When my grandmother’s dementia progressed, my relationship to her changed. I had been her loving grandchild, who she watched grow. She taught me to sew, make coconut bunny shaped cakes at Easter, and took me on a teddy bear picnic with her best friend Gloria once. Soon I became a beloved person whose name she couldn’t quite recall. In the end I was just a friendly visitor. We were lucky that she never lost her kind personality. She would say thank you for visiting and ask how I was. She never stopped trying to make me better. Her last words to me were “work hard!” Then she turned to my Dad and said “you, don’t work so hard.”

Don’t let the title of Elder Planning fool you. Everyone eighteen or older should have a power of attorney, a living will for health care decisions, and maybe a will. Why? Because anyone and everyone could have a car accident, or medical event, such as a stroke, and without a power of attorney or living will, your family will not have the ability to make decisions for you. But if you ever were to end up in a hospital with a medical emergency, you will want a family member or other trust person to make those critical health care decisions while alive, and in the event of death, to handle your assets and transfer them to the people you want. As a Navy JAG lawyer for many years, our command authority required every sailor from the lowest ensign to admiral to have those critical documents in place. Why? Because if the need arose to make legal or health care decisions for any sailor who was temporarily or permanently incapacitated, the Navy did not want to be stuck with any time consuming delays. Put in Boy Scout terms, be prepared.

Much of my time is spent encouraging families to plan ahead. This often means creating a Power of Attorney, Living Will, Last Will, and sometimes a trust. Usually, the spouse is named as the person who will assist, with one or more of the children as a backup in case both spouses become incapable, in need of long term care or pass away. In the best circumstances these documents are critical to ensure assets are protected and any life transitions are as smooth as possible. The trouble is getting started.

“Help please!” my daughter asks. It sounds more like “Hep Peas”, but it is always stated without pride or frustration. “Hep Peas,” as a fact. It could be help putting on her shoes, reaching for a snack, opening the toothpaste or refilling her water. “Hep Peas, Mama.” So I help, grateful she knows her limits. Grateful she still needs me. I also love “Hand,” when she insists we hold hands either to go down stairs, or cross a road, or fall asleep. “Hand,” she insists, and I wonder if it’s more for me than her sometimes.

When a parent or grandparent has dementia, and is still driving, a very difficult situation can arise when the adult children realize that mom or dad’s situational awareness and functional ability have decreased to the point where the parent is no longer safe to drive. Sometimes the parent realizes this and is willing to give up driving. But giving up driving when you have done it since you were 16, and when it is often a means of meeting friends and family or just going shopping for something to do, is often not easy. What are some ways to handle this without harming the elders feeling of independence in order to keep them and others safe?

I can’t remember how many times people with dementia have answered questions with those three words. It could simply be forgetting something for a moment. Everyone does from time to time. But if it is a regular and near complete occurrence, then it means two things: the ability to make decisions is impaired and some other family member or trusted person must be given the power to make financial and health care decisions if you cannot. That is where a power of attorney and health care directive are a must, because when a person’s memory becomes so impaired that rational decisions cannot be made, someone has to do it. When I was a Navy lawyer in the JAG Corps, the high command had a simple unavoidable rule: every new recruit should do power of attorney, a living will, and a will to pass on assets if the worst occurred. Why did the Navy have this strict rule? Because every one of those young sailors might by assigned to commands where it might be difficult to communicate with the outside world, or had some risk of being hurt and unable to handle their own financial affairs for a period of time.