Alzheimer’s care planning usually happens in stages that align with the progression of the disease: early-stage planning, middle-stage support planning and late-stage care planning.

Alzheimer's is a progressive disease, which means that over time, the symptoms of Alzheimer's-related dementia worsen. It's estimated that 7.2 million Americans ages 65 and older have this disease. In the early stage, many seniors can function normally. It's only as the disease progresses that those affected start to experience functional impairment and have difficulty looking after themselves.

The period between diagnosis and impairment may last several years. During this time, it helps if you and your family prepare a care plan for when the person with Alzheimer's can't make those decisions independently.

Understand the Stages of Alzheimer’s

The causes of Alzheimer's aren’t fully understood. Available information points to age-related changes in the brain that gradually accumulate over a period of years. There's no single test for Alzheimer's, as doctors use various tests, including neurological examinations, blood tests and psychometric tests, to arrive at a diagnosis.

Early-Stage Alzheimer's

During early-stage Alzheimer's, most people still function normally. Close family and friends may notice a difference, and the person may experience difficulties remembering things, organizing their lives and performing complex tasks.

Middle-Stage Alzheimer's

During middle-stage Alzheimer's, you may notice more obvious symptoms of dementia. These include confusion, frustration and an inability to express thoughts. A person with moderate dementia usually needs some help with daily tasks, although they can still participate in daily and social activities. Some show personality changes and may be withdrawn or moody.

Late-Stage Alzheimer's

The last stage of Alzheimer's is characterized by severe dementia symptoms. Significant personality changes occur, and the person becomes detached from their surroundings. They require around-the-clock care, help with daily needs and typically have difficulty communicating with caregivers and family.

Why Early Alzheimer’s Care Planning Helps

Alzheimer's is a progressive disease, so early planning helps smooth the way forward. In most instances, doctors diagnose Alzheimer's at an early stage, when you or a loved one still can make decisions for the future.

If you have an Alzheimer's diagnosis, early planning lets you have a say in your future treatment. It allows you to set your affairs in order and put in place legal documents to specify your future wishes.

Early planning lets you and your loved ones structure the care team that will help look after you as the disease progresses. Key decisions to make include where you'll live and who will provide interim and long-term care. Medicare helps pay for outpatient care and Alzheimer's medications, but it doesn't pay for long-term nursing care.

Financial and Health Care Planning

Important aspects of Alzheimer's care planning include financial affairs and health care. Points to consider include who looks after your money, what happens to your property and how your advance directives for health care are handled.

Financial Planning

While a diagnosis of Alzheimer's may be overwhelming, it's vital to consider your financial affairs while you still have the cognitive ability to do so. This includes making or updating your will so your executor carries out your wishes regarding your property when you die. Collect and collate all important documents, including insurance policies, investment documents and title deeds. It helps to use a financial template or spreadsheet.

Draw up a power of attorney appointing a loved one or someone you trust to act on your behalf. If you live in Texas, the law requires that the durable power of attorney form be notarized; requirements in other states may differ. The form allows the authorized person to handle your financial affairs once you're incapacitated.

Health Care Planning

Together with loved ones, make plans for where you'll live during different stages of the disease. This includes whether you'll live at home and have caregivers, move to an assisted living community like Bethesda Gardens in Frisco or move to a memory care community if you need more consistent support.

Consider using an advance directive to appoint a Health Care Agent who has the authority to make health care decisions when you're no longer able to do so.

Prepare a Care Plan

Working together as a care team, create a detailed care plan for when you or your loved one can no longer manage financial or personal affairs. The plan covers long-term care during the moderate stage of Alzheimer's and when you or your loved one needs full-time care.

Plan for Long-Term Care

As the disease progresses, there's an increasing need for assistance with daily tasks and hygiene. You can arrange for long-term care at home or, when needed, in an assisted living community. It's less stressful if the person with Alzheimer's doesn't have to move during this stage. The following points may help as you plan:

Daily routines. Create consistent daily routines to help reduce stress and encourage feelings of security and independence.

Caregivers. A spouse and immediate family members are often the primary caregivers, assisted by various support services. In preparation for this role, learn about Alzheimer's caregiving and consider helpful resources, including joining a local support group.

Respite care. Caregiving is hard work, and the primary caregiver should periodically arrange for a few days' respite to recharge physically and emotionally.

Plan for Late-Stage Alzheimer's

As the disease progresses, there may come a time when you or your loved one needs full-time care. It's best to plan ahead so you and your caregivers know your wishes. Care options include:

Memory care. Provided by a nursing home or memory care community, highly trained and compassionate caregivers take proper care of your loved one's needs.

Around-the-clock home care. As an alternative, it's possible to provide continuous care at home. This has the advantage of familiarity, but it's essential to choose a professional care team with specialized training in advanced dementia care.

Adapt the Care Plan

As your or your loved one's condition changes, the care plan may need to be adjusted. That's why appointing a health care agent is so important. They have the legal authority to make decisions in your or your loved one's best interests.