When Your Parent Has Dementia and Can't Make Decisions Anymore

Published May 6, 2026 · 5 min read

The decline wasn't sudden. First it was forgotten names. Then missed appointments. Then the call from the bank — your dad tried to wire $15,000 to someone he met on the internet. And now you're standing in his kitchen, looking at unpaid bills stacked three months deep, and you realize: he can't do this anymore. He can't manage his own life. And legally, you can't manage it for him.

That gap — between what your parent needs and what you're legally allowed to do — is where families get stuck. And the longer you wait to close it, the harder it gets.

What "Capacity" Means and Why It Matters

In legal terms, the ability to make decisions is called "capacity" (sometimes "competency," though technically they're different — competency is a legal determination made by a court, while capacity is a clinical assessment). A person has capacity if they can understand the relevant information, appreciate how it applies to their situation, reason through the options, and communicate a choice.

Dementia doesn't automatically eliminate capacity. In early stages, a person with dementia might still be able to make many decisions — where to live, whether to have a medical procedure, what to eat for dinner. Capacity is decision-specific and can fluctuate. Your parent might have capacity to choose their lunch but not to understand a complex financial transaction.

This matters because if your parent still has some capacity, they may still be able to sign legal documents like a power of attorney or a will. The window is narrow, though. And it closes without warning.

If There's a Power of Attorney Already in Place

If your parent signed a durable power of attorney before losing capacity, you're in relatively good shape. A durable POA remains in effect — that's what "durable" means — even after the principal becomes incapacitated. Our guide on legal steps after diagnosis covers this in detail.

The agent named in the durable POA can step in and start handling finances, medical decisions, or both, depending on what the document covers. Some POAs take effect immediately upon signing. Others are "springing" — they only activate when a triggering event occurs, usually a physician's determination that the principal is no longer competent.

If your parent has a springing POA, you'll need a letter from their doctor confirming they lack capacity. Some springing POAs require letters from two physicians. Check the document's specific requirements.

One common issue: banks and financial institutions sometimes resist honoring a POA, even a properly executed one. They worry about liability. If you're meeting resistance, bring the original document, ask to speak with a branch manager, and reference the Uniform Power of Attorney Act, which most states have adopted. Many states also impose penalties on institutions that refuse to honor a valid POA without reasonable cause.

If There's No Power of Attorney

This is the harder situation. If your parent didn't sign a POA while they still had capacity, nobody in the family has legal authority to manage their affairs. Not the spouse. Not the adult children. Not the person who's been providing all the care. Our guide on guardianship vs. power of attorney covers this in detail.

Your options at this point:

Guardianship (for personal and medical decisions): You petition the court to be appointed as your parent's guardian. The court will evaluate whether your parent is truly incapacitated (usually requiring a medical evaluation) and whether you're a suitable guardian. If granted, you get legal authority over personal and medical decisions.

Conservatorship (for financial decisions): Similar to guardianship, but focused on finances. Some states combine these into a single proceeding. Others treat them separately. The terminology varies by state — what's called a "conservatorship" in some states is called a "guardianship of the estate" in others.

Both processes involve: Our guide on what to do after a diagnosis covers this in detail.

• Hiring an attorney (costs range from $2,000 to $10,000 or more)
• Filing a petition with the court
• A medical evaluation of your parent
• A hearing where a judge reviews the evidence
• Appointment of a court investigator in many jurisdictions
• Ongoing court oversight — annual accountings, reports, and sometimes additional hearings

The whole process typically takes one to three months. During that time, your parent's bills might not get paid, their medical care might not be properly coordinated, and their assets might be at risk.

Protecting Your Parent Right Now

While you're pursuing legal authority, there are things you can do immediately:

• Contact Adult Protective Services (APS) if there's immediate risk. If your parent is being exploited, neglected, or is a danger to themselves, APS can investigate and intervene faster than the courts.
• Talk to your parent's doctors. Under HIPAA, providers can share information with family members involved in care when the patient can't object. Ask the care team to include you in medical discussions and treatment planning.
• Set up automatic bill payments where possible. Your parent may still be able to authorize autopay for recurring bills, even if they can't manage finances overall.
• Secure the home. Remove access to large sums of cash. Monitor mail for suspicious financial activity. Consider a credit freeze through the three major bureaus (Equifax, Experian, TransUnion) — you can do this on your parent's behalf with appropriate documentation.
• Document everything. Keep records of your parent's cognitive state, any concerning incidents, financial irregularities, and care needs. This documentation will be critical for the court proceeding.

Dementia doesn't ask permission. It doesn't wait for you to get the paperwork done. It just keeps moving. The families who do best aren't the ones who avoid the hard conversations — they're the ones who have them early, get the legal documents in place, and build a system for managing care together.

If your parent still has moments of clarity, that window is still open. Use it today. Because by the time you decide you're ready, the window may have already closed. For a side-by-side look at tools that help families coordinate, check our caregiving app comparison guide.