Alzheimer’s FAQs for Massachusetts Families

Alzheimer’s disease is a form of dementia that affects memory, thinking, behavior, and the ability to perform everyday activities. Symptoms generally become more significant as the disease progresses.

A diagnosis can affect far more than medical care. Over time, a person may need help paying bills, managing property, communicating with health care providers, arranging long-term care, or making other important decisions.

This is why legal should be considered along with medical treatment and caregiving arrangements.

Many estate planning documents must be signed while the person creating them has sufficient legal capacity.

An Alzheimer’s diagnosis does not automatically mean a person is unable to make legal decisions. A person in the earlier stages of the disease may still understand and participate in planning. The person’s ability to understand a particular decision and legal document must be considered based on the circumstances.

Starting sooner can give the individual more opportunity to choose who should manage financial matters, make health care decisions, and carry out estate planning wishes.

The appropriate documents depend on the individual’s circumstances, family, assets, health, and existing estate plan. Common documents that may need to be created or reviewed include:

• Durable Power of Attorney
• Massachusetts Health Care Proxy
• Last Will and Testament
• Revocable or other appropriate trusts
• Beneficiary designations
• Medical information authorizations and related health care documents

A Durable Power of Attorney can allow a chosen agent to handle authorized financial and legal matters. Massachusetts law permits a properly drafted durable power to continue despite the principal’s later disability or incapacity.

Families should also review older documents to determine whether the people named as agents, trustees, personal representatives, or beneficiaries still reflect the person’s wishes.

A Massachusetts Health Care Proxy allows a competent adult to appoint another adult to make health care decisions if the person later becomes unable to make or communicate those decisions.

The agent’s authority generally begins after the attending physician determines that the person lacks the ability to make or communicate health care decisions.

For someone living with Alzheimer’s, naming a trusted health care agent can provide clarity about who should communicate with doctors and make medical decisions if the disease progresses.

The person creating the proxy should also talk with the selected agent about personal values, treatment preferences, living arrangements, and other wishes.

If a person becomes unable to handle important matters and does not have effective legal documents in place, family members may have fewer options for acting on that person’s behalf.

In some situations, a Massachusetts Probate and Family Court proceeding may be required. A guardian may be appointed to make certain personal or health-related decisions for an incapacitated adult. A conservator may be appointed to manage property and financial affairs when the legal requirements are met.

Court involvement takes authority away from private planning and places certain decisions under court supervision. Creating appropriate documents while the individual can legally do so may reduce the likelihood that court intervention will later be necessary.

Alzheimer’s disease may eventually increase a person’s need for supervision, personal care, home-based services, assisted living, memory care, or nursing facility care.

Families should consider future care needs before a crisis develops. Planning may include reviewing income, savings, insurance, housing, caregiver availability, estate planning documents, and possible public benefits.

Medicare generally does not pay for ongoing custodial long-term care, including assistance with basic daily activities.

Families can learn more through the firm’s Nursing Home Planning and Options for Paying for Nursing Home Care resources.

For additional educational information about planning after a dementia diagnosis, see the National Institute on Aging’s guidance on legal.

MassHealth may cover certain long-term care services for people who satisfy the applicable medical, financial, residency, and other eligibility requirements.

MassHealth evaluates eligibility under specific program rules, and requirements can vary depending on the type of coverage and care involved. For long-term-care applicants, financial eligibility may include a review of income and assets.

Because actions involving property, gifts, trusts, or other assets can affect MassHealth eligibility, families should understand the applicable rules before making significant financial changes.

An estate plan should be reviewed when significant changes occur. For a person diagnosed with Alzheimer’s, changes in health, caregiving arrangements, finances, housing, or family circumstances may make a review especially important.

Early reviews can also help identify outdated documents, agents who are no longer able to serve, beneficiary designations that need attention, or planning provisions that no longer match the individual’s wishes.

As Alzheimer’s progresses, the person’s ability to make or revise legal arrangements may change. Families should avoid assuming that documents can always be updated later.