Yesterday, Today and TomorrowPart Two – Some AnswersDementia, Advance Directives, and Arizona Estate Planning
Yesterday, Today and Tomorrow
Part Two – Some Answers
Dementia, Advance Directives, and Arizona Estate Planning
Published August 10, 2026 | Updated August 10, 2026
Part Two of the Yesterday, Today and Tomorrow series
Read Part One: The CluesWhat can a family do after recognizing possible signs of dementia?
When a family becomes concerned that someone they love may be experiencing dementia or another cognitive condition, an appropriate medical evaluation can help identify what is happening. Existing estate planning documents may also become important. A trust, financial power of attorney, health care power of attorney, mental health care power of attorney, and HIPAA authorization serve different purposes, and the authority provided by each document depends on its language, whether it is currently effective, the individual’s capacity, and the circumstances involved.
This is Ilene’s personal account of how her family began seeking answers after recognizing possible signs of dementia. It is not a medical diagnosis or a recommendation for how another family should handle a similar situation.
Arizona Planning Context
What role can advance directives play when dementia is suspected?
Advance directives can record a person’s health care wishes and identify an agent who may act under specified circumstances. Under Arizona Revised Statutes Section 36 3223, an agent named in a health care power of attorney may make and communicate health care decisions while the principal is unable to do so. The agent’s authority is subject to the document’s express language and any applicable court order.
Does a dementia diagnosis automatically activate every power of attorney?
No. A diagnosis does not automatically make every authority in every document exercisable. The result depends on the type and language of the document, whether its authority is currently effective, the decision involved, and the individual’s capacity. Under Arizona Revised Statutes Section 36 3283, a mental health care agent may make mental health care decisions while the principal is incapable as defined by Arizona law.
Can a health care agent access medical information under HIPAA?
When a health care power of attorney is currently effective and the agent has authority under applicable law to make health care decisions, the agent generally has personal representative status under HIPAA for matters within that authority. A separate HIPAA authorization may also permit disclosures according to its terms. The United States Department of Health and Human Services explains how this depends on the authority granted and whether it is currently effective.
When Concern Became a Realization
Annie was not at home. Her car was gone, and I felt like someone had thrown a bucket of cold water over me.
The realization hit me.
Annie has dementia.
What do we do now?
I am a lawyer. I know what to do. But when it is my family, I am just like everybody else.
So, I did what I always do. I called a family meeting.
Our family is the traditional 21st-century family: everybody lives everywhere. Family meetings are virtual. We sit in different places, looking at one another through our computer screens.
Fortunately, Legally, We Were Prepared
Fortunately, legally, we were prepared.
Annie had her financial and health care documents in order. Her trust was written. Her Healthcare and Mental Healthcare Power of Attorney and HIPAA authorization were completed. We had copies in her Red Estate Planning Binder and available online through DocuBank®, where her health care documents were stored.
But documents were only the beginning.
First things first: we had to get Annie to a doctor who could determine what was happening and help us figure out what to do next.
There was one problem.
Annie hated doctors.
Her father had died in a hospital under interesting—shall we say—circumstances. After that, she refused to go to doctors.
Still, we had to find a way to get her evaluated.
Getting Annie to a Doctor
We made an appointment with a longtime family friend who was also a family doctor. Annie would not go to a doctor for herself, but she would always accompany one of us to our appointments.
So, I told her the appointment was for me.
We checked in and were taken to an examination room. I sat on the examining table, and Annie sat in the visitor’s chair. The nurse took my blood pressure.
(It was a little high, by the way.)
At my request, the nurse took Annie’s blood pressure too. Then the doctor walked in.
The doctor began asking Annie some simple questions.
“What day is it today?”
“What year is it?”
Annie became flustered. She could not answer.
Then she demanded to know why the doctor was asking her all these questions.
I told her the truth.
It was really her appointment.
She stormed out of the office.
Why Written Medical Directives Mattered to Our Family
Thank goodness for written medical directives.
Because Annie had prepared her health care documents in advance, the doctor and I could talk about what needed to happen next.
The doctor had a plan.
We needed a diagnosis.
To get one, Annie needed more extensive testing. The doctor believed that testing could best be done in a hospital, where neurologists, psychiatrists, gerontologists, and other medical professionals could evaluate her.
There was just one problem.
How were we going to get Annie to the hospital?
The doctor and I knew it would not be easy. We were going to need the entire family.
We needed a plan to get Annie to the hospital, have her admitted, and finally get the testing that might give us some answers.
And so, the plan began to unfold.
Let’s continue.
Ilene
Continue the Series
Begin with Yesterday, Today and Tomorrow, Part One: The Clues, in which Ilene describes the changes her family noticed before realizing that Annie might have dementia.
Part Three will continue the family’s experience as their plan unfolds.
Related Arizona Estate Planning Resources
Speak With an Arizona Estate Planning Attorney
Estate planning documents are most useful when they accurately reflect a person’s wishes, circumstances, and current Arizona law. Families who want to create or review an estate plan may schedule an estate planning consultation in Scottsdale or call 480 296 2036.
Disclaimer
Ilene L. McCauley is licensed to practice law in the State of Arizona. Ilene L. McCauley, Ltd. provides legal services for clients in the State of Arizona. This article is general and educational in nature and should not be construed as legal, tax, or medical advice. Reading this article or using this website does not create an attorney client relationship. Federal and state laws and regulations are complex and subject to change. Individuals and families should consult qualified Arizona legal and medical professionals regarding their own circumstances.