Issues of privacy, capacity, and guardianship are common problems in the management of dementia. These issues are complicated by the fact that the laws regarding such issues vary state to state. While many equate the diagnosis of a dementing illness with a lack of capacity and need for oversight, the lines are blurring as we have begun to diagnose disorders like Alzheimer’s in a predementia or even preclinical state. Issues include breach of privacy and potential inappropriate paternalism that can lead to social/legal/financial discrimination and breach of fundamental human rights. Understanding privacy laws/HIPAA and the essentials of capacity determination is critical for medical and support staff that work with persons suffering from degenerative disease.