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Caring for a person with a progressive dementia diagnosis requires more planning than many other types of caregiving because the disease strips away the care recipient’s abilities gradually. It is difficult to gauge how well an individual can perform a specific function because the progression of the disease proceeds at a different pace with each person. However, it is indisputable that with each person there will be a steady decline in his/her ability to perform tasks and make decisions. The decline continues throughout the course of the disease. Therefore, it is essential that, while the care recipient is able, the caregiver and care recipient have conversations about the tasks and decisions currently made by the person with the disease. At this moment in time, they may be handling all their tasks without problem, but eventually the ability to continue completing tasks will diminish.

The caregiver must know what the person with dementia is responsible for, how they discharge those responsibilities and how they want them managed in the future when they can no longer perform those tasks independently. In three areas it is important to make future plans: family roles, finances and legal matters. 

What are the tasks within the family the person with a dementia diagnosis performs? Is (s)he the family driver, shopper, lawn care worker, launderer? Someone else will have to provide these services eventually. Focusing now on what’s involved in each task can help the care recipient be involved in determining who and how these tasks will be performed in the future.

Who manages health insurance premiums, selects Medicare plans, pays the monthly bills, makes sure the car insurance payments are made, renews driver’s licenses? Failure to complete these tasks can result in lasting problems for families when they discover that insurance was allowed to lapse or Medicare D enrollment wasn’t completed. If the care recipient is responsible for any of these or other financial responsibilities sit down together and create a financial plan that encompasses all these matters.

Lastly, are legal issues. When a person faces diminishing capacity it is very important to know what their wishes are about health care decisions, assets, banking and other legal matters. Appointment of a power of attorney can only be made while the individual is mentally competent to grant authority to another. If you wait until it’s needed due to diminished capacity, it is too late to be appointed.