Alzheimer’s and dementia are 2 of the most feared words in the English language.  Both of these diseases have touched many, many Americans.  Estate planning can help you gain some control over a situation that probably feels totally out of control.

Let’s say you are named in your mom, Marilyn’s, Financial Durable General Power of Attorney, Durable Health Care Power of Attorney and Durable Mental Health Care Power of Attorney.  This means you are named to be an agent for your mom.

Marilyn is now 85 and been diagnosed with Alzheimer’s.  She is sliding quickly down that slippery slope.  Your 2 siblings, John and Carrie, are thrilled that you are named and that they are not.  John and Carrie are willing to help financially and will be supportive of your efforts, but most likely, will not take on any delegated duties you would like to give them.  It is not uncommon for responsibilities to be divvied up unequally among siblings.

Here are several suggestions on how to handle your new job as agent for Marilyn now that she has Alzheimer’s.

  1. Be sure to read Marilyn’s estate planning documents. Don’t assume you “basically know the lay of the land”.  Most Powers of Attorney are reasonably similar, but each attorney does things a little differently and so reading is critical.  Pay particular attention to the list in each document that says what you can do.  Keep in mind that you need to be super honest and super diligent.  Although there isn’t a judge watching over you, since no court involvement is needed, this doesn’t remove the legal duty to do things right.

What estate planning documents does Marilyn hopefully have?

  • Durable Health Care Power of Attorney. A Durable Health Care Power of Attorney names you to make medical decisions for Marilyn if she is incapacitated.  An Alzheimer’s or dementia diagnosis will qualify Marilyn as incapacitated.  She may still be able to do many things, but signing legal documents or making medical decisions for herself may not be included. I would make several copies of Marilyn’s Durable Health Care Power of Attorney.  Give one to each of her doctors.  I would put a copy up on your refrigerator in case anyone ever needs a copy instantly.  Keep a copy of the Power of Attorney with you wherever you go from this point forward.
  • Medical Living Will. A Medical Living Will says that if Marilyn is in terrible shape, and will not be getting better, then stop life support.  I would follow the same instructions for a Medical Living Will regarding copies as you followed for the Durable Health Care Power of Attorney.
  • Durable Mental Health Care Power of Attorney. A Durable Mental Health Care Power of Attorney names you to place Marilyn in a psychiatric facility.  Ideally, the Alzheimer’s will not disintegrate into violence, but if it does, often a psychiatric hospitalization is needed.  I would also provide a copy of this Durable Mental Health Care Power of Attorney to all of Marilyn’s doctors.
  • Financial Durable General Power of Attorney.  A Financial Durable General Power of Attorney names you to make financial decisions for Marilyn when she is incapacitated.
  1. Don’t guess at what the estate planning documents mean; be sure to understand what they mean. Spending a bit of time on the front end of this “adventure” can save you tons of wasted time and aggravation on the back end.
  1. Try to keep John and Carrie in a basic loop on what’s going on. You aren’t legally required to report to them on a frequent basis.  However, for family harmony, and your mental health, you may want to keep them informed.  Many family fights start when people don’t think information is forthcoming.  Try to be as transparent as possible.
  1. Keep copies of the following with you—Marilyn’s:
  • Driver’s license or Arizona State ID
  • Social Security Number
  • Insurance cards:  Medicare, Supplemental, Vision, Dental, Prescription
  • Durable Health Care Power of Attorney
  • Financial Durable General Power of Attorney
  • Living Will
  • Names and phone numbers of doctors, dentists and pharmacies
  • Names and dosages of all medications Marilyn takes
  1. Try to be as organized as possible.
    Keep track of the time you spend taking care of Marilyn’s affairs
    Keep all receipts for items you purchase on Marilyn’s behalf
  1. Since Marilyn is sadly never going to get better, organize her personal papers, etc. in a system that makes sense to you. It will make things infinitely easier for you.
  1. Remember that you still have a life, even if it doesn’t really feel like you do. The number one thing recommended in articles I have read on this topic is: you must take care of yourself.  You must take care of your own family, your responsibilities and most importantly, your health.  If you are a mess, you can’t be very helpful to Marilyn.
  1. Handling a loved one’s affairs can be complicated. You are usually allowed to delegate different responsibilities.  For example, if you are used to doing your own tax returns and figure you will do Marilyn’s as well, give serious thought to hiring an accountant or tax preparer.  If Marilyn has always mowed her own lawn, and so you feel you need to do this as well, hire a landscaper instead.  I am not saying to go hog wild hiring others to do your job, but it is reasonable to spend some funds on making things run more smoothly.
  1. Make a file of Marilyn’s health records if you can. This could be helpful later if you need to set up appointments with new specialists.  Marilyn’s Durable Health Care Power of Attorney should waive the HIPAA privacy laws so you can get your hands on Marilyn’s medical records.  (HIPAA is the federal law that allows your medical records to remain private unless you say they can be released).
  1. It bears repeating—take care of yourself. Be sure to get a flu shot if you are going to be around Marilyn a lot.  You don’t want to get sick and you certainly don’t want to get Marilyn sick.
  1. Keep your cool. It is very easy to get overwhelmed when you are serving as an agent.  Being an agent can sometimes feel like another full time job.  Take it all slow and steady.