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My wife is developing cognitive impairment which is likely to become dementia. No formal diagnosis yet. We have wills and a trust, POA, and health care proxies. We also have LTC insurance.


Should I alert our attorney of this situation? Anything I (we) need to do before a formal diagnosis?

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Update all your documents.
If SHE is your POA appoint someone else.
If she is designated to make any decisions if something were to happen to you change that.
I would also put in place a "Special Needs Trust" so that she will be take care of if something happens to you.

A word of caution about taking her to the lawyer. Make changes BEFORE a diagnosis. BUT if while talking to both of you if the lawyer does not think she is competent he will not be able to make changes that would involve her signing anything. So if you do this chose a time of day when she is at her best. Try to make the appointment as low key and comfortable as possible. (as a matter of fact if the lawyer would come to your home that might be better as she will be more relaxed.)
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Reply to Grandma1954
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When I realized my Dad was losing his grip, I urged both my parents to update their wills, health care proxy, and DPOA. Thank goodness, they did so. But they named each other as executor, health care proxy, and DPOA with me second.

A couple of years later, once he was diagnosed by a neurologist with frontotemporal dementia, I contacted their attorney who asked for a copy of the letter from the neurologist, which stated my dad was no longer competent to handle his own business or financial affairs. I sent it. The attorney pointed out that my mom needed to update her documents again, to omit my dad as having any legal authority to make decisions for her were she to become incapacitated or pass away. She did that.

My parents moved to be near me (crossing to another state) and then my Dad passed another couple of years later (2024) so my mom had to update her legal documents yet again.

Good luck!
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Reply to Suzy23
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If everything is up to date and your estate is in order I would recommend just trying to enjoy every minute with your wife now before things get worse.
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Reply to Kimbasimba
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I'm so happy to hear that you already have wills, trust, POA, and health care proxies established. That is exactly how it should be. If all of those documents were finalized before her cognitive impairment, then the information they contain does not change. I hope you have a durable POA, as that continues to be in effect even as the subject loses their mental capacity.
Get the medical diagnosis before talking to your attorney. That medical diagnosis can be included in all the other paperwork.
As the spouse, you will make decisions on her behalf, unless someone else is named as POA for her.
Relax, and take care of each other, knowing that you already have all your wishes documented.
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Reply to CaringWifeAZ
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KPWCSC Jul 4, 2025
@ CaringWifeAZ said "Get the medical diagnosis before talking to your attorney."

I would question doing that. OP only said "likely" to become dementia.

Once it is diagnosed, everything will be limited as to what she can legally sign, if an attorney advises to make any updates to the legal documents.
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As her spouse, you will be primary person to make decisions for her when she is no longer mentally competent. Her diagnosis will not affect wills, trust... unless she is listed as a person to make decisions. If need be, I would suggest adding a younger person - trusted family member or friend - as to your legal documents to be a secondary, or "back-up", in case the primary person is unable to execute the necessary functions on each document.
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Reply to Taarna
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It's good that you have these legal documents in place. This is the type of situation that they're needed for.

I think the most important thing is to discuss end of life care while your wife is still capable of making decisions. Mum told the GP that she wanted a DNR in place - she didn't want any heroic measures taken, as she knew that it's better to try and have a peaceful death, rather than a long drawn out death, potentially in pain.
I was at the appointment and knew of my mum's wishes, which was helpful later.
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Reply to MiaMoor
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danieldaniel: Pose your concerns to your attorney.
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Reply to Llamalover47
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Whether she is ever diagnosed with dementia or not, it is a good idea to contact your attorney and have your documents reviewed since you have that concern. Laws change so there may be a reason to update some of the legal documents to be sure they still reflect what you both want, especially since you feel dementia may be in her future. This way you are not trying to beat the clock later and whatever happens to you or her, you will know you have everything in place. Life happens! Last time we updated ours, we were advised to take my husband's name off my POA, etc. It makes perfect sense, but something I had not even thought about because our sons were secondary. This way no one has to worry that he legally could step up and cause issues... especially if he should have a very lucid period at that time.
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Reply to KPWCSC
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Yes, I would do that consult with the attorney. In fact you may be able to make this a phone consult. You will want to be certain there is a good solid POA or Spring POA in place. Your wife will be making no changes to any legal documents once she is diagnosed with impairment severe enough. Discuss, again, with your attorney and good luck.
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Reply to AlvaDeer
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Find a neurologist specializing in cognitive disorders to get an accurate diagnosis, preferably one at an academic medical center. S/he will also be able to tell you whether there are medications that might slow its progress. Then she (or you if she loses capacity) decide whether she should take them. Check with the company in charge of the long-term care insurance. You'll probably have to continue paying its premiums as long as the policy covers her (but that's another reason to check w/the company), as Geaton777 has said. I concur that she might want to have a backup POA. You may or may not need an Executor for her will, depending on her assets. My late husband had term life insurance and I was the primary beneficiary. When he died, he also had money remaining in his 403b account and I was the primary beneficiary. Since those were his only assets (except for a condo in both of our names), he didn't need an executor for his estate. But check with the attorney as well on that.

This is a stressful time for both of you. One or both of you might want to attend a support group. Or one or both of you might benefit from professional counseling. Her or your PCP can probably recommend someone. Or if one or both of you are members o regular attenders of a church, synagogue, mosque, or temple, check with the clergy there. In addition to providing pastoral counsel, they probably can also recommend a qualified professional.
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Reply to swmckeown76
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You could ask the lawyer to review current docs if they are over 5 years. MCI is mild and she should still be able to make decisions. The lawyer can assess her for her level of understanding
For instance, I was mom's guardian for moderate dementia and we both were in the doctor's office with her stating she would never want to go on dialysis
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Reply to MACinCT
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