Planning for Future Incompetence of a Family Member Diagnosed with Dementia
People with dementia undergo a gradual transition from being independent to needing assistance in all domains of life, even though a diagnosis does not immediately invalidate a person's competence.
A person diagnosed with dementia is still considered competent to make decisions on medical and other issues, manage their financial affairs, and even drive a car. Dementia gradually impairs the patient's concentration, judgment, and memory capabilities.
As family members, it is crucial to be aware of the disease’s impact, particularly in situations requiring lucidity, such as handling payments, shopping (including over the phone), driving, operating hazardous tools, engaging in work requiring focus and responsibility, and cooking with gas or boiling water.
It is important to note
- The decline in functioning occurs gradually and varies based on the severity of the situation and the progression of dementia
- Fluctuations may occur in functionality levels and the patients’ competence
- It is advisable to consult with the family doctor regarding the level of the patient's competence and the implications of the disease on the patient's ability to make decisions in various matters
- The patient’s autonomy should be respected, and they should be allowed to make decisions for themselves and according to the progression of the disease
- It is essential to undergo a comprehensive geriatric assessment, including a cognitive-functional assessment by an occupational therapist
Planning ahead for future competence impairment is essential both from both medical and financial standpoints, as it will greatly facilitate decision-making further along.
Offer the patient to appoint a person with a power of attorney for healthcare
During the initial stages of the disease, individuals diagnosed with dementia, as long as they remain competent and comprehend the consequences of their actions and decisions, have the ability to appoint a person of their choice with the power of attorney for healthcare.
In accordance with the Patient's Rights Act, the individual holding the power of attorney for healthcare will be granted the authority to make decisions regarding both medical and healthcare matters on behalf of the patient when they become incapable of making such decisions independently.
The power of attorney for healthcare will be limited to making medical decisions only, while the designated person will not have authority over financial matters or end-of-life decisions.
Encourage the patient to consult regarding financial matters
During the early stages of the disease, there is a decline in the ability to handle personal financial matters and possessions. It is essential that a person with power of attorney will be an individual both you and the patient trust, as they will get access to the financial resources required to care for the patient.
It is crucial to be aware that, in accordance with the guidelines of the Bank of Israel, the bank has the authority to restrict any account transactions for an individual who is deemed incompetent. To prevent the risk of financial resource depletion for future medical care, it is recommended to promptly designate a person for financial power of attorney.
Determine the designated bank account for receiving the National Insurance allowance
It is recommended to appoint a family member or another trustworthy person to receive National Insurance allowance on behalf of the patient with dementia. This will ensure that the allowance funds are utilized for healthcare purposes.
Consult with healthcare professionals
- Maintain regular connection with the doctors and stay updated on the decline of functionality and capabilities
- Consult with all the professional caregivers involved to determine the necessary restrictions in daily life
- Accompany the patient to a cognitive-functional assessment conducted by an occupational therapist and seek guidance on the appropriate level of care and assistance needed. Consult with them regarding the measures required for preventing accidents and injuries to ensure the patient’s well-being
- Consult with a social worker regarding the family's situation and the potential implications involved
- Check with a lawyer regarding the legal implications of appointing a person with a financial power of attorney