnosis of dementia, is advance directives. 
The State of Tennessee's "Advance Directives for Health Care" form combines the Living Will and Medical Power of Attorney forms. 

A Living Will is used to ensure that what you want happens even whenever you are unable to say so. Although anyone and everyone is encouraged to complete a Living will, this process is especially important for individuals with dementia, who may lose legal capacity to make decisions for themselves as their condition worsens. Taking time to discuss a Living Will with caregivers soon after diagnosis can ensure the decisions are made later. 

A Medical Power of Attorney, Durable Power of Attorney for Health Care, and Appointment of Health Care Agent are all terms defining a person that can make medical decisions for you when you are unable to make your own. 

Your advance directives or health care appointee can also be made known to law enforcement during emergency situations by entering information in the “Add Emergency Contacts” section of the Driver’s Services page here. ³

For more information on the Health Care Decision making in Tennessee, please visit this website.

TRAVELING TIP 
If a person living with dementia travels outside of Tennessee, it’s a good idea to check the local laws of their destination to find out whether existing legal documents will be recognized there.²

Tissue Donation
Research institutions collect brain tissue to learn more about Alzheimer's disease and related dementia. Certain facilities may only accept donations from individuals who participated in research with their facility prior to death. If this is something you are interested in, make sure to contact the tissue bank, university, or research center to decide prior to death.⁴

Other legal matters to consider: 

The Tennessee Bar Association has The Legal Handbook for Seniors

• Financial durable power of attorney
• Financial Planning
• Last will and testament
• Preservation or transfer of assets 
• Medicare claims and appeals
• Social Security and disability claims and appeal
• Supplemental and long-term health insurance issues
• Living Trust
• Guardianship/Conservatorship issues
• Probate
• Elder abuse and fraud recovery
• Medical legalities
• Asset Management

Long term planning resources

When a loved one is diagnosed, sometimes it can be hard to initiate the conversation to plan for end of life. The Conversation Project has created a guide to help begin those difficult talks and decisions. 

The Alzheimer's Association has created a step by step guide on how to take action after diagnosis Taking Action: A personal and Practical Guide for Persons with Mild Cognitive Impairment (MCI) and Early Alzheimer's Disease.

Alzheimer’s Tennessee has videos for caregivers and those living with dementia to help on a variety of topics including long term planning. Some topics include “Basic Estate Planning Documents” and “Legal Issues: Durable Power of Attorney.” Checkout Alzheimer’s Tennessee’s Caregiver Academy videos here.

For legal resources in your area, make sure to check our Local Resources page!

REFERENCES:

1. https://www.alz.org/help-support/caregiving/financial-legal-planning/planning-ahead-for-legal-matters
2. https://www.alz.org/media/Documents/alzheimers-dementia-legal-plans-b.pdf
3. https://www.tn.gov/health/health-program-areas/health-professional-boards/hcf-board/hcf-board/advance-directives.html)
4. https://www.alz.org/alzheimers-dementia/research_progress/brain-donation

Any Questions?

If you have questions about services in your area, please reach out to your local Area Agency on Aging and Disability (AAAD) at 1-866-836-6678 or submit a request for information online through our Information Request Tool.”