Planning for Incapacity
As a caregiver, you should begin making legal preparations soon after your loved one has been diagnosed with a serious illness. People with Alzheimer's disease and other long-term illnesses may have the capacity to manage their own legal and financial affairs right now. But as these diseases advance, they will need to rely on others to act in their best interests. This transition is never easy. However, advance planning allows people with a long-term disease and their families to make decisions together for what may come.
Legal Documents for Caregivers
Clearly written legal documents that outline your loved one's wishes and decisions are essential for caregivers. These documents can authorize another person to make healthcare and financial decisions, including plans for long-term care. If the person being cared for has the legal capacity -- the level of mental functioning necessary to sign official documents -- they should actively participate in legal planning.
To give your loved one the best care possible, obtain legal advice and services from an attorney experienced with these issues. If the person you're caring for is age 65 or older, consider hiring an attorney who practices elder law, a specialized area of law focusing on issues that typically affect the elderly. As you plan for the future, ask the attorney about the following documents:
- Power of attorney: This document gives a person (the principal) an opportunity to authorize an agent (usually a trusted family member or friend) to make legal decisions when they are no longer competent. There is no standard power of attorney; thus, each one must be geared toward an individual's situation. It is important for the caregiver to be very familiar with the terms of power of attorney because they spell out what authority the caregiver does and does not have. The agent should make multiple copies of the document and give one to each company with which the principal does business.
- Durable power of attorney for health care (also known as health care proxy): This document appoints an agent to make all decisions regarding health care, including choices regarding health care providers, medical treatment, and, in the later stages of the disease, end-of-life decisions. This means that the agent may authorize or refuse any medical treatment for the principal. This power only goes into effect once the principal is unable to make decisions for themselves and is activated by the principal's attending physician.
- Living will: A living will allows the person to state -- in advance -- what kind of medical care they desire to receive and what life-support procedures they would like to withhold. This document is used if a person becomes terminally ill and unable to make their wishes known or if they become permanently unconscious. A terminal illness is defined as one from which a person's doctor believes there is no chance of recovery. Living wills can also be used if a person becomes permanently unconscious. To be considered permanently unconscious, two physicians must determine that the patient has no reasonable possibility of regaining consciousness or decision-making ability. Laws on living wills vary from state to state.
- Living trust: This document enables a person (called a grantor or trustor) to create a trust and appoint a trustee to carefully manage trust assets once the grantor is no longer able to manage finances. A person can appoint another individual or a financial institution to be the trustee.
- Will: A will is a document created by an individual that names an executor (the person who will manage the estate) and beneficiaries (those who will receive the estate at the time of the person's death).
If you cannot afford an attorney, legal forms can be accessed through resources including books and the Internet. Legal issues may be discussed with a social worker or clergy free of charge.
A caregiver of an individual who no longer has the legal capacity to execute powers of attorney or trusts may have to become that individual's guardian or conservator. A guardian has the legal authority to make decisions about the lifestyle and well-being of another person. The decisions a guardian may make include where a person may live, what care and medical treatment will be provided, and what religious and educational activities will be made available. A conservator has legal authority to manage another person's financial affairs.