As with all life-changing events, when a person is diagnosed with dementia, there are many factors to consider and challenges to face. With the progression of dementia, one loses one’s ability to manage finances, often leading to not having the resources to enable quality care later in life. Financial considerations must be made early in the diagnosis as decisions and planning will become increasingly complex over time as and when the condition progresses. Currently, the law provides and utilises curatorship as a way in which to handle the loss of the ability to make decisions in persons with dementia. This, however, is an expensive and somewhat outdated option for many South African families caring for their loved ones with dementia.
Power of attorney is another option that many families decide upon; this is when one needs someone to act on their behalf while they are temporarily – or permanently – unable to do so. Unfortunately, for this to be valid, the person has to be competent (compos mentis) at the time of signing the Power of Attorney document; thus when a doctor has made a diagnosis of dementia, the power of attorney option falls away.
In other countries, such as the UK, Canada, USA, New Zealand and Australia, there is the option of enduring power of attorney or conditional power of attorney. Enduring power of attorney endures, or lasts, the duration of incapacity of the person who granted it while conditional power of attorney comes into effect only when the person is believed to be incapacitated. Unfortunately, these are not options for South African families.
Listed below are some options which have been suggested:
1. Curatorship: A curator is appointed to take control of the person with dementia’s assets. Appointing a curator involves visiting the High Court in the same area of residence of the person with dementia. A curator ad litem may be appointed to manage the court proceedings on behalf of the person where the Master of the High Court will present a report including certain orders. The application to have a curator appointed needs to include recent reports from two doctors. Curatorship is an expensive process, and it is also a prolonged, often drawn-out procedure and even though it is transparent, there is room for abuse. A curator bonis is someone who will look after the assets of the person with dementia, and a curator personae is the curator ‘over the person’. A curator personae will only be appointed if the person is declared unable to look after his or her personal needs.
2. Forming a Trust: This is a useful alternative as it allows you to appoint trustees whom you trust and who will safeguard your interests and protect your assets. Trusts can not be set up once a diagnosis has been formally made.
3. Living Will/Advanced directive: A Living Will is not a legal document, but it might help the person in the later stages of dementia. A person can voice their wishes for treatment in a Living Will; this includes the care they would like to receive and refusal of certain treatments. They can also choose someone whom they trust to make decisions regarding their care on their behalf.
4. Financial Planning: Having a financial advisor can have many benefits as they will be able to advise families on the best type of cover going forward. It is clear that early planning for the later stages of life is essential as we are all at risk for developing dementia. Imara Assets Management South Africa has a built-in ‘red flag’ system where they monitor whether the person with dementia’s’ budgeting and spending diverts from what was agreed on. Personal Trust has Client Wellness Consultants working for them with the sole purpose of looking after the client’s’ well-being. Netto Invest and Bankmed also make provisions for frail care and covering certain care options later in life. When choosing a long term care policy ask whether the policy covers dementia care. Financial companies are becoming increasingly aware of these great challenges facing persons with dementia.