Dementia is a broad term, and if you suspect your parent’s dementia has gotten worse, it can be hard to pinpoint when it can be too much to handle. If you are at the beginning of this process, and your parent is just now showing signs of cognitive decline, act quickly. Putting the power of attorney documents in place sooner rather than later can help you avoid stress, legal fees, and possible harm.
Do a complete estate plan with all of the documents necessary to ensure that your parent’s wishes are honored. As we state several times in this article, it is well worth the money to hire a good attorney to make sure your documents are complete and legal.
Jump ahead to these sections:
- What is Power of Attorney?
- Why is Power of Attorney Important?
- Steps to Get Power of Attorney of a Parent with Dementia
Dementia symptoms can wax and wane and the severity of the disease and its progression are different for everyone. According to the Alzheimer’s Association, “dementia is a general term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia.”
What this all means is that there comes a time when your parent has dementia, they will not be able to manage their healthcare and finances. The best time to get power of attorney documents in place is before they get dementia or if they have it, get any worse. Some types of dementia have a rapid progression, and decline can occur quickly.
What is Power of Attorney?
Simply put, power of attorney is a legal document designating someone else other than you responsible for making decisions on your behalf should you be incapacitated. There are different types of power of attorney, in particular ones that can be used to help protect an aging parent with dementia.
Anyone over the age of 18 should have a power of attorney and other advance directives in place. Dementia is a condition associated with old age, but the fact remains we never know when we may need a trusted person to help us make decisions.
Why is Power of Attorney Important?
Power of attorney helps to prevent any physical and financial harm that could come to your parent. Dementia is generally a progressive disease, which means that time is of the essence. It is far better to have the power of attorney documents signed by your parent when they are of “sound mind” to help you gain proper authority.
Here are some of the signs your parent may be exhibiting as a result of dementia and cognitive decline:
- Mismanagement of finances. They could be not paying bills, become vulnerable to scams and fraud, and may even give money away to strangers. You will want the ability to take over finances in case your parent becomes incapacitated.
- The inability to manage healthcare. You will want to have the authority to advocate and get medical information on behalf of your parent.
- Decisions on medical treatment. Your parent may need you to help make reasonable healthcare decisions or end-of-life decisions. A power of attorney for healthcare is sometimes referred to as an “advance directive.”
- Your parent’s safety may be at risk due to wandering or unsafe driving.
Steps to Get Power of Attorney of a Parent with Dementia
You need the legal authority to take over if finances are being squandered or your parent’s health is suffering. Access to bank and retirement accounts, social security income, any other estate holdings is critical. Without authority, you will have no way to gain control of what could be a very harmful situation.
Step 1: Make sure your parent knows what they are signing
If your parent’s decision-making abilities are in question, so will any legal document they sign. That is why it is so important to have advance planning documents in place before they are needed. Otherwise, anyone could question the legality of a power of attorney document signed by someone who is incapacitated.
If you think your parent may not be able to understand what they are signing, consider guardianship as an option. One possible path to making this decision is to have an evaluation of your parent completed and then getting a letter of competency from a physician. Then you will have a medical opinion to back up your claim and have a better understanding of their prognosis.
Your parent may have dementia but retain capacity and refuse to sign a power of attorney document. In this case, there is not much you can do except keep trying and if necessary wait until incapacity is reached. You can then petition the court for guardianship and conservatorship.
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Step 2: Consult an attorney
Every state has different forms and processes for setting up advance directives. An estate planning or elder law attorney will make sure you are following legal and ethical protocols. The other advantage of hiring an attorney is to consider all of the available options for surrogate decision making.
To find a good attorney, ask friends and healthcare professionals if they have any recommendations. Also consider doing some online research on elder law attorneys as well in the area. Attorney’s fees can be high, so when you choose someone, ask about fees and the total expected costs.
Step 3: Talk to your parent and other siblings
Before making this decision, you may want to talk with the rest of your family about advance planning. One of your siblings might be willing to be a co-agent on a power of attorney with you. This has several advantages. If you are unable to make decisions, you have a backup. Also, having someone to consult with on decisions can provide you with much-needed support.
Your parent may not understand what your intention is, which could be problematic. You will have to assess their level of comprehension and avoid pressuring them to make a decision.
If your parent states they want a different sibling to have power of attorney, that is their right. Suspicion and paranoia are sometimes symptoms of dementia, and this might sabotage the process or make it impossible to reach an agreement.
Your parent might also keep procrastinating, saying that they will get to it eventually. Your parent with dementia may also refuse your help. It isn’t easy having to think about needing the help of your children to manage your life. An open and honest discussion about the reasons for needing these documents can help. Let your parent know that this is something that will make your life easier in the end. Explain that without legal authority there will be no one to ensure that their wishes are carried out.
Having the attorney present for the discussion might help. Attorneys who have worked in this area are very skilled at explaining the reasons and processes for power of attorney to someone with dementia.
Pick a time of day when your parent is less confused. Cognition tends to fluctuate in people with dementia, so you may have better luck choosing an appropriate time. If you feel confident in your parent’s ability to understand what they are signing during that window of clarity, have them sign it pending your attorney’s approval.
Step 4: Understand the limits of your authority
If your parent with dementia is still able to make decisions for themselves, then they can make their own decisions. A durable power of attorney states that you, as the trustee, can only make decisions when your parent becomes incapacitated.
How do you know when that has happened? The best way to answer that question is to get a medical opinion from someone who specializes in assessing a person with dementia. There are standardized tests designed to ascertain cognitive ability. Some testing is very sophisticated and involves imaging of the brain. The more information you have, the better.
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Step 5: Handling family conflict
Hopefully your family can agree about the need for power of attorney and who it should be, but this is not always the case. Sibling disputes can be disruptive and at times, expensive. That is another reason why it is so important to settle these documents early in the process to prevent any additional losses of time and money.
If a conflict does occur, consult your attorney who might recommend mediation to resolve differences. Unfortunately, these conflicts often happen when large sums of money are at stake, and it is not unusual for both parties to incur large legal fees during such a battle.
Step 6: Ethical considerations
As the power of attorney, you have not only legal obligations, but ethical ones as well. Most of all, you should understand that being a trustee involves significant responsibility. It also requires you to abide by the written terms of the trust document.
In addition, it is important to make sure that you are not substituting your wishes for what your parent wants. Make decisions that are consistent with the directives set forth in the trust documents. It is also legally necessary to maintain accurate accounting of expenditures and other financial transactions. Try to get informed consent for medical procedures when possible. Informed consent is informing your parent of a medical decision and getting their consent.
Power of Attorney for a Parent with Dementia
Simply put, if you want to help make decisions for a parent with dementia, you must have the legal authority to do so. Above all, it is recommended that you involve as many family members as possible to avoid misunderstandings later. There might be some bumps in the road, but by making ethical and caring decisions, you will succeed.
If you're looking for more resources on caring for a parent with dementia, read our guides on blogs about dementia and what to do when a parent with dementia refuses help.
- “What is Dementia?” Alzheimer’s Association. www.alz.org/alzheimers-dementia/what-is-dementia
- “Power of Attorney.” Alzheimer’s Association. www.alz.org/help-support/caregiving/financial-legal-planning/legal-documents