Practical Matters: legal, financial and safety

The principle

The most important rule of practical planning in dementia: do the legal and financial groundwork as early as possible. A diagnosis of Mild Cognitive Impairment or mild dementia is exactly the right time. Capacity to make these decisions is preserved at that stage, and the planning makes everything that follows easier for you and your family.

Many of these arrangements (Lasting Power of Attorney, a will, an emergency contact list, vascular risk reduction, home safety) are good practice for any adult. A diagnosis simply gives them the priority they always deserved.

The first six months: priority list

1. Lasting Power of Attorney for both health and welfare, and for property and finance. This is the single most important step. Register both LPAs while capacity is intact.
2. Will. Update or write a new will if needed. Consider an advance decision to refuse treatment if relevant to you.
3. Driving. Notify the DVLA of the diagnosis. Notify your motor insurer. A practical driving assessment may be required.
4. Benefits. Check eligibility for Attendance Allowance, Personal Independence Payment, Council Tax reduction and Carer's Allowance.
5. Home safety. Smoke alarms tested, hob safety, hot water temperature, key safe for entry, hallway lighting, removal of trip hazards.
6. Mental Capacity Act. Understand how decisions are made when capacity is impaired.

Within the first year

• Work and employment. If you are still working, talk to your employer; you have rights under the Equality Act 2010.
• Insurance. Tell your motor, travel, home and life insurers as required. Some products have specific dementia provisions.
• GPS trackers and locator devices. Useful if there is any risk of going out and getting lost. Register with the Herbert Protocol.
• Care homes and residential options. Even if you intend to stay at home, it is helpful to understand what is available locally and how funding works.
• End-of-life and palliative care planning. Initiating these conversations now, while there is no immediate pressure, gives the best outcomes later.

Common questions about timing

Three questions families often ask:

• "It feels too soon to do LPA. Am I being pushy?" No. LPA only takes effect when it is needed, and only the parts that are needed. Doing it now means it is there if needed; it does not change anything in daily life.
• "Will telling the DVLA mean automatic loss of licence?" Not necessarily. Driving may continue after a clinical and, where indicated, practical assessment. See the driving page for the detail.
• "Will telling the insurer push up premiums?" Premiums may change, but the alternative (not declaring and invalidating the cover) is much worse. Some specialist insurers cover dementia without significant loading.

Capacity over time

Mental capacity is decision-specific and time-specific. The same person may have capacity to decide about lunch but not about a major financial transaction; capacity may be present in the morning and impaired in the late afternoon. The Mental Capacity Act 2005 framework guides assessment and decision-making when capacity is impaired:

• Assume capacity unless there is evidence otherwise;
• Give all reasonable support to help the person make the decision themselves;
• An unwise decision is not the same as a lack of capacity;
• If capacity is lacking, decisions are made in the person's best interests;
• The least restrictive option that meets the need is preferred.

See the Mental Capacity Act page for detail.

If decisions need to be made without an LPA

If capacity is impaired and no LPA was put in place, family members may need to apply to the Court of Protection for a Deputyship. This is slower and more expensive than an LPA; it can take many months and several hundred pounds in court fees plus ongoing costs. This is the practical reason for doing LPAs early.

Where to find professional help

• Solicitors: Solicitors for the Elderly (SFE) is a national association of UK solicitors with specialist accreditation in older people's law, including LPA, wills, advance decisions and care funding. Look for SFE accreditation.
• Citizens Advice: Free advice on benefits, debt and housing.
• Age UK Advice Line: 0800 678 1602.
• The Office of the Public Guardian (OPG): the government body that registers LPAs and supervises Deputyships.
• The Court of Protection: resolves decisions where capacity is in dispute or where no LPA exists.

Where The Dementia Service fits in

Practical matters often emerge during a diagnostic conversation. A structured assessment letter from The Dementia Service provides a clear cognitive baseline that can support capacity assessments later, and an explicit recommendation to address LPA, driving and other priorities. Many families use the structured letter to brief a solicitor or the family conversation that follows.