Importance of Living Will and a Last Will and Testament
Laurence Tabanao Gayao, MD
As I have gotten older, I have had more and more encounters with folks with Alzheimer’s disease, especially among members of my family. Early on, I noted them not only more forgetful but also repeating questions or stories in one setting. I remember one relative would tell the same story once or twice over one dinner, which only became more frequent. I also observed changes in their demeanor from warm and charming personality to one with flat affect and a don’t care attitude about what’s going on around them.
We had a couple in our family that it affected both of them the same time. Eventually, they both needed 24/7 nursing care, which would have been financially prohibitive to do here in the US because they did not want to live in a nursing home. The did not have any children their closest relatives were my wife and his brother. The family decided to take them to the Philippines so they could get full round-the-clock nursing care. Because of their dementia, taking both on a long plane trip to the Philippine was very challenging. It was like taking care of toddlers in adult bodies. Trip from Dallas to Iligan City was very exhausting for the three relatives that accompanied them on the trip. They were not able to sleep for about over 24 hours because of the both couples were hallucinating, paranoid and at times combative due the unfamiliar environment they were in.
As much as I would like to say otherwise, an Alzheimer’s journey doesn’t get better, and it is not an easy disease to navigate. I know it is hard advice to hear, but this is advice I have given friends currently facing this disease in their family. Whatever you can do to prepare for the future, prepare now. Prepare today. Don’t ignore the signs. Use the resources that are available, because you will need them. As a family, we learned first-hand caring for my wife’s first cousin and her spouse. Both became mentally incapacitated and after they both passed away, my Edith, my wife, was the executor of their last will and testament. It was an eye opener and after their estate was settled; we consulted an estate probate lawyer and updated our own wills.
While it’s important for everyone to plan for the future, legal plans are especially vital for a person diagnosed with dementia. The sooner they put these plans in place, the more likely it is that the person living with dementia will be able to participate in the process. Three years ago, our family had to prepare documents for general power of attorney to handle financial and heath decision for my wife’s cousin and her spouse before they became fully mentally incapacitated. After both husband and wife passed away, we discover their last will and testament have not been updated for the over 35 years and the probate lawyer we hired was shaking his head. He said it did not take advantage of current changes of the state laws and a lawyer did not draft the document but by the insurance agent using a one size fits all generic document.
Legal planning should include:
- Preparing for long-term care and health care needs.
- Making arrangements for finances and property.
- Naming another person to make decisions on behalf of the person with dementia.
Before a person with dementia signs a legal document:
- Discuss the document. Make sure that the person understands the document, the consequences of signing it and what he or she is being asked to do.
- Ask for medical advice. If you have concerns about the person’s ability to understand, a doctor will be able to help determine the level of his or her mental capacity.
- Assess existing legal documents. Even if a living will, trust and power of attorney were completed in the past, it’s important to review these documents for any changes and update as necessary.
If you meet with a lawyer, be sure to discuss these key issues and any other concerns you may have:
- Options for health care and long-term care decision-making for the person living with dementia.
- Options for managing the individual’s personal care and property.
- Possible coverage of long-term care services, including what is provided by Medicare, Medicaid, veterans’ benefits and other long-term care insurance.
Gather all documents relating to the assets of the person with dementia ahead of time so you can bring them to your appointment.
The difference between a Living Will and a Last Will and Testament
A Last Will and Testament dictates how your assets will be distributed and utilized following your death. A Living Will states your wishes regarding life support in the event that you are in a persistent vegetative state or irreversible coma and cannot communicate your wishes.
Both documents need to be updated to apply to the needs to be addressed at a certain point in your life. If you have minor children who will take care of them, how and when your assets would be given to them to manage or distributed? If you are young and have children, and don’t have both documents, the courts will decide after someone petitions the court should face unexpected death. God forbid, but if both parents die in a car accident or of COVID, you need a last will and testament to designated care for your children and take care of disposition of your assets.
Remember, a will may be the most important document that you ever write, because it allows you to select the persons who will receive what you own when you die. If you don’t have one in place, you cannot select the recipients of your property and the state you reside in will determine how your property is divided.
