DOL­LARS & SENSE

Hav­ing a plan in place, step-by-step tips

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Get­ting Ahead of Alzheimer’s

A per­son must clearly state in writ­ing who is au­tho­rized to see or read their per­sonal med­i­cal records.

More than 5 mil­lion Amer­i­cans over age 65 have Alzheimer’s disease, a sus­tained and ir­re­versible brain dis­or­der than can take three to 10 or more years from di­ag­no­sis to death, de­pend­ing on fac­tors such as age. Early signs may in­clude trouble with fa­mil­iar tasks, mood changes and social with­drawal, time, rea­son­ing and place con­fu­sion, you not be­ing you for longer pe­ri­ods. The disease is named af­ter Dr. Aloy­sius Alzheimer, a Ger­man neu­ropathol­o­gist.

One of the first things fi­nan­cial, le­gal and med­i­cal ex­perts all en­cour­age those re­cently di­ag­nosed with Alzheimer’s disease to do as soon as pos­si­ble is to update their es­tate doc­u­ments. Disease com­pli­ca­tions grad­u­ally af­fect the de­ci­sion-mak­ing process, mak­ing early es­tate and fi­nan­cial plan­ning even more im­por­tant.

Ad­vance di­rec­tives for fi­nan­cial and es­tate plan­ning must be cre­ated while the per­son still has le­gal ca­pac­ity―a will, to pro­vide for dis­tri­bu­tion of as­sets upon death; a durable power of at­tor­ney for fi­nances, to help avoid fu­ture court ac­tions; and a liv­ing trust, to hold ti­tle to prop­erty and as­sets for the ben­e­fi­cia­ries once a per­son can no longer man­age their own af­fairs.

There are also ad­vance di­rec­tives for health care, in­clud­ing such doc­u­ments as a liv­ing will to record a per­son’s wishes for med­i­cal treat­ment near the end of life; a durable power of at­tor­ney for health care, to des­ig­nate a per­son to make healthcare de­ci­sions; and a do not re­sus­ci­tate, or a DNR or­der that in­structs health-care pro­fes­sion­als to not per­form CPR if the heart or breath­ing stops. Ac­cess to pri­vate med­i­cal in­for­ma­tion is closely reg­u­lated by the fed­eral Health In­sur­ance Porta­bil­ity and Ac­count­abil­ity Act, so a per­son must clearly state in writ­ing who is au­tho­rized to see or read their per­sonal med­i­cal records.

Pay­ing for care is also a big con­cern as Alzheimer’s disease pro­gresses. Com­mon costs can in­clude on­go­ing med­i­cal treat­ment and doc­tor vis­its, med­i­cal equip­ment, home safety mod­i­fi­ca­tions, pre­scrip­tion drugs and, even­tu­ally, ei­ther in-home care or full-time res­i­den­tial care ser­vices out­side the home. Many of th­ese costs are not cov­ered by Medi­care and the av­er­age cost of car­ing for an ear­lier-stage pa­tient at home is $56,800 per year, plus an av­er­age of an ad­di­tional $7,000 per year to fam­ily mem­bers also pro­vid­ing care­giv­ing ser­vices. For late-stage pa­tients, in-home, round-the-clock health aides, or as­sisted-liv­ing fa­cil­i­ties when com­bined with other an­cil­lary costs, can eas­ily ex­ceed $100,000 per year.

Alzheimer’s is a ter­ri­ble, de­gen­er­a­tive and fa­tal disease that can rob an in­di­vid­ual of a life­time of mem­o­ries and a life­time of sav­ings. With the help of fi­nan­cial, le­gal and med­i­cal pro­fes­sion­als, hav­ing a plan in place for the fu­ture can ease some of the fam­ily’s stress and un­cer­tainty. LE­GAL, IN­VEST­MENT AND TAX NO­TICE: This in­for­ma­tion is not in­tended to be and should not be treated as le­gal ad­vice, in­vest­ment ad­vice or tax ad­vice. Read­ers, in­clud­ing pro­fes­sion­als, should un­der no cir­cum­stances rely upon this in­for­ma­tion as a sub­sti­tute for their own re­search or for ob­tain­ing spe­cific le­gal or tax ad­vice from their own coun­sel. Steven V. Green­stein is Ex­ec­u­tive Vice Pres­i­dent, Wealth Ser­vices, for The Sanibel Cap­tiva Trust Com­pany.

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