Dementia is an incurable, progressive condition. It causes a deterioration in memory, judgement, communication and reasoning abilities over time. This means that at some point you might lose the ability to make decisions for yourself. However, this doesn’t mean that you have no say in your future. Making plans early on means that you can get your affairs organised in advance. You can also direct the sort of care you would like to receive in the future when you are less able to choose for yourself.
There are some circumstances that mean your future wishes cannot be adhered to, but families and clinicians take advance plans seriously and will try to see they are carried out. It is also very useful for your family to have some guidance when they must make tough decisions about you, especially if this is written and not reliant on someone’s memory.
You can make an advance plan for whatever is important to you, be it who looks after the cat if you can’t, to donating your body to science or being involved in research while you are still alive.
Medical Assessment for capacity
If you have dementia before you do any of the following, you may be asked to see a doctor who will check your reasoning skills. This is to make sure that you can still make sound decisions.
If your thinking deteriorates, at some point you will lose the capacity to change your Will. Now is the time to check that your Will is up to date, and you have made it clear who should inherit your money, property and other things. Get good legal advice to ensure it is reasonable. Make sure those around you know where your Will is kept and which lawyer was involved in putting it together. It may be helpful to have a book in your house with all this written down.
Your solicitor, Public Trust, Citizens’ Advice Bureau, Community Law Centre or Dementia Waikato can help.
It is helpful to have your financial affairs are sorted out. Often this means simplifying your affairs if you have several accounts or a lot of investments. It may be easier to bring everything into just one or two accounts. If possible, make sure that bank accounts are in joint names (if you’re part of a couple), so that if you can no longer operate the bank account, your partner can. Discuss this with your bank manager. They can help you make the necessary arrangements including organising your bank cards and internet banking.
Early in dementia you will not necessarily want to give up all control over your financial affairs, and it might be just a matter of having a warning system in place if you or anyone attempts to make an unusual transaction. Some bank staff are now trained to be “dementia friendly”. Your bank manager or other financial advisor also may be able to assist.
Enduring Powers of Attorney (EPOA)
After you receive a diagnosis of dementia, it is useful to nominate people who will take responsibility for decisions in the future, when you can no longer make those decisions. You will need to see a lawyer, who will draw up the Enduring Powers of Attorney documents. They will ask who you trust to make decisions for you and check that you are thinking clearly about this. You can appoint someone in your family or a friend, and you can also nominate someone as back-up for that person if they can no longer act for you. The Enduring Powers of Attorney are mostly not active until a clinician has assessed that you can no longer make decisions yourself. At that point the person you have nominated will take over decision-making. Even then, they will need to make sure that the decisions they make are in your best interests. They will also continue to consult you about things, as far as you can contribute. You need to keep your Enduring Powers of Attorney in a safe place, and you should give copies to those that you have nominated. Write it down in your book.
Under the law (The Protection of Personal and Property Rights Act) there are two types of Enduring Power of Attorney.
This person (or people, as it can be shared), nominated by you, will take care of all your financial and property affairs, including businesses. They will make sure that everything is under control and being looked after. They will pay any bills for you and manage your income for you.
For Personal Care and Welfare
This person (and it can only be one person), nominated by you, will take care of all decisions about your welfare, but only from that time that you cannot do this for yourself. That time depends on how your dementia progresses, but a clinician will need to do an assessment to show you cannot make decisions any longer. This protects you from someone interfering before you need it.
For Enduring Powers of Attorney, talk to your lawyer, Public Trust, Community Law Centre or Dementia Waikato advisor.
Advance Care Directive
This is about making a plan for your end-of-life care. This information needs to be shared with a care team. An advance care directive is especially important when communication may be limited in the later stages of dementia. The plan would include anything that is important to you and would give meaning to your life. It is very helpful to your support people to have on paper what you want done and relieves them of the burden of having to make such decisions. If you have an EPOA for Welfare, they will be the person who helps ensure your wishes are carried out. The plan can be written and kept in a safe, known place. Put it in your book! It does not have to be in any particular form, but it might be easier to download it from www.advancecareplanning.org.nz so you know what you might like to cover.