An end-of-life planning checklist for Alzheimer's caregivers covers advance directives, finances, care wishes, comfort care, hospice eligibility, and after-death tasks. It helps families record decisions while the person can still participate. End-of-life planning means choosing medical, legal, financial, and funeral preferences before severe memory loss removes choice. Early choices prevent guessing during a crisis.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Record medical and legal wishes early
- How do palliative care and hospice differ?
- What does hospice require under Medicare?
- What changes during late-stage care?
- What should caregivers arrange for after death?
Record medical and legal wishes early
Talk about health, caregiving, long-term care, and money soon after diagnosis. Alzheimer's steadily reduces decision-making ability, so waiting forces others to guess. Complete a living will that states treatment preferences.
Name a health care proxy through a health care power of attorney, as the Alzheimer's Association advises in its advance care planning guide. Handle money and property while the person still has legal capacity to understand decisions. Useful tools include:.
- Durable power of attorney for finances
- Will or living trust
- Written funeral and burial wishes
How do palliative care and hospice differ?
Palliative care can start at any stage of serious illness such as dementia. It relieves symptoms and helps guide treatment choices. Hospice is comfort care near the end of life.
It generally replaces treatment aimed at cure, according to the National Institute on Aging in its explanation of palliative and hospice care. Ask the doctor when to add palliative support. Ask separately when the goals should shift fully to comfort.
What does hospice require under Medicare?
Medicare Part A covers hospice only when both the regular doctor and hospice doctor certify terminal illness with a six-month life expectancy. The patient must accept comfort care instead of cure and sign a hospice election statement, under rules published by the Centers for Medicare & Medicaid Services in its Medicare hospice coverage rules. Dementia decline is slow and uneven, so that six-month prognosis is often hard to certify.
Coverage continues through 90-day periods and then unlimited 60-day periods only while doctors recertify eligibility. Medicare does not pay room and board at home or in a nursing home during hospice. Families should confirm housing, food, and daily supervision costs separately.
What changes during late-stage care?
In late-stage Alzheimer's the person often needs help with nearly all daily activities. Swallowing becomes difficult, which raises risk for food or liquid entering the lungs and causing pneumonia. Infection risk also rises.
Practical care shifts toward comfort, safe positioning, skin care, assisted eating, and watching for infection. Keep the care team informed about appetite changes, coughing during meals, fever, restlessness, pain, or new skin redness. Small changes can signal a need to adjust comfort measures.
What should caregivers arrange for after death?
A clinician or hospice nurse must officially pronounce the death. Families using hospice follow the prearranged after-death plan from the hospice team.
Others should arrange funeral or burial plans, death certificates, and notifications in advance. After death, notify the care team and funeral home promptly, as the National Institute on Aging advises in its guidance on steps after death. Keep contact numbers, funeral-home information, and burial documents where another family member can find them quickly.
