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Caring for a Loved One with Alzheimer's or Dementia

Daughter caring for her Mother

When a loved one is diagnosed with a debilitating disease such as Alzheimer’s or dementia, it is important to contact an elder law attorney as soon as possible. An elder law attorney can ensure that all necessary legal documents are in place while the loved one is still competent and assist you in applying for government benefits.

This guide to protecting a loved one with Alzheimer’s or dementia is designed to help provide you with basic information and hopefully answer some of your questions.

Care Options for a loved one with a debilitating disease:

Besides a nursing home, there are other options to create a more customized care plan for your loved one:

1. In-Home Nursing:

In-home nurses can be hired through an agency or privately. If you desire to use Medicare or Medicaid to pay for the services then the caregiver must be hired through a licensed agency. Using an agency is often a better choice in the long run concerning in-home care because the agency will handle all of the paperwork involving income taxes, background checks on employees, and replacing a worker if they are on vacation or take a sick day.

Home health services funded by Medicare generally do not meet all of the patient’s needs. Medicare will only cover aid services for a couple of hours for one to three days a week.

2. Adult Foster Care:

This is an option that allows you to care for a loved one if you work during the day. Adult foster care centers are normally very expensive but the expenses can be covered through Medicaid under the MI Choice Waiver program.

3. Assisted Living:

Assisted living facilities are perfect for a loved one in an early stage of Alzheimer’s or dementia. The nursing staff can assist the patient with bathing, eating, medication and laundry. A homelike environment can be created in their room and there are recreation and socialization opportunities for residents. The downside to assisted living is that almost all of the expenses must be covered through private pay. The only exceptions are those receiving Social Security Income and Veteran’s benefits.

Senior Citizen enjoying a puzzle with her caregiver

4. There is no place like home:

If staying in one home with the patient and providing all of their care is a feasible option, it is important to consider the effect this transition would have on the entire household’s privacy and daily life. It is also pertinent to consider if your home is a safe living environment for the loved one with Alzheimer’s.

There are many professionals that can assist you with caring for your loved one at home including a geriatric care manager, friendly visitors, family caregiver support programs, and senior centers.

As the primary caregiver of your loved one, it is important to recognize that you can’t do it all alone. It is important to take some time for yourself to maintain your own health - which is just as important as maintaining the health of the patient. Getting in touch with your local chapter of the Alzheimer’s association can provide you with caregiving training. It is also extremely important to be prepared for the day when you can no longer care for your loved one by meeting with an elder law attorney and visiting possible nursing homes or assisted living facilities.

Interacting with a loved one diagnosed with Alzheimer’s or dementia:

As a caregiver, you must learn how to combat the oftentimes difficult behavior involved with these diseases. A person with Alzheimer’s or dementia will often become agitated. The best way to deal with agitation is to validate the person’s feelings. Be sure to take your time to make them feel that all of their concerns and emotions are valid. Also, be sure to offer positive encouragement for help around the house or things that the patient does right - even if it is a small task they completed.

When communicating with a person with Alzheimer’s, try not to upset them. Throughout a typical day, make sure that the patient is given options on how to spend their day even if it is basic decisions such as what to have for lunch. Finally, give your loved one plenty of time to respond to questions or conversation.

A person with Alzheimer’s or dementia will exhibit non verbal communication. Try and understand what they could be expressing. For example, if your loved one cries when you leave the room, they may be afraid of being alone. Be sure to find a solution to ease their fears such as a stuffed animal to hold during alone time.

The environment can have a serious effect on the behavior of an Alzheimer’s patient. The temperature, lighting, and the people surrounding the patient can affect their mood. When caring for a loved one, look for a connection between the environment and agitation and then adjust your schedule to avoid those circumstances.

What are the legal steps I need to take after a loved one is diagnosed with Alzheimer’s or dementia?

1. Powers of Attorney:

There are powers of attorney for finances and health care. The power of attorney document allows someone you appoint to have the authority to make decisions for you in the event that you can’t make these decisions yourself. If a loved one is diagnosed with a debilitating disease such as Alzheimer’s or dementia a power of attorney is especially important because it is almost guaranteed that the time will come when the person can no longer make important financial or medical decisions for themselves. Without a power of attorney in place when the loved one becomes incompetent, you will have to go through a lengthy and costly court proceeding in order to be appointed as guardian.

2. Wills and Trusts:

No matter what your circumstances, it is important to have a will or trust in place to ensure that your assets will be distributed to your loved ones as you desire. Whenever a life changing event occurs such as being diagnosed with Alzheimer’s or dementia, you should review your will or trust to ensure that the plans put into place years ago still reflect your wishes. Just as with a power of attorney, failure to plan ahead can be costly. You can only plan until incapacitation occurs.

3. Government benefits:

Because a loved one with Alzheimer’s or dementia may eventually require nursing home care it is important to plan ahead for the possibility of requiring Medicaid benefits to afford nursing home costs of over $9,000 a month. In order to qualify for Medicaid, you should consult with an elder law attorney before making any gifts or transferring property, entering into a caregiver contract, or changing property titles - if any of these are done for less than fair market value Medicaid benefits could be denied. Also, speak with an elder law attorney about spending down your assets or establishing an irrevocable trust to meet Medicaid requirements. The same process applies if your loved one is a wartime veteran or the surviving spouse of a veteran and may require Veteran’s benefits.

What should I do NOW?

After reading all this information it is important to ask a qualified elder law attorney any of your remaining questions. Your first step in caring for your loved one should be developing a comprehensive plan of action. Because Alzheimer’s and dementia are progressive diseases the plan must be long term and prepare for the future. An elder law attorney can help ensure that you are on track financially and legally for events down the road such as requiring nursing home care and incapacitation. The Elder and Estate Planning Law Firm can help you develop this plan of action and successfully execute it every step of the way. Call (810)953-3846 to schedule a confidential consultation and start on the path towards peace of mind.

This blog post is written by Brett A. Howell, Certified Elder Law Attorney. The blog is written as a service of The Elder and Estate Planning Law Firm, P.L.L.C. This information is for general informational purposes only and does not constitute legal advice. For a consultation to address specific questions, please call (810) 953-3846.


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