Karen Henley and her daughter, Courtney, leave the hospital after...

Karen Henley and her daughter, Courtney, leave the hospital after visiting husband and father Mike Henley. The Alzheimer's patient was taken there because of seizures. (May 27, 2008) Credit: Newsday / J. Conrad Williams Jr.

Caregiving experts often advise that after an Alzheimer's diagnosis, family members meet with an elder law attorney to begin the process of planning for down the road as the illness progresses.

"I don't think families are well-versed in this," said Barbara Vogel, program coordinator for the Neuwirth Memory Disorders Program at Hillside Geriatric Center in Glen Oaks. "I don't think they're seeking the legal assistance or financial guidance that they need to do this early on so when the time comes they are prepared."

Instead of doing all of their planning with a lawyer, some caregivers turn to geriatric care managers or social workers who hire themselves out as guides to those attempting to navigate the system. Orlando Gonzalez, 66, and his daughter Kim Latkovich, 38, both of Manorville, paid a social worker $700 and found the experience both cheaper and faster than dealing with an attorney.

"Lawyers, I just think a lot of times they just charge a lot of money," Latkovich said. "Whereas I think social workers, they're not interested as much in the money, they're more interested in helping people in whatever field or expertise that they're in."

But experts advise that attorneys can help best with intricate financial planning. Vincent Russo, an elder law attorney with offices in Westbury, Woodbury, Lido Beach and Islandia said for him, the first step is determining the person with dementia's capacity for decision-making.

"Any time I hear the word Alzheimer's . . . decision-making would be my starting point of any discussion because we know that at some point that person is [not going to] have capacity, unfortunately," Russo said.

If the person is still in the relatively early stages of the disease there are three key documents that need to be made up, Russo said. These are power of attorney, health care proxy and a living will. The power of attorney enables someone to step in and make financial decisions going forward, Russo said, and the health care proxy allows for health care decision-making once the person loses capacity. The living will is a document that allows a person to give instructions to a selected person under the health-care proxy regarding whether they would want extraordinary medical treatment under certain circumstances.

"New York presumes everyone wants artificial nutrition and hydration under all circumstances unless there's evidence to the contrary," Russo said.

If the person lacks capacity and these documents are not in place, a guardianship hearing must be held, he said. It's not uncommon in these situations to have more than one family member vying for guardianship, Russo said, and in such cases an independent guardian -- pulled from a court list of attorneys, social workers and other qualified professionals -- may be appointed.

"We stress to families all the time, especially when we're doing planning, hopefully in advance, that we want to avoid the guardianship," Russo said. "We want to avoid the fights. We want to minimize legal fees . . . "

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