The paperwork, in the order to do it

Do first: at diagnosis / early stage

An elder-law attorney (a specialty, not a general estate lawyer) can do most in one or two visits, and documents capacity at signing to protect them from a later challenge.

• Durable power of attorney (financial). Names who handles money and property. It must be durable (effective through incapacity), not "springing," which banks resist and which leaves a dangerous gap. Ask their bank to put the original on file before it's needed.
• Healthcare proxy / medical power of attorney. Names who speaks to doctors. A separate document from the financial POA; you need both.
• Advance directive / living will. Their wishes for the medical lines ahead (hospitalization, resuscitation, feeding). Ask the concrete question kindly and write the answer verbatim (quotes carry authority that summaries don't).
• HIPAA releases at each doctor's office, so the family who'll be calling can get records before an ER visit.
• Will / trust review, and beneficiary designations checked. Retirement accounts and life insurance override the will, and stale beneficiaries (an ex-spouse, someone deceased) are a common, avoidable mess.
• Banking set up right: for a non-spouse, a POA on the account usually beats a joint account (a joint owner fully owns the money and exposes it to their creditors or divorce). Add a trusted contact to bank and brokerage accounts (five minutes, free): they can be called if exploitation is suspected, but can't see balances or move money.
• Passwords & digital access: a password manager with an emergency contact, plus Apple Legacy Contact and Google Inactive Account Manager. Locked accounts are slow and painful to reach after incapacity.
• Check any long-term-care insurance policy now, not at claim time. Dementia usually triggers coverage on "severe cognitive impairment," but there's often a 30–90 day waiting period you pay for first.
• Screen for benefits early: VA Aid & Attendance for wartime veterans and spouses (filed free by a Veterans Service Officer), and your state's Medicaid rules. Medicaid has a 5-year look-back on asset transfers, so anything you do today starts that clock. See the resources page.
• Can Medicaid pay YOU to caregive? Often yes. Most states let a Medicaid home-care participant hire and pay a family caregiver through a "consumer-directed" program: CDPAP in New York, CDASS in Colorado, IRIS in Wisconsin, CFSS in Minnesota. In 29 states, Medicaid waivers for older adults can pay a spouse or close relative (KFF, 2025). Search "[your state] consumer-directed Medicaid" or ask your Area Agency on Aging.

The agencies that won't take your power of attorney

Several of the biggest agencies don't accept a durable power of attorney: each runs its own permission system.

• Social Security: a POA is not enough. The Treasury doesn't recognize powers of attorney for federal payments, so to manage someone's Social Security or SSI you must be appointed their representative payee (form SSA-11), a separate application with its own accounting duties. SSA says having POA, being an authorized representative, or sharing a joint bank account is not the same as being a payee.
  Do this early, while they can still choose: SSA's Advance Designation lets any capable adult name up to three people, in order, they'd want as payee. It is not a POA and not an appointment; SSA considers your person's own choice first. Free, optional, changeable any time: one call to 1-800-772-1213 or a few clicks in a my Social Security account.
• Medicare wants form CMS-1696, an Appointment of Representative, to handle claims, appeals or grievances. The representative must sign within 30 days of the beneficiary, or the form is void. It covers the claim or appeal it was filed for, and other appeals during the year it stays valid.
• The IRS wants form 2848, and incapacity breaks it. A pre-existing Form 2848 is generally voided once the taxpayer becomes incapacitated, and someone already incapacitated can't sign a new one. The route then is the broad durable POA submitted with Part II of Form 2848.
• The VA appoints its own fiduciary, whatever a state-law POA says: usually the person the beneficiary names, after a suitability investigation.
• Banks and brokerages each have a house form. Most accept a valid durable POA, but many prefer their own: file it early.

Verified July 2026 at ssa.gov, cms.gov, irs.gov and va.gov. Each agency's own current form governs, and the free legal help below can do all of it with you.

Money you may already be owed

Call even if you think you earn too much. Medicare's own guidance: "Even if you don't think you qualify, you should still apply." Some states ignore some income and savings, so the federal limits below are a floor, not a verdict.

Ask for these by name

• Medicare Savings Programs pay the Part B premium, which is $202.90 a month in 2026: about $2,435 a year. QMB pays the premium and deductibles, coinsurance and copays, and providers may not bill for covered care. SLMB and QI pay the premium. The 2026 federal limits for QMB are $1,350 monthly income and $9,950 in resources for one person ($1,824 and $14,910 for a couple); SLMB and QI allow more income at the same resource limits. Apply through your state (SHIP does it with you). QI must be re-applied for every year, first come first served: put it on the calendar.
• Extra Help (the Part D low-income subsidy) takes the drug plan premium and deductible to $0 and caps 2026 copays at $5.10 for a generic and $12.65 for a brand name. Once total drug costs pass $2,100, you pay nothing for covered drugs. Anyone on QMB, SLMB or QI gets it automatically. Everyone else applies to Social Security, online or at 1-800-772-1213 (TTY 1-800-325-0778), any time. Not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa; those areas run their own programs through the Medicaid office.
• SNAP, counted the way it's counted for older people. In a household with someone 60 or older or disabled, out-of-pocket medical costs above $35 a month are deducted before eligibility is figured: doctor bills, prescriptions, dental, approved over-the-counter items. (A 2025 law changed SNAP work and non-citizen rules, not the $35 deduction. Your state SNAP office has the current rules.)
• Free legal help for anyone 60 or older. The Older Americans Act funds legal assistance in every state through Area Agencies on Aging: advance directives, decision-makers, benefits, guardianship alternatives, housing and long-term-care costs. Priority goes to those with the greatest economic need. Ask before you hire anyone.
• Energy bills: LIHEAP. Help paying heating and cooling (someone with dementia can no longer judge temperature safely). Your state's program: energyhelp.us or the national referral line, 1-866-674-6327.
• Phone and internet: Lifeline. Up to $9.25 a month off phone or internet service (up to $34.25 on tribal lands). SNAP or Medicaid makes you eligible; you still apply. lifelinesupport.org or 800-234-9473.
• Rides to appointments, if they have Medicaid. Federal rules require every state Medicaid program to assure transportation to and from covered care, usually booked days ahead. Say: "I need to arrange NEMT for a medical appointment."
• Property tax relief. Most counties offer an exemption, freeze, or deferral for elderly or disabled homeowners, and it is never automatic. One call to the county assessor can lower the bill for good.

Figures verified July 2026 on medicare.gov, ssa.gov, fna.usda.gov, acf.gov, acl.gov and lifelinesupport.org. Dollar limits change every January; the programs themselves don't.

Protect them from exploitation

Dementia is a top target for fraud: failing judgment, but still answering the phone. The theft is usually a slow bleed of small recurring transfers, so watch all year. Some fraud sells false hope instead: memory "cures" by the bottle.

• Freeze their credit: free, at all three bureaus (Equifax, Experian, TransUnion). New credit in their name becomes much harder to open; existing cards are not covered. A POA holder can freeze and unfreeze for them.
• Turn on the bank's own tools: the trusted contact, alerts on large or unusual transactions, and ask whether they'll flag the account. Brokerages can place a temporary hold on suspicious withdrawals.
• Guard against the classics: the "grandchild in jail" call, romance and lottery scams, and high-pressure "act now" sales. A therapeutic fib and a screened phone are kinder than an argument. Autopay the essential bills so a missed payment isn't the crisis that reveals the problem.
• Set a family code word, today. The "grandchild in jail" call now arrives in the grandchild's actual voice, cloned from a few seconds of video posted online. Pick a word only the family knows, and say the rule aloud: no money moves, ever, until the caller says the word.
• Make the phone stop ringing for strangers. Check the carrier before buying a call blocker: AT&T ActiveArmor, Verizon Call Filter, and T-Mobile Scam Shield all have free tiers that flag or block high-risk calls. The screens setup page has the free settings that silence unknown callers.
• Monitoring services exist (EverSafe, Carefull, True Link's blocking debit card) if no one in the family can watch the accounts.
• Selling their valuables draws its own scams. "We buy gold" ads and mail-in kits are built to lowball a stressed family. Know the day's price, get two written quotes, walk away from pressure: selling their silver & coins.
• Watch the subscriptions. Hard-to-cancel "free trials" and countdown-timer pressure target stressed caregivers and older adults. Review recurring charges with the accounts.

If you still have a job: it has protections

The federal FMLA gives eligible employees up to 12 workweeks of unpaid, job-protected leave per year to care for a spouse, child, or parent with a serious health condition. Your group health insurance keeps running on the same terms. Dementia care qualifies.

• It can be taken intermittently when medically necessary: Thursday-afternoon appointments, a reduced week during a bad stretch.
• FMLA protects the job, not the paycheck. Twelve states plus D.C. add paid leave on top of it (partial wages; dementia care qualifies), and Maryland and Virginia will from 2028, and the Labor Department advises checking your state. Search "[your state] paid family and medical leave," or ask HR about both in one meeting.
• The federal "Credit for Caring" tax credit is still a bill, not a law (as of October 2026), so there is nothing to claim yet. A few states have their own: search "[your state] caregiver tax credit."

No HR department, hourly, gig, or self-employed? FMLA may not reach you: it has employer-size and tenure tests (a flaw in the system, not in you). Respite and day programs exist so the job and the caregiving can both survive. If FMLA does cover you, your doctor fills in a certification form (details at dol.gov/agencies/whd/fmla). Talk to HR before the crisis week.