Instead, he advises naming a healthcare decision maker.
“It’s incredibly hard to imagine what it’s going to be like in that state and to write an advance directive so specifically doesn't necessarily get anyone much further because it has be interpreted by people,” said Dr. Sulmasy.
Financial advisors can help by reviewing their client’s advance directives once a year whether they are dementia specific or not in order to avoid situations in which the named healthcare decision maker may also be demented.
“In those circumstances, it’s a good time to get an ethics consult at the hospital because that’s one situation that can invalidate the person named as the healthcare decision maker when they don't have decision making capacity themselves,” said Dr. Sulmasy.
Because managing money, calculating numbers and paying bills requires the highest level of cognitive function, Dr. Sellers suggests advisors have a conversation with their aging client sooner rather than later about assigning a representative payee to help with their finances.
“They can also refer the client to their primary care physician for an assessment if they notice slippage in this area,” Dr. Sellers said.