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Medical, Care and Financial Arrangement

When your cognition is intact, you should reach a consensus with family members, who may have to make decisions on your behalf about medical, care and financial matters if you are unable to do so due to the onset of dementia or mid-to-late stage dementia

Reaching a consensus with the family

When you’re still cognitively sound, agree on medical, care and financial arrangements earlier to:

Avoid conflicts among family members about medical, nursing and financial arrangements

Avoid putting pressure on family members to make decisions on your behalf

Avoid differences in opinion among family members affecting your interest, safety and health, which could lead to an application from family members, social workers or medical personnel to the Guardianship Board to have the board appointed as your guardian and make decisions on your behalf

What should you and your family members arrange?

Finance

Prepare an Enduring Power of Attorney (EPA)

The EPA allows you to appoint one or more attorney(s) to take care of your financial matters even after you become mentally incapacitated; the EPA will become effective after registering at the High Court.

 Please appoint a trustworthy attorney(s) to avoid financial abuse


Arrange your assets to be co-owned by a trustworthy person

Allowing your family members to use or sell your assets to pay for your care. They may run into a financial crisis if they cannot access your bank accounts or sell your investments.

Please appoint a trustworthy person to avoid financial abuse

Long-term care choices

Discussions with your family about your preference

If you and your family members can reach a consensus earlier, your wishes can be executed, such as:

  • You prefer to stay at home or in a residential care facility when your family can no longer accommodate the level of nursing care you needed
  • You prefer to stay at home or receive palliative care at palliative care wards (aims at relieving pain and symptoms of distress); or in the hospitals or nursing homes receiving life-sustaining treatments (such as cardiopulmonary resuscitation, artificial respiration, blood products, pacemakers, vasopressors, etc.) when you are terminally ill

Medical Arrangement

Prepare an Advance Directive in relation to Medical Treatment (AD)

You can give advance instructions via an AD when you are mentally capable of doing so, on whether to receive the following medical care and treatment when you are “terminally ill” or “in a persistent vegetative state or a state of irreversible coma”, or “in other specified end-stage irreversible life-limiting condition,” e.g. Cardiopulmonary resuscitation (CPR), Artificial respiration, i.e. CPAP, BiPAP, etc., Blood products, Pacemakers, Specialised treatments for particular conditions, such as chemotherapy or dialysis, Intravenous antibiotics, Oral antibiotics, Intravenous infusion, Subcutaneous infusion, Tube feeding.

  • AD must be countersigned by two witnesses. One of them must be a registered medical practitioner
  • You can revoke or revise an AD verbally or on paper as long as you are mentally capable
  • An AD only becomes valid when you are unable to take part in decisions about your medical care and treatment
  • Medical staff might violate the law or consider guilty of professional misconduct if they administrated your instructions before receiving the original AD

Complete an Advance Care Plan (ACP)

If you are diagnosed with dementia, you can discuss with your family whether to receive, try, or refuse life-sustaining treatments that can prolong your life for a few hours to a few days but is futile physiologically. The decision should be made after you, and your family received clear and comprehensive information about your current condition, anticipated progression and prognosis of the disease, and the medical and care treatment available from a registered medical practitioner. Such life-sustaining treatments include: Cardiopulmonary resuscitation (CPR), Artificial respiration, i.e. CPAP, BiPAP, etc., Intravenous antibiotics, Oral antibiotics, Intravenous infusion, Subcutaneous Infusion, Tube feeding.

  • Your family member can discuss with the medical professionals and decide on behalf of you if your dementia has progressed to the moderate or late stage.
  • Life-sustaining treatments can induce physical and psychological distress and pain in you. You should carefully consider whether your priority is to preserve life, relieve suffering, maintain social contact, or stay at home when you are terminally ill and mentally incapacitated.
  • Your family can revoke or revise an ACP verbally or on paper at any time
  • Medical staff might violate the law or consider guilty of professional misconduct if they administrated your instructions before receiving the original ACP
  • To find out how to prepare an Enduring Power of Attorney, please contact your lawyer
  • To find out about the services and application criteria for various government-funded long-term care services, please contact the District Elderly Community Centre or Elderly Centre in your neighbourhood
  • To make an AD or ACP, please contact the Hospital Authority or your doctor