And How to Complete them with Care and Empathy.
Over the course of your caregiving journey, you will need to assist your loved one in several ways. To be an effective advocate and operate without challenges, it's best to possess pertinent legal documentation that grants you the power of attorney to act as a health care and financial agent for your loved one. It's necessary to have when partnering with health care providers and financial institutions in the event that your parents are not able to communicate and act for themselves. The best time to initiate the process of getting legal authority in health care and financial decision making is when you know you will need to advocate on your parent's behalf.
In my personal situation, I hesitated to ask my mother to get the paperwork drafted and completed for fear of making my mother feel as if I were attempting to take away her independence and take over her assets. I feared she might wonder if I had an ulterior motive for my request to get the legal paperwork in order.
I was unaware that reluctance on a care recipient's behalf was normal. Feeling guarded when it comes to touchy subjects like this is human nature, as it is their desire to hold on to their own perceived independence for as long as humanly possible. So, while it's normal to feel reluctant and hesitant to initiate this type of conversation with your loved one, it's truly in their best interest to have it. It's what's necessary to provide the help they will need to get the care and assistance they're require in the future.
If you're feeling nervous about pursuing the conversation of acquiring legal documentation for your care recipient, my advice would be to have an open and empathetic dialogue acknowledging their need for independence. Be sure to also explain the necessity of having the proper authority to be of assistance when they can't make proper decisions for themselves or for the simple transactions with banking.
You might also consider that sometimes these conversations are best held while in the presence of professionals such as social workers, attorneys, and other medical professionals. Feel free to schedule a consultation with them in order to address any initial questions or concerns your loved one may have.
Because my mother had difficulty walking and preferred to stay at home, I found an elder care attorney who was willing to do home visits. My mother was more open to having the conversation with the attorney and agreed to the draft and execution of all of the necessary paperwork.
My fear of having the paperwork executed caused unnecessary inconveniences for us both, later down the road. What I've learned is to trust that communicating my authentic interest in what's best for my mother will enable me to have difficult conversations with her. Communication may be complicated in the beginning, while you're still navigating the journey and defining the roles in each other's lives. But in time, you will eventually learn to trust your ability to communicate your intent in a way that is well received by your loved one.
Here's a list of required documents for operating as an advocate on your loved one's behalf.
1). Living Will - This is not to be confused with a will. A Living Will is a legal document stating the type of medical care
your parents prefer to receive in the event that they are no longer able to communicate or make decisions for themselves. When this occurs, they must name someone as a decision maker on their behalf. In addition, a health care power of attorney will be drawn up to give the assigned "agent" to act
on their behalf.
Living Will forms are generally provided by medical professionals, hospitals, nursing facilities, and attorneys. Your loved one must indicate their preference and have a witness as well as the document signed and notarized. Copies should be provided to all members of your loved one's medical care team.
2). Healthcare Power of Attorney - We all have preferences about our personal care. A person, or agent, is named and will legally act on your loved one's behalf to make decisions based on the values and specifications made in a healthcare power of attorney document.
The document grants legal authority to a named agent or person to act on your loved one's behalf. Early discovery, you're loved one is still able to communicate and advocate for themselves, is best. This helps determine whether they would like to be on life support and for how long, a pain management strategy, where they will live if they're under care with a chronic illness and more. Having a healthcare power of attorney is very important as it gives instructions for their personal wishes to their health care team. Once provided with this document, medical professionals are legally bound to follow the directives of the health care power of attorney and living will. Hospitals and medical personnel will usually ask for copies of the health care power of attorney and living will to be used together.
Lastly, HIPAA laws protect the patient's privacy and having this legal document gives the medical staff permission to share and discuss their medical information with you as their caregiver.
3). Financial Power of Attorney - This paperwork is important because this legal document gives a trusted person the ability to make financial decisions and operate on financial matters on your loved ones' behalf when they are no longer able to do so, due to an injury or chronic illness. This documentation allows the caregiver the power of attorney to open mail, pay bills, make deposits, make investment, file and pay taxes, and communicate on their behalf with financial institutions and authorities.
From my personal experience, this document is especially important because banks often will not accept copies of a financial power of attorney. When my mother wanted to close out her IRA, the bank wanted her to come into the branch bank to do so in person. The issue was, she had relocated and no longer lived in the area. She was no longer in the condition to travel, and the bank required an original financial power of attorney from me in order to act on her wishes. If possible, be sure to have several original copies made for each banking institution your parent does business with, in case you need to make a change to their account.
4). Do Not Resuscitate Order: a DNR is an end-of-life medical directive for the medical team. It is needed if your loved one has a chronic or terminal condition and does not wish to have medical intervention or life saving devices activated in the event that they are no longer breathing or their heart stops. This form can also address other life-saving measures such as feeding tubes, breathing machines, and other lifesaving medical interventions. This form is generally offered by hospitals, nursing homes, and medical professionals and can be revoked and updated at any time.
5). Will or written document - This document outlines how your loved one wants their remaining assets to be distributed with a named executor. Depending on their financial and personal situation, an attorney may advise your loved one to enter into a trustor other document stating intent after death. Trusts are often used to avoid probate. This is a discussion best suited between your loved one, you as the caregiver, and an elder care or estate attorney.
6). A Declaration of intent for end-of-life final arrangements - What's most helpful to have here is to have the details of your loved one's wishes once they have passed away. This includes a decision about having a burial versus cremation, location, funeral service preferences, and any other specific details. It's best to get this information in advance before your loved one cannot communicate this information. This way their wishes can be adhered to as outlined. You can consult your preferred funeral home for assistance with documenting your loved one's preferences.
Here is some additional information you need to have on hand without the assistance of counsel.
Account Username & Passwords
For online bill payments and account management
For all medical team access. Medication names, doses, intended use, and frequency.
List of medical team members
For emergency contact. Contact names, addresses, phone numbers and email addresses.
List of attorneys
Those who are involved in elder care planning and any other legal matter pertinent to your loved one's life. Names, addresses, phone numbers, and email addresses.
Social Security Card
Medicare Membership ID Card or Medicare Advantage, Medigap Coverage or Supplemental Insurance Coverage cards, Medicaid Membership ID Card (if benefit recipient).
Have the ID numbers and copies of the front and back of each card.
Driver's License or State Identification Card
This is sometimes requested for benefit requests
Case manager of the Medicaid Waivers Program
Name, phone number and email.
Caregiving Agency Contact Information
In case of need or emergency. Not if they're receiving private pay or insurance paid (Medicaid) support.
List of Food and Medication Allergies
In case of an emergency
Emergency Contact Names and Phone Numbers
In case of an emergency
Blood Type and List of all Conditions and Illnesses
In case of an emergency
There are several sites that offer free resources and forms for emergencies and legal representation requirements. But keep in mind that each state has different sets of laws and forms may not be specific to your loved one's needs. I recommend scheduling a consultation with an elder care attorney to plan for your loved one's future. As a result, you can familiarize yourself with state laws as they apply to the elderly, and you'll be more familiar with the Medicaid program application (if needed) as well. It's an investment that will give you and your loved one peace of mind.
If you consult an attorney and focus on gathering each of the items on this list, you will have the right tools to be prepared for the various situations you'll encounter your caregiving journey.
The Durable Power of Attorney: Health Care and Finances - NOLO
Understand medical and financial powers of attorney and why you need to prepare both.
By Shae Irving, J.D.