A dementia caregiver's 2026 checklist covers four fronts: medical treatment decisions, legal paperwork completed while your relative can still sign, financial and Medicare support, and home safety planning. Handle the legal documents first, because they require legal capacity, then move through the medical, financial, and safety tasks below. You are not alone in this work. About 12 million Americans serve as unpaid dementia caregivers, and roughly 7.4 million people age 65 and older now live with Alzheimer's, according to the Alzheimer's Association 2025 Facts & Figures — the first year that number has topped 7 million.
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
- Legal documents: do these first
- Medical: what the 2026 treatments can and cannot do
- Financial help: the Medicare GUIDE Model
- Home safety and wandering
- Frequently Asked Questions
Legal documents: do these first
Legal capacity is the ability to understand and sign binding documents. It can fade quickly, so the National Institute on Aging urges families to complete core papers soon after diagnosis, while the person still has capacity. Three documents form the foundation.
Sort them out before anything else: If your relative loses capacity before signing, your only route is often a court-appointed guardianship — slower, costlier, and more stressful. Acting early avoids that. Consider an elder-law attorney if assets or family dynamics are complicated.
- A durable power of attorney for finances, naming who manages money and bills.
- A durable power of attorney for health care (a health proxy), naming who makes medical decisions.
- A living will, stating wishes about life-sustaining treatment.
Medical: what the 2026 treatments can and cannot do
Two amyloid-targeting drugs are now fully FDA-approved: Leqembi (lecanemab) and Kisunla (donanemab). Both are for *early* symptomatic Alzheimer's — mild cognitive impairment or mild dementia — and both slow decline rather than cure or reverse it, per the Cleveland Alzheimer's Disease Research Center. Delivery is getting easier. The FDA approved Leqembi IQLIK, a once-weekly under-the-skin maintenance injection a caregiver can give at home, on August 29, 2025, according to a BrightFocus 2026 forecast.
These drugs carry real risk. Both can cause ARIA — brain swelling or small bleeds — which is more common in people who carry the ApoE4 gene. That is why treatment requires genetic testing and repeated MRI monitoring, and why it suits only the earliest stages. Ask the clinician whether the stage, genetics, and monitoring capacity make treatment appropriate.
Financial help: the Medicare GUIDE Model
care coordination is expensive, but a Medicare program may cover much of it. The CMS GUIDE Model, launched July 1, 2024, pays for care coordination, caregiver training, a 24/7 support line, and up to about $2,500 a year in respite care for eligible enrollees, according to the Centers for Medicare & Medicaid Services.
Eligibility has limits worth checking. It applies to people with traditional fee-for-service Medicare, not Medicare Advantage, and care must come through one of roughly 330 participating programs. To use it, find a participating dementia-care program through the CMS GUIDE Model directory, then confirm your relative's Medicare type before enrolling.
Home safety and wandering
Wandering is one of the most dangerous behaviors in dementia, and it is common: about 6 in 10 people with dementia wander at some point. The National Institute on Aging recommends layered precautions against wandering.
Put these safeguards in place before a crisis: If your relative does wander off, call 911 immediately — do not wait to search alone first. Then activate the MedicAlert and Alzheimer's Association Safe & Found 24/7 response line, as the Alzheimer's Association safety guidance advises.
- Install locks and alarms on doors and windows.
- Provide an ID or medical bracelet.
- Enroll in a safe-return program.
- Assess driving with the clinician and lock away car keys when it is no longer safe.
Frequently Asked Questions
Which task should a new caregiver do first?
Complete the legal documents — financial and health-care powers of attorney and a living will — while your relative still has the legal capacity to sign them.
Can the new Alzheimer's drugs help someone with advanced dementia?
No. Leqembi and Kisunla are approved only for early symptomatic disease and slow decline; they are not used in moderate or advanced stages.
Does Medicare help pay for caregiver support?
Yes, for eligible fee-for-service enrollees. The CMS GUIDE Model covers care coordination, training, a 24/7 line, and up to about $2,500 a year in respite.
