If you are not convienced, let me share this...
Most caregivers know that you should plan as early as you can. And plan for contingencies. Murphy follows Alzheimer's around like a puppy dog. (Murphy's law that says if anything can go wrong, it will.)
My 81-year-old DW was officially diagnosed two years ago. She is now in stage 4 or 5, depending…
She needed hip replacement surgery. Local doctors wouldn't treat an Alzheimer's patient with a 10-foot pole. (I live in rural western PA).
I found a Pittsburgh Doctor who would do the surgery, but I was worried the general anesthesia would boost her impairment into overdrive. I made a tough decision of quality vs quantity of life for her because we talked about it long before she was diagnosed.
We felt we did a good job of finalizing our estate plans. It was one of the very first things we did. We have wills, trusts, Power of Attorneys, and so forth.
A year after we signed all the estate documents, we wanted to make changes to the terms of the family trust. It was revocable. We called the attorney and he was concerned that my DW was not of "sound mind" to make some of the changes.
One of the changes could be viewed as not to her benefit. This is a valid concern for his job was to look out for her interest as well as mine.
However, this creates an issue where we now are not able to make any changes to her estate documents because of her advanced impairment. Our joint trust is now basically nonrevocable. The good news it is only about money and not a life or death clause. The bad news, it is not what we want.
The point I'm trying to make is to talk to your loved one early. Get your affairs in order, fully understand each other's wishes, and do not expect they can be changed once your loved one with dementia advances to a certain point.
Caregiving is hard enough. Talking about the tough issues, planning early may head off some discomfort later.
Comments
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Having the necessary legal documents in place is essential even if dementia never enters the picture. There are so many ways a person can quickly become physically and/or cognitively impaired, and knowing a loved one's wishes and being legally able to act on them is imperative.
Though we did not set up a trust, DH and I updated our wills and made each other DPOA and Living Will/Healthcare POA back in 2016, seven years before he was diagnosed. Our only issue was having no one trustworthy to name as successor POA or executor at the time, so he is still on my documents as such. I am in the process of deciding exactly what I want in my revised documents. Fortunately, I have recently reconciled with my previously estranged adult sons and my brother and plan to name my elder son as POA and executor and my brother (who is unfortunately out of state) as successor for both. Since everything in my estate currently goes to DH, I won't change my will until after he dies. My ex-husband died unexpectedly three weeks ago leaving no will, and our sons are just starting the legal process to set up Letters of Administration so the estate can begin to be settled. Fortunately they are the only legal heirs.
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I have setup our estate plan with a trust, DPOAs, and MPOAs. However, my DW is in an early stage where she is still able to take care of herself and looks normal to casual observance, but has progressing memory and cognitive decline. I am now concerned that we are joint trustees on our trust. in the event of my passing she will become trustee. With the crazy courses this disease takes I am concerned about leaving her as trustee. I would prefer that in the event of my passing trusteeship goes to my daughter with direction to care for my DW until her passing. I am now looking into how I can make the change. I highly recommend trusts for everyone but you may want to consider this situation.
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@JiminTexas I did exactly what you are planning. My wife resigned as trustee and my son is the survivor trustee. Also, make sure that you have DPOA and MPOA other than your wife (perhaps your daughter).
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I do. I hold her DPOA with my daughter as successor.
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@JiminTexas : Just to be clear - your daughter is your DPOA and MPOA?
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She has both. She is a nurse so I had her on both of our medical POAs.
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But if you are her DPOA, then if the lawyer feels she is incompetent that should indicate you are now the decisionmaker, right? So you should be able to make the desired changes to the trust in that new role (DPOA). That’s what I would expect anyway…
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That is true but I am concerned about using the DPOA too much while we do not have a recorded diagnosis. She is not incompetitent right now just has memory and cognitive issues. I had experience with my dad where after he passed the bank would not reecognize the DPOA, claiming he could have revolked it before his death. It took a lawyer for them to recognize it. And since she does not recognize she has a problem, gettinig a diagnosis is going to be difficult. I am working through it with the estate planning lawyer just wanted to raise with the community.
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Powers of attorney cease to be "active" upon death. The will then becomes the operative document.
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Banks — knowing that POA ends on death, we added a ‘payable on death’ (POD) designation to accounts that were not joint. The bank should automatically transfer the account to whoever you designate.
DH added me to his accounts. I added my sons to mine as, if I go first, DH will not be capable of managing the money. Our separate accounts are at different banks and he’s never realized he isn’t on my account. There’s not much money in either account, but the POD avoids having these to pass through probate.
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This happened with my grandparents- my grandmother's dementia progressed very rapidly and my grandfather died before they could name my dad or aunt as survivor trustee or successor or whatever is the appropriate term. They spent months working through legal and banking nightmares.
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Please be aware the using a POA is not dependent on a diagnosis, or even a problem. Rich people use POAs all the time to let someone else manage the day-to-day operations of life while they're busy with other things. There is no shame in using a valid DPOA to support our loved ones.
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Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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