Dementia: Early Planning While Decisions Are Yours

That window closes as capacity declines, and arrangements not made within it become considerably harder and sometimes impossible.

Legal arrangements first

A power of attorney for finances and for health and welfare allows a trusted person to act when you cannot. Making one requires capacity, so it must be done early.

Without one, family members generally must apply to a court for authority, which is slow, expensive, publicly recorded and involves ongoing supervision.

Advance decisions about medical treatment allow you to record what treatment you would refuse in defined circumstances, and are legally binding in many jurisdictions when properly made.

A statement of wishes about care preferences, daily routines and what matters to you is not legally binding and is enormously valuable to those making decisions later.

Review your will while capacity is clear, since wills made after capacity is questioned are more vulnerable to challenge.

Financial organisation

Consolidate and simplify accounts where possible. Multiple scattered accounts become difficult to manage.

Set up direct debits for regular bills to reduce the chance of missed payments.

Create a written record of accounts, policies, pensions, subscriptions and where documents are kept. This is invaluable later and takes an afternoon.

Consider whether banking arrangements allow appropriate third-party access, and set this up formally rather than through shared credentials.

Practical planning

Discuss preferences about where you would want to live if care were needed, and under what circumstances.

Identify who would take on which roles among family and friends, and check they are willing rather than assuming.

Consider the home environment: adaptations that would help, and whether the property remains suitable.

Address driving, which will need to stop at some point. Notification requirements to licensing authorities apply in most jurisdictions following diagnosis.

Support available

Dementia support organisations exist in most countries and provide practical guidance, local services and support for carers as well as those diagnosed.

Early involvement is generally more useful than waiting until a crisis, and many services are free.

Carer support matters considerably. Carers of people with dementia report high levels of strain, and respite and support services exist for this reason.

Living well

Diagnosis does not mean immediate incapacity. Many people live independently for years, and maintaining social contact, activity and routine supports wellbeing.

Making arrangements early is not pessimism; it is what allows the intervening period to be lived without the decisions hanging over it.