Dementia Care Plan Georgia

Why a Written Care Plan Changes Everything

A dementia care plan is not a medical chart or a to-do list. It is a single document that coordinates every moving part of your parent's care — medical providers, legal documents, financial accounts, daily routines, emergency contacts, and facility preferences — so that when a crisis hits at 3 AM, whoever responds has the information they need without calling six family members.

Most Georgia families operate without one. They carry fragments of the plan in their heads, in text threads, and in a folder somewhere in the filing cabinet. When the primary caregiver gets injured or sick, the backup has no roadmap, and the family scrambles through decisions that should have been settled months earlier.

The Four Sections Every Georgia Dementia Care Plan Needs

Medical and Clinical

Start with the diagnosis itself. Document the diagnosing physician, the date, the specific type of dementia (Alzheimer's, vascular, Lewy body, frontotemporal), and the current stage. This clinical baseline drives every subsequent decision — from medication management to facility eligibility to Medicaid functional assessments.

List all current medications, the prescribing physician for each, the pharmacy, and any known adverse reactions. Keep this list readily available so emergency responders and clinicians can review it immediately.

Include the schedule for follow-up appointments with the neurologist, primary care physician, and any specialists. Note whether your parent is enrolled in Emory's Integrated Memory Care program or receiving services through the Medicare GUIDE model, which coordinates primary medical care with caregiver respite.

Legal Authority

Document which legal instruments are in place and where the originals are stored:

• Georgia Advance Directive for Health Care: Names the healthcare agent, specifies treatment preferences, and combines the old healthcare proxy and living will into one document. Valid when signed by the principal and two adult witnesses who are not heirs, healthcare agents, or involved in medical care
• Georgia Statutory Financial Power of Attorney: Authorizes the agent to manage bank accounts, real estate, tax filings, and Medicaid applications. Durable by default under the Georgia Power of Attorney Act
• Guardianship or conservatorship orders: If your parent lacked capacity to execute voluntary documents, note the probate court case number, the appointed guardian and conservator, and the date of the next required court filing or report

If any of these documents do not exist and your parent still has decision-making capacity, establishing them is the single most urgent item on the care plan. Once capacity is gone, the family is forced into probate court — a process that runs $3,000 to $8,000 and takes two to six months.

Financial and Benefits

Map your parent's monthly income against Georgia's Medicaid eligibility thresholds. The CCSP waiver income cap is $2,982 per month; SOURCE is capped at $994. Countable assets cannot exceed $2,000 for an individual.

Document all income sources: Social Security, pension, retirement account distributions, rental income. If retirement accounts (IRAs, 401(k)s) are in payout status, the account value is exempt from the asset calculation — but the distributions count as income toward the cap.

If your parent's income exceeds $2,982, note whether a Qualified Income Trust (Miller Trust) has been established, the bank where the dedicated QIT account is held, and the trustee responsible for monthly administration.

For married couples, document the Community Spouse Resource Allowance (up to $162,660 in protected assets) and the Monthly Maintenance Needs Allowance (up to $4,066.50 transferred to the healthy spouse).

Daily Care and Safety

This is the section the day-to-day caregiver actually uses. It covers:

• Daily routine: Wake time, meal preferences, bathing schedule, medications and timing, activity preferences, nap patterns, bedtime routine
• Behavioral triggers and de-escalation: What causes agitation (loud environments, unfamiliar faces, schedule disruptions), what calms it (specific music, a walk outside, a particular family member's voice)
• Wandering risk and safety measures: GPS tracking devices, door alarms, Mattie's Call preparation status, and a pre-compiled emergency profile with physical description and recent photo
• Emergency contacts: Primary caregiver, backup caregiver, healthcare agent, physician on call, nearest emergency room, local AAA

Keeping the Plan Current

A care plan written once and filed away becomes stale within months. Dementia is progressive — the person your parent is at diagnosis is not the person they will be in 18 months. Review and update the plan at every clinical transition: after a hospitalization, after a medication change, after a DON-R reassessment, after any wandering incident or fall.

The Georgia Dementia & Memory Care Guide includes structured templates for each section of the care plan, along with the Medicaid financial workbook and facility vetting checklist that plug directly into the plan when residential placement becomes necessary.

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