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Choosing a Health Advisor & Planning for Future Care Needs

This article helps you choose a trusted person to make medical decisions for you (a health advisor) and plan ahead for the care you may need as dementia progresses. It can feel overwhelming, but there are concrete steps you can take today to bring clarity and peace of mind. You'll learn what documents to prepare, how to talk with your loved one, and where to get professional help.

Key points

  • Start planning early, while the person with dementia can still participate in decisions.
  • Choose a health advisor (healthcare proxy) who is willing, able, and aligned with your values.
  • Create both a living will and a durable power of attorney for healthcare.
  • Discuss financial planning with a professional to ensure you can afford future care.
  • Review and update your plan regularly, especially after major life changes.
  • Seek help from elder law attorneys, financial advisors, and social workers to navigate complex decisions.

Why you need a health advisor and a plan

When you or a loved one receives a dementia diagnosis, it's natural to feel uncertain about the future. But life is unpredictable, and accidents or sudden changes in health can happen at any time. Having a plan in place means that your wishes for medical care will be known and respected, even if you become unable to speak for yourself. Without a plan, family members and doctors may be left guessing, which can lead to stress, disagreements, and care that doesn't match what you would have wanted.

What a health advisor does

A health advisor—often called a healthcare proxy, agent, or durable power of attorney for healthcare—is a person you trust to make medical decisions for you when you cannot. This role is different from a financial power of attorney, which handles money matters. Your health advisor should be someone who is willing and able to discuss medical care and end-of-life issues with you, can follow your wishes and values, and can speak up for you if there are disagreements about your care. It's wise to name a backup person in case your first choice is unavailable.

The importance of advance care planning

Advance care planning involves creating legal documents that outline your preferences for medical treatment. The two key documents are a living will and a healthcare power of attorney. A living will spells out the types of care you do or do not want in life-ending situations—such as feeding tubes, breathing machines, or other invasive treatments that keep the body alive without quality of life. A healthcare power of attorney names the person who will make decisions for you. These documents are not just for older adults; they are valuable for anyone, starting at age 18, because accidents and serious illness can happen at any age.

Planning for financial and care needs

Advance care planning isn't complete without thinking about the financial side. You need to consider what happens if you outlive your savings or don't have enough income to pay for the care you need. This includes exploring insurance options (employer plans, long-term care insurance, life insurance), government help (Social Security Disability Income, Supplemental Security Income, Medicaid, Veterans' benefits), and community resources (low- or no-cost support services, respite care, support groups, transportation, meal delivery). Professional financial advisors and elder law attorneys can help you navigate these options and create a plan that fits your situation.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start the conversation early, while your loved one can still express their values and wishes, using open-ended questions such as 'Who would you trust to speak for you?' and 'What kind of care would you want if you were facing a life-ending situation?'

  2. Choose a health advisor (healthcare proxy) who is willing to discuss difficult end-of-life topics, can make decisions that honor your wishes, and will advocate for you if there is disagreement. Name a backup person in case your first choice is unavailable.

  3. Create a living will that specifies which life-sustaining treatments you do or do not want (such as feeding tubes or breathing machines), and a durable power of attorney for healthcare that appoints your chosen advisor. Have both documents signed, dated, and witnessed according to your state's requirements.

  4. Organize your advance directives, financial power of attorney, and insurance policies in a secure but accessible place, and share copies with your primary care doctor and close family so they are retrievable in an emergency.

  5. Plan for future care needs by discussing where your loved one wants to live, who will provide daily care, and how to handle work and family obligations. Consult an elder law attorney for state-specific legal guidance and a financial advisor for long-term care insurance and Medicaid planning.

  6. Review your plan at least once a year or after any major life event—such as a change in health, marriage, divorce, or the death of a loved one—to make sure your documents and chosen advisors still reflect your wishes.

What not to do

  • Do not wait until a crisis to start planning; rushed decisions after a fall, stroke, or wandering incident leave fewer options and less time to honor your loved one's wishes.

  • Do not assume your spouse or partner will automatically know what you want—have the conversation explicitly, because even close family members are often surprised by specific preferences for end-of-life care.

  • Do not choose a health advisor based solely on convenience or family obligation; the person must be comfortable discussing difficult topics and willing to advocate for you firmly, even when other relatives disagree.

  • Do not forget to name a backup health advisor—without one, a court may appoint a stranger to make decisions if your first choice is unreachable or unable to serve.

  • Do not neglect the financial side of planning; running out of savings or lacking income for care can undermine even the most thoughtful medical wishes, so consult a financial advisor or elder law attorney early to explore long-term care insurance, Medicaid eligibility, and tax considerations.

Practical tools

  • The Conversation Project Starter Guide

    A free, step-by-step guide that helps you talk with your loved one about their wishes for medical care, with conversation starters, questions to ask, and tips for handling difficult topics. Available at theconversationproject.org.

  • State-Specific Advance Directive Forms

    Free, state-specific living will and healthcare power of attorney forms are available from the National Hospice and Palliative Care Organization at caringinfo.org. Fill them out, sign them in front of the required witnesses (and a notary if your state requires it), and give copies to your health advisor, doctor, and family.

  • Advance Directives Document Organizer

    A single folder or binder labeled 'Advance Directives' that holds your living will, healthcare power of attorney, financial power of attorney, and insurance policies (health, life, long-term care). Keep it in a fireproof location that your health advisor and backup both know about.

  • Sample Script for Asking Someone to Be Your Health Advisor

    Concrete language for the often-awkward conversation, such as: 'I'm putting my wishes in writing in case I ever can't speak for myself, and I want to ask if you'd be willing to be my health advisor. It would mean talking with my doctors and making decisions based on what matters most to me. You can say no—I just want someone I trust.'

Discuss with your clinician

Ask your doctor: 'Given my loved one's specific type of dementia (e.g., Alzheimer's, Lewy body, vascular), what medical decisions are most likely to come up in the next few years?'

Ask your doctor: 'What are the signs that my loved one is entering a terminal phase, and when should we consider hospice or palliative care?'

Ask your doctor: 'Are there any medications or treatments that might be inappropriate or harmful in late-stage dementia that I should include in a living will?'

Ask your doctor: 'How can I ensure that my loved one's advance directives are followed in a hospital or emergency setting?'

Ask an elder law attorney: 'What are the specific legal requirements for advance directives in our state, and do we need a notary?'

Related guides

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