In most states, dementia is a reportable disease. Since 1988 physicians in California are required by law to report patients with dementia to their local health departments, information that is then shared with the Department of Motor Vehicles (DMV). Similar to sexually transmitted diseases, infections, and food borne illnesses, dementia is reported to both state and federal agencies. Unlike transmittable diseases however, the diagnosis and reporting of dementia initiates a cavalcade of medical, financial and legal consequences that might strip you of some of your rights as a citizen.
If you are diagnosed with dementia the first thing that you will notice is that the DMV informs you that you need your driving skills to be re-examined—if you are lucky and your physicians indicated that you have mild rather than severe dementia which in the eyes of the DMV renders you unsafe to drive and you automatically lose your license. Statistically drivers with dementia are eight times more likely to be involved in a car accident. The DMV will schedule a meeting for you to meet with one of their driving instructors to determine your level of awareness, cognitive processes, and perception. Failure to pass these tests will results in your driving privilege being revoked. But if this meeting goes well then you will be scheduled for a special drive test, which includes vision screening. If you are successful at this test as well, then your license might be re-issued but it might come with some restrictions (driving at night driving on certain routes). From here on you will be reevaluated usually every 6 months or less. If the tests are unsatisfactory, you will lose your license. This loss will jeopardize your ability to work and provide for your dependents, restrict your social participation, diminish your involvement in personal interests, and severely curtail participating in community activities.
The second metamorphosis will involve your relationship with your bank. Banks are catching up slowly to the consequences of dementia both in terms of financial abuse and mismanagement of accounts. Banks are however blind to the diagnosis unless your diagnosis is reported by your spouse, business partner, or family. If you owe a lot of debt, own or manage or a company with a board of directors then it is likely that knowledge of your diagnosis will change your status dramatically. At this stage you can be declared incompetent and treated as such. But you might also be tricked into buying or investing in low-interest or volatile stocks/shares, or sign over assets by your bank or lawyer. Although rare, bankers and lawyers have been found guilty of such abuses. Especially when banks are actively trying to sell new policies, you might be an attractive customer to them despite your diminished capacity. Bankers cannot judge your capacity, and in most cases will not assume that you are incompetent, unless it is to their determent. Whether you like it or not, your spouse or family will become more important to you. Not only because they are privy to your diagnosis but because they can also determine your legal standing. They can submit legal motion to declare you incompetent and take over your estate and business dealings.
A diagnosis of dementia is life changing. In the eye of a personal storm there are important legal and financial questions. In a complex legal field that is evolving, your best bet is to access professional legal advice as soon as possible. Legal Aid Society, the local Area Agency on Aging, or the Alzheimer's Association might be able to provide you with the names of attorneys practicing in your area who deal with these issues. The obvious start should be determining your eligibility for Medicaid, investigating long-term care insurance, writing a living will and assigning a durable power of attorney for health care.
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For those that have assets,, gather your wills and trusts, prior tax returns, health and life insurance policies, pension information, deeds, mortgage/s, bank accounts (and PIN numbers), and information on other financial investments including ownership of property. Discuss the benefits and implications of transferring assets. If you do not have family or friends that can manage your accounts or business there are fiduciary agents who are certified to do this work for you. In some states you can prepare all your documents and then have them applied at a later period when your diagnosis become more severe. For those who have no or few assets, it is important to realize that you still need help with living arrangements and health directives.
In some cases, especially among people with extensive wealth, the strategy is not to get the diagnosis of dementia in the first place. They either go abroad where mandatory reporting is non-existent, or they go to a private physician and present a different identity. There are obfuscations from the patient as well. The central kingpin in all this is the family practitioner. His or her determination will guide bankers, lawyers and fiduciary agents. This is why a relationship with your primary care physician is important because he or she can help you coordinate and in some cases maneuver this complex medical and legal field.
© USA Copyrighted 2015 Mario D. Garrett
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