I recently had the opportunity to give a talk at the California Central Coast Estate Planning Council about this topic, here are the highlights.
Alzheimer’s in San Luis Obispo
According to the San Luis Obispo Tribune, the prevalence of Alzheimer’s in San Luis Obispo is particularly high. In San Luis Obispo County, 10.6% of the population 65 and older has been diagnosed with Alzheimer’s disease as of 2023, the data shows.
How Alzheimer’s was diagnosed before 2025
Historically, diagnosis relied heavily on clinical assessments and cognitive tests to observe symptoms like memory loss and cognitive decline. The diagnosis was often made late, and the process was lengthy and costly, with many patients never having been diagnosed or being diagnosed too late.
How Alzheimer’s will be diagnosed in 2025 and beyond
With new and more effective medications coming out this year, it is imperative to diagnose Alzheimer’s disease early because they do not work in later stages. High-quality blood tests and imaging biomarkers have the potential to revolutionize Alzheimer’s diagnosis, enabling more patients to use newly approved disease-modifying treatments.
Alzheimer’s and Estate Planning
Having a diagnosis of Alzheimer’s disease doesn’t mean that you lose legal capacity. In the early stages, you may be fully competent to enter into any number of more or less complex legal arrangements. This includes trusts and wills. However, an Alzheimer’s diagnosis makes it a priority to get your estate in order because as the disease progresses, you are risking that any contract you sign or any estate plan that you make is challenged by others, unfortunately, often family members.
Proper planning ensures that your wishes are honored and that you and your loved ones are taken care of as the disease progresses. Here are essential steps and considerations for writing a will or setting up a trust after an Alzheimer’s diagnosis.
Seek Legal Advice Early
Consulting with an experienced estate planning attorney who feels comfortable with clients who have memory loss is vital. Early planning is essential because Alzheimer’s can affect cognitive abilities over time. A qualified attorney can guide you through the complexities of estate planning and ensure your documents are legally sound.
Establish Advance Directives
Advance directives are legal documents that outline your preferences for medical and financial decisions:
- Durable Power of Attorney: Appoint a trusted person to handle financial and legal matters on your behalf.
- Healthcare Power of Attorney (Advance Health Care Directive): Designate someone to make healthcare decisions if you become unable to do so and specify your wishes regarding medical treatment and end-of-life care.
Create a Revocable Living Trust
A revocable living trust allows you to manage your assets while you’re capable and appoints a successor trustee to take over if you’re no longer able:
- Flexibility: You can modify or revoke the trust as long as you are mentally competent.
- Avoiding Probate: Assets in the trust can be distributed without going through the probate process, saving time and money.
- Trustee Selection: There are many considerations in the selection of a trustee. Your attorney will be able to advise you.
Update Your Will
Ensure your will reflects your current wishes and circumstances:
- Specific Bequests: Clearly outline the distribution of your assets.
- Executor: Name a reliable executor to manage your estate.
Plan for Dependents
If you have minor children or dependents, appoint a guardian in your will. This ensures that someone you trust will care for them if you’re unable to do so.
Financial Planning for Care
Alzheimer’s care can be expensive, so it’s essential to plan for future costs:
- Long-Term Care Insurance: Consider purchasing insurance to cover the costs of care, but insurers may have restrictions once the disease is diagnosed.
- Savings and Investments: Review your financial portfolio to ensure you have adequate funds for your care.
Update Beneficiary Designations
Review and update beneficiary designations on life insurance policies, retirement accounts, and other financial instruments to ensure they align with your estate plan.
Communicate Your Plans
Discuss your plans with family members and anyone appointed in your directives or trust. Clear communication can prevent misunderstandings and conflicts later on.
Regularly Review Your Estate Plan
Your estate plan should be a living document that evolves with your circumstances. Regularly review and update it to reflect changes in your health, financial situation, or family dynamics.
Address Digital Assets
Include provisions for managing and distributing digital assets, such as online banking accounts, social media profiles, and email accounts.
Legal Capacity Considerations
Acting while you have the legal capacity to make decisions is crucial. Documenting your capacity with medical evaluations can be beneficial in ensuring your wishes are respected. In the early stages many attorneys will be comfortable with determining capacity. Don’t wait until your disease has progressed to a stage where you may need to undergo neuropsychiatric testing.
Create a Care Plan
Develop a detailed care plan outlining your preferences for living arrangements and care as your condition progresses. This can include in-home care, assisted living, or nursing home care.
Build a Support Network
Establish a support network of family, friends, and professionals who can assist you as needed. Having a reliable support system can provide peace of mind and practical help.
California Central Coast Alzheimer’s Association
The Association is the world’s largest nonprofit funder of Alzheimer’s research and the nonprofit with the highest impact worldwide. It has chapters in communities across the nation, and the California Central Coast Alzheimer’s Association has offices in San Luis Obispo, Santa Barbara, and Ventura. Among many other things, including a national 24-hour helpline (800-272-3900), the California Central Coast chapter offers online and in-person support groups.
Select an attorney who is comfortable with clients with memory loss
Klaus Gottlieb, Esq, of Wealth Care Lawyer in San Luis Obispo, was a physician before he became an estate planning attorney. As an attorney, he has written about less restrictive alternatives to conservatorship (supported decision-making), a topic where medicine and law intersect.
