As estate planning attorneys, we at Frankel, Rubin, Klein, Payne & Pudlowski, P.C. have seen firsthand how difficult it can be for families to cope with the challenges that arise when a loved one is diagnosed with dementia. As first reported by the journal Nature Medicine and summarized in this ABC News Article, with dementia cases projected to double by 2060, this is a reality that more and more families will face. The growing prevalence of dementia is not only a public health concern—it’s a personal one that directly impacts your family’s financial, medical, and legal well-being.

The reality is that by 2060, an estimated 13 million people in the United States will be living with dementia, a stark rise from today’s numbers. With this in mind, planning for the future, while you still have the capacity to make decisions for yourself, is essential.

Understanding the Dementia Crisis

Dementia encompasses a range of cognitive impairments, including Alzheimer’s disease, which affects memory, thinking, and behavior. The aging Baby Boomer generation, combined with the medical advancements that help people live longer, is driving this projected rise. In fact, the Centers for Disease Control and Prevention (CDC) reports that by 2060, more than 12 million people in the U.S. will have Alzheimer’s disease alone, with many others affected by other forms of dementia.

The truth is, dementia doesn’t just impact the person diagnosed; it affects entire families. If you or someone you love is diagnosed with dementia, you’ll likely face difficult decisions about health care, living arrangements, and how to manage finances as cognitive decline progresses. While no one can predict who will develop dementia, there are steps you can take now to make sure your wishes are honored, even if you lose the ability to make decisions for yourself in the future.

The Estate Planning Challenges of Dementia

As an estate planning attorney, I’ve seen how dementia complicates legal and financial matters. For many clients, the idea of facing cognitive decline may seem far off—until it’s not. Without proper planning, a person with dementia can lose the ability to make key decisions about their health care, finances, and even their estate, which could lead to the necessity for court involvement.  This is where thoughtful estate planning can help ensure that you retain control over your decisions, even when you may no longer be able to manage them yourself.

Here’s how estate planning can help you prepare for the possibility of dementia:

1. Power of Attorney (POA)

A durable power of attorney (POA) is one of the most critical tools in planning for the future. A POA allows you to designate someone to make financial decisions on your behalf if you become incapacitated. Without a POA, if you are unable to manage your finances due to dementia, your family may have to go through a lengthy and expensive court process to have someone appointed as your legal guardian or conservator. Establishing a POA while you are still competent ensures that a trusted individual will step in to manage your financial affairs when the time comes.

2. Healthcare Power of Attorney, Medical Directives and Living Wills

As dementia progresses, many individuals lose the ability to communicate their preferences for medical treatment. This is why having healthcare directives (sometimes called a living will) is so important. In these documents, you can clearly outline your wishes for end-of-life care, organ donation, and other healthcare decisions. You can also designate a healthcare agent to make decisions for you when you’re no longer able to do so. The more specific and clear your directives are, the less burden it will place on your family during what will already be a difficult time.

3. Trusts

A revocable living trust is another essential tool in planning for dementia. A trust allows you to place your assets in the hands of a trustee who will manage them for your benefit if you become incapacitated. One of the advantages of a trust is that it avoids the probate process and allows for smoother distribution of assets when you pass away. If you are diagnosed with dementia, the successor trustee you’ve appointed can step in and manage the assets in the trust according to your instructions, even as your capacity declines.

The Legal and Ethical Considerations

When planning for dementia, there are several legal and ethical considerations. First and foremost, you need to ensure that any documents you sign—such as a POA, healthcare directive, or trust—are done when you are mentally competent. As your attorney, we will work with you to confirm that you understand the documents and that your wishes are clearly reflected in them.

There’s also the risk of undue influence or financial abuse when dementia affects decision-making. It’s important to select your agents, trustees, and healthcare proxies carefully to ensure they are trustworthy and act in your best interest. We can guide you through the process of choosing the right individuals for these important roles, and we will make sure that the documents you sign protect you from potential exploitation.

Why You Should Act Now

Book a call with one of our experience estate planning attorneys today. The best time to plan for dementia is before it becomes a reality. By establishing a comprehensive estate plan, you can help protect your assets, ensure that your healthcare wishes are followed, and ease the burden on your family when the time comes.

Frankel Rubin’s attorneys are licensed in Missouri and Illinois and our law firm services all of the St. Louis Metropolitan Area. We are especially convenient for estate planning in Clayton, Brentwood, Des Peres, Frontenac, Glendale, Webster Groves, Kirkwood, Ladue, Maplewood, Olivette, Overland, Richmond Heights, Rock Hill, Shrewsbury, Town and Country, Creve Coeur, Affton, Crestwood, Sappington, Sunset Hills, Maryland Heights, University City, Warson Woods, and St. Louis City.

References: Journal of Nature Medicine (Jan. 13, 2025) “Lifetime risk and projected burden of dementia“, ABC News (Jan. 14, 2025) “New dementia cases in US projected to double to 1 million by 2060: Study“, Center for Disease Control and Prevention (Aug. 17, 2024) “About Dementia“