It’s a jungle out there…a tangle of required documents, uncertain preferences, family misunderstandings, and sometimes uncooperative elders. Having essential documents in place before emergency measures are needed will give families some peace of mind and confidence in providing appropriate care for elderly loved ones.
Plenty of Advice
There’s plenty of advice around…on the Internet, on the golf course, at the yoga studio, at church activities…people are often willing and eager to share their hero or horror stories about required paperwork for taking care of their elders.
Some families are blessed with elders who planned well and have all the essential paperwork ready in case they are ever unable to make or express decisions for themselves. Lucky them.
Unfortunately, too many families lack knowledge about documentation often required by senior living communities, hospitals, nursing homes, or in-home care organizations.
Note: The information in this blog post is based primarily on pbs.org “Caregiver’s Handbook.” It provides useful information and offers related resources as featured in this post.
The Best Advice Is Legal Advice
A “Caregiver’s Handbook” created by pbs.org encourages us to “find a lawyer who specializes in legal planning for elders.” The handbook points out that if your loved one qualifies because of limited income, legal assistance can be obtained from your local Area Agency on Aging. Some communities have volunteer lawyer programs, and states also have legal assistance through their attorney general’s office.
It’s good to know that legal assistance is available for all income levels. It’s important to understand that the sooner families seek legal assistance, the better.
Recommended Legal Resources
The PBS “Caregiver’s Handbook” recommends additional specific resources:
“The American Bar Association offers a free resource guide by state on its website. It will direct you to local bar associations, legal aid providers and other helpful organizations.”
“The America Bar Association Commission on Law and Aging provides a free list of key legal service providers for elders in each state.” Visit the website or call 202-662-8690.
“The National Academy of Elder Law Attorneys will help you locate an attorney. Visit its website and click on ‘Public’ then ‘directory,’ and enter your city or zip code.”
“The National Senior Citizens Law Center, 202-289-6976, focuses on the legal needs of poor and vulnerable elders and persons with disabilities.”
Speak with an Eldercare Advisor: 573-544-0745
Professional legal advice will guide you in the creation and use of many of the following documents:
Durable Power of Attorney (DPOA)
This document will give a designated individual or individuals the “legal powers to perform on behalf of the elder” on matters related to “real estate, banking and financial transactions, personal and family maintenance, government benefits, estate trust and beneficiary transactions.”
Health Care Power of Attorney/Health Care Proxy
This document will designate an individual to serve as the elder’s health care agent. “The health care agent or proxy needs to be able to talk openly and often with the elder, so that he or she understands the elder’s wishes and values and can make treatment decisions (when the elder cannot) without having to argue with family members or medical staff.” Trust is a big issue here. Who does your loved one trust to ensure that her health care wishes are carried out? Surprisingly, it may be a close friend or business colleague rather than a family member. It’s up to the elder to decide at a time when he or she can make a careful and informed decision.
Personal Suggestion: When you have power of attorney forms in place, make several copies, and distribute them to all named "agents." In the future, there may be many instances where you will have to prove power of attorney: utility companies, insurance companies, social security, real estate matters, banking matters, medical and dental matters, filing taxes, Dept. of Motor Vehicles visits, assisted living/memory care communities, etc.. Every time you turn around, someone will need proof of power of attorney, so be ready. I've gone through at least 20 copies dealing with my parents' affairs.
The word out on the Internet is that we should all have advanced directives in place if an accident or illness leaves us unable to speak for ourselves regarding our medical care preferences.
Documents associated with advanced directives include a Living Will, Health Care Power of Attorney, Health Care Proxy, and Do Not Resuscitate (DNR) or Do Note Intubate Order (DNI).
Although legal advice about advanced directives might be useful, you can create these documents yourself.
The American Bar Association Commission on Law and Aging, 202-662-8690. They offer free online publications such as “Consumer’s Tool Kit for Health Care Advance Planning.”
The Medline Plus website also has a variety of resources to create advance directives.
Caring Connections is a program of the National Hospice and Palliative Care Organization. Their website offers free advance directive packages with instructions, or call 800-658-8898 and request a package.
The U.S. Living Will Registry “offers links to advance directive forms for each state. It creates a database and sends annual reminders to review and update your directives. Hospitals and health care providers check this registry.” 800-548-9455
Speak with an Americare Eldercare Advisor: 573-544-0745
Wills and Trusts
Whether our loved one has minimal assets or an extensive portfolio of property, investments, and bank accounts, legal advice on having an up-to-date will and/or trust “that designates financial, estate, and legal control and distribution” is important. It gives the elder some piece of mind that her wishes are in place and will be followed. Guardianship
If essential documents mentioned above are created and put in place, then the legal issue of guardianship (or conservatorship) does not need to be addressed. That’s a good thing because filing for guardianship takes time and money. It can also be emotionally exhausting for those involved.
Nevertheless, there may be situations where guardianship is the only option. The court has final say as to who is guardian, and it might very well not be a family member. The court also decides the specific type of authority to give to the guardian, whether related to health care, living arrangements, finances, etc. Once again, legal advice will be needed because requirements vary by state.
The National Guardianship Association, Inc. offers standards for guardians.
In addition, AARP also has information on guardianships.
Experienced caregivers know the importance of having these essential documents in place. For those who are new to care giving or those who expect to be caregivers in the future, you will never regret the time taken to read, seek legal advice, and get the needed documents in place. And while we’re at it, the rest of us need the same documents for ourselves. Our future caregivers will be immensely grateful. And that’s a promise.
About the Author:
Jenny Mummert, M.Ed., has a career background in higher education. She lives in mid-Missouri and has managed the care of her elderly parents, both of whom had dementia and lived 400 miles away. Her personal blog, “Drifting Toward Planet Elderly,” serves as therapy, a family history, and a case study of her family’s journey with dementia. Jenny’s mother now lives in Mid-Missouri where they enjoy daily morning coffee and chat time with friends at The Arbors at Mill Creek Village.