Adjusting for Alzheimer's

“For most people, there’s an adjustment period,” says Neil Rimsky, an elder law attorney at Cuddy & Feder in White Plains. “And there’s a level of concern, because they’ve heard about the costs of care of Alzheimer’s, and the impact on people’s lives. Part of what lawyers do is explain what the options are, and that there are ways to adjust so the person who has Alzheimer’s can have the best quality of life.”

Lissett C. Ferreira, an elder law attorney in New York City, stresses that, after a diagnosis, it’s important to start planning as soon as possible. “When people first start to develop the symptoms, their doctors—or family members or therapists—may suggest they start doing some advanced planning, while they still have capacity,” she says, “so that they can leave their affairs in order the way that they want them to be—rather than later on, when it’s more difficult, or perhaps too late.”

Rimsky says that due to complicated federal laws, a last will and testament offers clients with Alzheimer’s much greater protection and flexibility than a lifetime trust.

Whether you’ve been diagnosed or are concerned for someone who has been, “the same factors and considerations” apply, says Ferreira. If it’s loved ones initiating the planning, she adds, it’s important that the subject be on board.

There are situations, of course, when a person with Alzheimer’s disease may not be able to get his or her affairs in order before they’re incapable of doing so. When this happens, a guardian—often a child, other family member or friend—does it for them.

Ferreira says guardianships are more expensive and more restrictive than advanced planning. “There’s court supervision; there are fees that have to be paid; the guardians get paid. The court examiners that are utilized by the court to examine the reporting and accountings of the guardians get compensated,” she says. “There’s just a level of administrative expense that can usually be avoided if you do advanced planning.”

The petition for a guardianship gets filed in court—and anyone concerned with the welfare of the alleged incapacitated person can bring the petition, says Ferreira. A court evaluator will conduct an independent inquiry, which includes speaking with family members and gathering records. Then, the evaluator will write a report, which is followed by a hearing. If there’s sufficient evidence that the subject is incapacitated and a guardianship is required, the court will appoint one.

While it may seem natural that a child of the person with Alzheimer’s will be appointed the guardian, that isn’t always the case. Saundra Gumerove, a special needs attorney in Jericho, has seen cases involving families wherein a parent needs a guardian due to Alzheimer’s and a child needs a guardian due to a developmental disability.

In any case involving Alzheimer’s, good legal advice and early planning can go a long way. “The quality of life of a person that has Alzheimer’s—and the family that’s affected by it—can be improved dramatically with careful counseling, including social counseling and legal counseling,” says Rimsky. “The priority is protecting the individual that has Alzheimer’s.”

For more information on powers of attorney, care planning, advance directives, end-of-life care, legal planning and legal documents, living trusts, and financial decisions, long-term care decisions, and health care decisions for those with Alzheimer’s, see our overview of elder law and estate planning.