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Elder law solutions for people with dementia

For people dealing with a dementia diagnosis, the complexities of aging and future medical needs can feel overwhelming. Fortunately, a good estate plan may ease some of that anxiety.

Here are some estate planning solutions to mitigate the financial burden and other matters that people with dementia may face.

Advance health care directive

Pennsylvania advance health care directives allow people to choose who will make decisions on their behalf if they cannot choose for themselves. This form also includes a number of treatments that people can choose ahead of time. For example, they may indicate whether they want a health care provider to perform CPR, insert breathing and feeding tubes, perform dialysis or give them blood transfusions.

They may also choose whether they want to die at home or in a medical facility and provide funeral and burial details.

Medicaid planning

Often, dementia effects make it impossible for people to live at home, even with a dedicated caregiver. However, nursing homes are expensive. In order to qualify for Medicaid to cover the costs, income and assets must be below a certain threshold. While spouses’ income and assets do count toward that limit, there are exemptions that allow them to retain a residence, a certain amount of income and certain other assets.

Medicaid does not allow people to simply spend or give away enough assets to qualify right before they apply. There is a five-year lookback period for the income and asset limits, so anyone who receives a dementia diagnosis should begin planning immediately.


A trust is an entity someone creates and transfers assets to. The trust owns the assets, and a trustee manages them on behalf of the trustor. This is a good solution for people who know they will not be able to manage financial matters for themselves.

It allows them to dictate how they want assets used during their lifetimes as well as what will happen to the assets after they die. For example, the assets may go directly to beneficiaries after the trustor dies. As a bonus, these assets do not go through the probate process.

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