Seeing a loved one decline is not easy. For many family members, witnessing a decline in mental capacity may be even more painful than physical impairment. An estimated 14% of people age 71 and older in the United States suffer from some form of dementia, according to the Alzheimer’s Association’s Alzheimer’s & Dementia 2015. Alzheimer’s is the sixth leading cause of death in the United States and the fifth leading cause of death for individuals age 65 and older, according to the same publication.
While good planning is not a cure, it can ease the financial, planning and end-of-life issues that may arise for families. Here are three steps your clients can take avoid common landmines when it comes to planning for diminished capacity.
Step 1: Have the Tough Conversations Before the Tough Times
“I don’t want to achieve immortality through my work. I want to achieve it through not dying.” -Woody Allen
It is not easy to face your own mortality or that of your parents, spouse or loved ones, but open discussions about preferences for end-of-life care can help family members when they have to make difficult decisions. Helping your clients have a clear understanding of mom or dad’s preferences about care can also keep familial peace among children and grandchildren who will be dealing with their own grief.
A health care agent will be responsible for your clients’ wishes with respect to medical treatment, or lack thereof. Clients should consider whether they want life-sustaining measures like tube feeding and IV hydration in the event that they can no longer eat and swallow and have no hope of recovery. These are issues that they should discuss with their health care agent.
The more guidance you can help your clients impart to their families and named agents while they are mentally competent, the fewer questions—and struggles—families and named agents will face if they must step in as a health care agent.
Whether end-of-life care will be provided at home or in a memory care or assisted living facility is another important discussion point. Financial and practical considerations will play as large a role as personal and emotional preferences, but it is helpful to discuss the possibilities with family members early.
It’s best not to put family members in the position of promising to keep someone at home. Providing in-home care can often be impossible for family members for a number of reasons, such as safety, cost, physical ability to provide hands-on care, etc.
Step 2: Don’t Procrastinate; Plan Now
“Most people don’t plan to fail, they fail to plan.” -John L. Beckley
A basic estate plan typically comprises a will, revocable trust, health care proxy, durable power of attorney and living will. It names fiduciaries to act in the event of incapacity and determines how assets will be held and administered by family members and loved ones after death. It is important to ensure that your clients’ estate plans are up to date and accomplish their wishes with respect to their families.
In order to execute valid estate planning documents, an individual must have the mental capacity to understand the purpose and effect of those documents. Different legal documents require different levels of competence and diminished capacity does not necessarily mean that an individual can no longer execute an estate plan.