Making Health Care Decisions for Aging and Incapacitated Loved Ones

How should we plan to handle our grandmother's health care needs and financial affairs now that she's beginning to show signs of dementia?

Most caregivers struggle with knowing how and when to get involved in managing an elder’s money and assets. If dementia is becoming a serious problem for your grandmother, she’ll need to authorize someone to make her financial and health care decisions on her behalf. You or some other member of your family may be called on to help if she runs into problems with Medicare, needs Medicaid coverage, or is exploited in some way. In time, you may also need to serve as an intermediary between your grandmother and a host of businesses, health care professionals and insurance and government agencies.

The best way to begin this process is to sit down with your grandmother to review her will, trust, health care wishes, or other arrangements while she’s capable of participating. Choose a time when both of you are rested and calm. Chances are that she will appreciate some assistance sorting through complicated legal matters. If she resists, back off and try again some other time.

It would probably be best to hold this discussion within the context of a family meeting. Having family members present helps to ensure agreement on arrangements and reduces the likelihood that someone will be surprised by your grandmother’s decisions. Together, you, your parents, your siblings, and any other interested family members can make sure that your grandmother has a trust or will and has named an executor, with successors named if the first-named executor is unable to serve. Take stock of all her assets – for example, real estate holdings, savings and checking accounts, investments, 401(k), IRA, pension, retirement accounts, etc. – and help her work out an estate plan. An estate plan is a written expression of how she wants her assets to be managed during her lifetime and distributed after her death.

If you and your family members are good with figures and computers, there are a variety of products available to help you work up such a plan on your own. At the website you’ll discover a number of companies producing estate-planning software, including Brentmark Software, Cowles Legal Systems, InsMark, ProBATE Software, and Zane & Associates. If you don’t feel competent to tackle this assignment yourself, you should seek the assistance of a professional estate-planning attorney. The Christian Legal Society is a reputable source for locating a lawyer who is qualified to help you in this area.

It’s particularly important that your grandmother give someone power of attorney over her affairs. You can have either general or special power of attorney. General power of attorney grants you power to take care of any financial transactions. A special power of attorney authorizes you to do a limited number of actions for your grandmother. A power of attorney is usually granted only for a specific period of time. However, a Durable power of attorney, which does not terminate if the person granting it becomes mentally incompetent, involves the creation of a document (with the help of a lawyer) to give a trusted friend or relative the power to make either financial or medical decisions on your grandmother’s behalf when necessary. If she becomes totally incapacitated, someone can be appointed by a probate court to serve as conservator of her money and property or even as legal guardian of her person.

If your grandmother does not complete an estate plan instructing how her assets will be divided after her death, you may face lengthy lawsuits, court battles and family splits. That’s why we’d advise you to take time now to hammer out all the details with a lawyer who specializes in estate planning.

We know estate planning can feel overwhelming. For additional help and information on this topic, we’d encourage you to consult the resources and referrals highlighted below.

Did you know that Focus on the Family has a trained Planned Giving team? We are here to help you get started. Or, download your free copy of our eBook, Estate Planning Basics, and take the first steps toward gaining peace of mind knowing you there’s a plan in place for your family.


Caring for Aging Parents

Caregiver Action Network

National Association of Area Agencies on Aging

Caring for Ill or Aging Parents

Elderly Care

Discussing Your Medical Wishes: A Patient’s Guide

Making Medical Decisions for a Loved One: A Caregiver’s Guide


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