Part of aging is accepting that any one of us may face mental or physical health challenges along the way. When a serious diagnosis like Alzheimer’s or Parkinson’s occurs, it can feel overwhelming. For the family, too, this moment is significant. It doesn’t just involve planning for the individual with the diagnosis; it also means needing to protect and inform the entire care system. A well-organized incapacity plan can offer legal protection, clarity, control and emotional steadiness during uncertain times. Here are some helpful guidelines to get started.
Establish the Legal and Structural Foundation
When someone is diagnosed with a progressive condition, their ability to make and communicate decisions will decline over time. Planning before and early in the process allows the individual to protect their family and express their wishes. These are the documents that play an important role:
- A Revocable Living Trust allows a trustee/co-trustee to manage assets without court involvement. Naming a co-trustee at the onset can ease the transition if the original trustee is no longer able to serve. Assigning a co-trustee requires trust and clear communication, however, as giving someone shared control while you’re still capable can be tricky if there is a lack of defined roles and boundaries.
- A Medicaid Asset Protection Trust (MAPT) can be used to protect family assets from Medicaid spend-down for future long term care needs. MAPTs require advanced planning, ideally five years, and are helpful when planning for a family member to go on Medicaid.
- A Durable Power of Attorney provides authority to someone who is trusted to manage finances, including paying bills, handling property and dealing with the IRS when the individual is recovering from surgery, out of the country or otherwise incapacitated.
- The Durable Power of Attorney is effective immediately, not when incapacity occurs, and can be enacted before banks or institutions ask for doctors’ letters or legal opinions. Many families underestimate how challenging it can be to get a Durable Power of Attorney accepted once cognitive decline starts. Discussing this early with financial institutions can prevent obstacles and reduce stress when it matters most.
- A Health Care Proxy names the person who will make medical decisions for the individual if they become unable to.
- A Living Will outlines the individual’s care preferences, including life support and palliative care, and relieves the family from the responsibility of having to make those difficult choices. This document is more than legal authority; it’s about honoring the person’s wishes. Sharing these documents with family and medical providers helps ensure that decisions reflect known values and are not just guesses.
- HIPPA Authorization allows healthcare providers to share medical information with designated family members or caregivers. Families can find themselves in the dark due to privacy rules, even when they’re present. HIPPA Authorization is a small document with a big impact and without it, even well-meaning professionals may be legally prevented from speaking to those most involved in care.
Preparing the Family System Emotionally
Documentation cannot solve for everything. Families must also be equipped with the emotional tools needed to stay strong and united in the face of chronic illness. It’s important to start the conversation early and to present it through the lens of kindness rather than crisis. Ask the tough questions. For example: What do we want this to feel like as things get harder? Especially for families with adults who have special needs, these conversations can help maintain care continuity. If a primary caregiver falls ill, who will step in? How will that be funded? Where are the necessary documents? Below are some steps that should be taken to help prepare further:
- Clarify Roles: Define who will be responsible for financial matters, caregiving, daily logistics, medical oversight and emotional support. In families and blended families where siblings are involved, this clarity helps prevent confusion, resentment or potential legal conflicts in the future. Clarity around roles also ensures that everyone can participate to the best of their ability in the care of a loved one. For those who may not know how to engage or aren’t skilled at certain tasks, this planning can address those obstacles.
- Family Meetings: A simple, structured conversation, ideally with a neutral facilitator, can be very helpful. Someone who is not emotionally involved, like an advisor, can assist in setting the tone and guiding the discussion toward shared goals.
- Revisit the Conversation Regularly: Scheduling quick check-ins every six months can help to recalibrate roles, address burnout, and adjust to any necessary changes.
- Support for the Caregiver: The healthy spouse or primary caregiver often becomes the center of stressful situations. They may be managing medical visits, paperwork, finances and the emotional strain of witnessing their partner’s decline. Therefore, it’s important that they have their own support system, whether through friends, faith, therapy or professional care managers. They shouldn’t have to carry the entire load alone. These are some organizations offering support:
Financial Decisions
A serious diagnosis alters financial reality. Focus shifts from growth to preservation, access, and adaptability. Decisions that once centered on long-term returns now demand immediate flexibility and the ability to respond rapidly to changing needs. Families must assess how to safeguard assets while ensuring that funds can be drawn quickly for urgent expenses. This period often requires rethinking investment strategies and reviewing liquidity options so that care and comfort are never compromised all while mitigating potential risks. The following should be considered:
- Emergency Liquidity: Identify funds that can be accessed quickly without disrupting retirement accounts or trust structures. Selling illiquid assets or triggering capital gains can negatively impact long-term planning.
- Asset Titling: Work with an Elder Law Attorney to ensure that the right people have access to the correct accounts. Avoid naming the individual with special needs as the owner. Examples for a married couple:
- Home: Title in the name of the spouse or an irrevocable trust.
- Bank Account: Title in the name of the Spouse or the Medicaid Asset Protections Trust. Be sure to keep less than $250K in each institution
- Retirement Account: Since these accounts distribute as income and not assets, leave this account in the name of the owner.
- Brokerage: Title in the name of the Spouse or the Medicaid Asset Protection Trust
Insurance Review
Thoroughly assess your insurance coverage to ensure that all possible needs are addressed. When considering long-term care, it is crucial to determine whether appropriate insurance coverage is in place or whether self-insuring will be necessary. If a long-term care insurance policy exists, it’s important that families understand how to trigger the benefits and are aware of what expenses are and are not covered. Life insurance policies also warrant a careful review. They may provide funds for future care, replace lost income or support a dependent with special needs. At this stage, it is wise to be cautious about purchasing new insurance products, as each should serve a clearly defined purpose within the broader financial plan.
Conclusion
A serious diagnosis like Alzheimer’s or Parkinson’s doesn’t come with a clear path, but the right planning can prevent chaos. Proactive legal, emotional and financial preparation ensures that everyone, including those who are diagnosed as well as caregivers and dependents, can move forward with clarity and compassion.
At Wealthspire, our mission is to help you maintain what matters most during a difficult time: your dignity, your legacy and your family’s stability. Planning for incapacity is not merely a legal strategy; it is love made practical. If you’d like to connect with one of our advisors to learn more about how we can help you through a transition like this, contact us today.
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