Preparing for Incapacity

Diseases leading to dementia are characterized by a progressive decline in cognitive functions, including memory loss, decline in decision-making abilities, and difficulties in managing finances. As the disease progresses, it is anticipated that physical impairments will arise, leading to challenges in driving and independently carrying out various aspects of daily life.

If you have been diagnosed with dementia, you may feel concerned about the future, but it is important to point out that the status of the diagnosis does not immediately indicate a loss of competence. Even after the diagnosis, you will be able to make decisions regarding your medical condition and other matters, to manage your financial affairs, and continue to maintain a regular daily routine (such as driving). However, it is recommended that you prepare ahead for future incompetence to facilitate decision-making further along.

How to cope with functional decline and prepare for future incompetence

The decline in function and loss of competence both depend on the progression of the disease. In most cases, functional decline will be gradual, and fluctuations may occur in functionality and competency levels.

It is advisable to consult with your family doctor to evaluate your competence and decision-making ability in various aspects of life. The doctor will conduct a thorough and professional assessment of your functionality and determine your level of competence.

Furthermore, you can undergo a decision-making competence assessment conducted by occupational therapists. This assessment evaluates your capacity to make independent decisions. Based on the results of this assessment, a determination will be made regarding your legal competence. If necessary, you can utilize this assessment as evidence in a court of law.

Appointing a supporting decision-maker

At the early stages of dementia, you can appoint a supporting decision-maker. The supporting decision-maker can be a close family member, a volunteer, or a paid supporting decision-maker. Any individual selected as a supporting decision-maker must complete a supporting decision-maker course and obtain an appointment from a court of law. The role of the supporting decision maker is to help you in making decisions pertaining to financial, medical, and other important matters. This appointment helps preserve your independence to the greatest extent possible and ensures future assistance when your cognitive condition impedes your ability to make informed decisions.

Appointing an individual holding the power of attorney for healthcare

Even during the initial stages of the disease, it is recommended to appoint an individual to hold the power of attorney for healthcare in accordance with the Patient's Rights Act (Hebrew). The individual with power of attorney will have the authority to make decisions on your behalf when you are no longer able to do so. It is crucial for the person holding power of attorney to be aware of your preferences regarding future medical treatment.

The person with the power of attorney can be a trusted family member or any other individual chosen by the patient based on trust and confidence.

The person with power of attorney will be authorized to make medical decisions only at a stage when you, the patient, can no longer make these decisions independently.

It is important to note:

• The power of attorney for healthcare is utilized for making decisions related to medical issues only
• The person appointed as power of attorney will not have authority in financial matters such as managing bank accounts, receiving benefits, etc.
• The person appointed as power of attorney will not have decision-making authority concerning end-of-life decisions or the right to die with dignity

Take prompt action in managing financial matters

During the early stages of the disease, there is a decline in the ability to handle personal financial matters and manage possessions. Therefore, it is recommended that you prepare ahead of time and appoint a financial manager with the power of attorney. The person with the power of attorney will be a trustworthy person or family member. The person with the power of attorney will be granted access to the necessary financial resources for continued treatment, including benefits, bank accounts, etc.

Receiving the National Insurance benefit

It is advisable to appoint a family member or a trustworthy person who will receive the National Insurance benefit on your behalf. This will ensure that the allowance funds are utilized for your future healthcare purposes.

It is important to point out: 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 appoint a person for financial power of attorney.

It is recommended to consult professional healthcare providers, who specialize in their respective fields: