Dementia and Power of Attorney in the NT: Aged Care Planning

The Capacity Window Is Smaller Than You Think

An early-stage dementia diagnosis does not automatically mean someone has lost decision-making capacity. Under the Advance Personal Planning Act 2013, capacity is assessed on a decision-specific basis — a person with mild cognitive impairment may still understand what an APP is, who they are appointing, and the consequences of the powers they are granting.

That window does not stay open long. The progression from mild cognitive impairment to moderate dementia can happen over months, not years. Once the person can no longer demonstrate understanding of the APP's effect, no one — not the family, not a lawyer, not the court — can create one on their behalf. For financial or lifestyle authority, the family's path at that point is an NTCAT guardianship application; healthcare decisions may instead follow the statutory hierarchy.

What the APP Needs to Cover for Aged Care

An APP created with aged care in mind should address:

Financial authority: The decision-maker needs power to manage bank accounts, pay aged care fees (the daily basic fee, the means-tested care fee, and the accommodation payment), manage pension payments, and potentially sell the family home to fund a refundable accommodation deposit.

Healthcare authority: The decision-maker should be authorised to consent to medical treatment, liaise with the aged care facility's clinical team, and make decisions about hospital transfers.

Lifestyle decisions: This covers placement decisions — which facility, which level of care, whether to accept a place in Darwin versus Katherine, and day-to-day living preferences within the facility.

Binding directives: If the person has strong views about end-of-life care — no tube feeding, comfort care only, no transfer to hospital for acute events — these should be documented as Advance Consent Decisions in Section C of the APP, not just mentioned as preferences.

The Aged Care Placement Process with an APP

When a person with dementia needs residential aged care in the NT:

1. Aged care assessment. Apply through My Aged Care for an assessment. An assessment organisation assesses the person's needs and eligibility for residential care. The decision-maker coordinates this referral, usually through the person's GP.

2. My Aged Care registration. The decision-maker registers with My Aged Care on behalf of the person, using the APP as evidence of authority. Some My Aged Care assessors will want to see the APP or a certified copy.

3. Facility selection. With limited aged care beds in the NT (particularly outside Darwin), the decision-maker may need to accept a placement quickly. Having clear authority under the APP to make this decision without convening a family conference is critical.

4. Financial arrangements. The facility will issue a fee schedule. The accommodation payment alone can exceed $300,000 as a refundable lump sum or $50+ per day as a daily payment. The decision-maker needs financial authority under the APP to access savings, sell property (requires LTO registration), and negotiate payment terms.

5. Ongoing management. Once placed, the decision-maker manages the person's finances, liaises with clinical staff, and makes treatment decisions as they arise. Detailed financial record-keeping is a legal obligation — the APP's fiduciary duties require the decision-maker to maintain up-to-date accounts of all assets, income, and expenditure.

What Happens Without an APP

If a person with advanced dementia has no APP:

• Healthcare decisions fall to the statutory hierarchy (spouse or partner, primary carer, close relative, or friend). This usually works for routine treatment consent but breaks down when family members disagree about major decisions — like whether to accept a particular facility placement or refuse hospitalisation.

• Financial management requires an NTCAT application. No family member has automatic authority over banking, property, or pension matters. The NTCAT process is free to file but requires formal medical capacity reports and can take weeks to months. During that time, the person's bills go unpaid, their pension accumulates in an inaccessible account, and property transactions are frozen.

• If no suitable family member exists, NTCAT may appoint the Public Guardian for personal decisions and the Public Trustee for financial management. The Public Trustee may charge fees for financial guardianship; the applicable fees depend on the service being provided.

The Split-APP Strategy for Aged Care

For families planning around dementia, the split-APP approach is particularly valuable. By creating two separate APPs — one covering financial and property matters, one covering healthcare and lifestyle — the family can:

• Present only the financial APP to banks and aged care facilities, keeping medical details private
• Name different decision-makers for each domain (an accountant sibling for finances, a healthcare-trained sibling for medical decisions)
• Reduce bank compliance delays by simplifying the document they need to review

The Northern Territory Power of Attorney Kit includes aged care-specific guidance on structuring the APP, the decision-maker worksheet, and the bank acceptance protocol for presenting financial authority to institutions.

See more Northern Territory guides →