Professional Documents
Culture Documents
c
c
c
!
± Primary payer for individuals with Alzheimer¶s disease; eligible at
65 or after 24 months on SSDI
-
± Employer-based or private insurance
± Long term care insurance
!
± Federal/state program for low income individuals and children
± Each state¶s program is different
,
)
± Broad array health care benefits, including long-term care benefits
and nursing home care
Managing Health
& Personal Decisions
At some point, someone else will have to
make health care decisions for an individual
with dementia
Who will be the decision maker?
What guidance will be provided in advance?
How will it be communicated?
What is Surrogate Decision-Making?
Individual
(Directed)
Others
designated by
individual
(Delegated)
Health Care Advance Directives
-.
Directive that provides guidance or instruction
about the care and decisions wanted
Usually includes specific instructions on life-
sustaining conditions
c" /
Choose an agent/proxy (and successor) to make
health care decisions if unable to make them
Should be someone who can be a strong
advocate and willing to make difficult decisions
What ADs Can Do
1. CAN be an important part of a
communication process in ³advance
care planning´
2. CAN help you stop and think and
DISCUSS.
Less about specific medical decisions, more
about GOALS, VALUES & PRIORITIES:
3. CAN empower and give direction if
reflective of the patient¶s voice.
Not the legislature¶s canned language.
What ADs Can¶t Do
Can¶t provide cookbook directions.
Can¶t change fact that dying is
complicated.
Can¶t eliminate personal ambivalence.
Can¶t be a substitute for Discussion.
Can¶t control health care providers.
a%"
0
c-
-
& !''
# /
a *
$ '
1 c2'3"")
4 /
'-
)
-
5 - '-6-3
'
7 -
'
8"c-
0
2" *
*' !
6c "
92(
/
/
Close Friend and Unbefriended
*
"
'22
)
2
2
2*
'3
Make a Plan to Manage Money
& Property
Planning for management of affairs while
alive helps maintain control to the
greatest extent possible
Variety of legal tools
Powers of Attorney
Representative Payee
Joint bank accounts
Inter-vivos or Living Trusts
Advantages and disadvantages of each
Powers of Attorney
For property
Durable ± since planning for incapacity
Document by which one person
(³principal´) gives legal authority to another
(³agent´) to act on behalf of the principal.
Generally must be signed & notarized.
Governed by state law
PoA Advantages/Disadvantages
´
". ' "
-
´c-
'
´
´/'
" )
´
6
´:
´
6
6
´
(
6
"
Types of POA Abuse
'
± Legal document that provides for distribution of some or all property at
death
± If a single parent of a minor or disabled child, can designate a guardian
of the child