Blog Archive
- Advance directives are oral or written instructions about future medical care.
- Each state has different regulations.
- Advance directives can be revised and updated.
As a caregiver it is very important that your parent or loved one make their wishes known in the case of health care planning. It is vital for you to know what their wishes are and important to write out what the plans are for taking care of your loved one if and when you can no longer do so.
One of the ways to do that is by documenting their plans in an advance directive. Advance directives are important because they express your parent’s wishes and convey decisions that they want carried out in case they are too ill or impaired and can not make them for themselves. Writing them down and making them known can help alleviate confusion at a later date. It is also important to write a will that gives instructions about the distribution of their property. Advance directives do not replace a will.
Advance directives include a living will and durable power of attorney. A living will explains how your loved one feels about being kept alive through artificial means. They can accept or refuse medical care, decide whether to become an organ donor, express their wishes about the use of dialysis or breathing machines, being resuscitated if their heart stops or their feelings about tube feeding. Your loved one will not be denied pain medication or other means to keep them comfortable.
A durable power of attorney for health care is someone your loved one can appoint to be their proxy and make health care decisions for them when they can not. The durable power of attorney is a legal document that names the health care proxy. As always, this document should be signed in front of witnesses, dated and notarized. Once this is completed the document should be copied and distributed to the appropriate people and incorporated into the person’s medical records.
Making these decisions ahead of time will give you peace of mind. Remember that your loved one can always revise and update this document if they change their mind or have new information.
Resources:
National Institute on Aging
Administration on Aging
National Association of Area Agencies on Aging (n4a)
One does not always need a lawyer to write up a will but it is better to have one to insure that everything is in order. In some states one can write what is called a holographic will that must be signed and dated in the handwriting of the person making the will. If there is no will the state will determine who will acquire property.
A will is one of those things that a person always intends to do but does not ever seem to find the time to do. Often waiting until a will must be written can creates stress and undue pressure. It is especially difficult to encourage one’s loved ones to make a will.
There is often superstition that follows the writing of a will. Some people will think that because they have written it down then they may die. Logically, we know that is not based on fact but it still crosses people’s minds.
When you are taking care of a loved one and you know they do not have a will, it may be a sensitive topic to pursue. It may be uncomfortable to encourage them to write one so you may want to approach it as if you do not have a will then suggest you each write one. If you are the main caregiver of a parent or other vulnerable adult it is extremely important that you have procedures in place that will assure that your loved one is taken care of if you are no longer able to do so.
Here are some items that should be considered:
- Deciding what property to include.
- Determining who will inherit property.
- Choosing an executor or executrix.
- Making sure to sign the document in front of witnesses.
- Then be sure to store the will in a safe place.
Most people are capable of writing their own wills with the help of a form but if there are a lot of assets you may want to consider hiring a lawyer just to be on the safe side. In some states you can write what is called a holographic will that must be signed and dated in the handwriting of the person making the will. Make sure to check your state’s rules before relying on the holographic will to hold up in court. Your local Agency on Aging can help you with the information you need.
National Institute on Aging
AARP Information on Wills and Estate Planning
Nolo Information on Wills and Estate Planning
Legal Zoom Estate Planning Services online
Important facts about living trusts:
- Living trusts can decrease delays in distributing property but do not take the place of a will.
- Creditors can go after trust property.
- There are various types of trusts.
- A trust is an agreement under which money or other assets are held and managed by one person for the benefit of another.
Different trusts accomplish specific goals. When you are attempting to choose which one is right for your loved one (s), it can be confusing. It is always sound advice to hire an attorney. This is true even if you and your loved one (s) are comfortable with going through the process without one present.
Deciding in advance who will get what is not something most of us want to think about but it may reduce stress and headaches for all those involved. There are a lot of reasons to consider a trust.
Several of those reasons are that it may help to reduce or eliminate estate taxes, protect property for certain beneficiaries, avoid a contested will and set up long term property management. Having a trust possibly will cost less over time if your your loved one(s) have large amounts of assets or if they own property in more than one state.
Your loved one(s) should have selected a trustee that they trust to fulfill their wishes. It will be helpful if their trustee is able to make sound financial decisions and understand basic legal concepts. They must also keep a record of transactions that affect the property under the guidance of your state’s laws.
Your loved one(s) should also set up provisions for a trustee resigning, being removed or replaced. Putting this system in place will help the process run a little more smoothly when and if they have to replace a trustee. Already having it in writing will avoid misunderstandings.
This document should spell out what they expect of the trustee. There will be no discrepancies about the interpretation of what their expectations of the trustee or misunderstanding what your parent’s expectations are. Clearly documenting, having the trustee sign and having the document notarized will avoid most any difference of opinion.
The trustee that your loved one (s) appointed will hold legal title to the property on behalf of the beneficiary. Beneficiaries are the individuals that one decides to leave their property to. Your loved one (s) can be their own trustee until they are deemed incapable of making sound financial decisions. Then when they become debilitated their financial well being will be handled by people whom they have appointed and trust.
Make sure your that papers are signed in front of a notary. If they are not, you can find one by contacting your town official such as a town clerk’s office or your local City Hall. Another tool you can help them use if you are using the internet is Notary Rotary that can locate notaries by zip code.
Living Trust Network
Nolo Information on Living Trusts
Save Wealth Planning your estate
AARP Wills and living trusts
The concept of a living will was brought to the forefront after the Terri Schiavo case. Terri entered a vegetative state in 1990. Her brain damage was related to her battle with bulimia that caused a deficiency in potassi
um. Individual family member thought that Terri would have wanted different treatments. It created a division in the family and in the country. After that case living wills became a part of many family’s conversations. It made it clear as to why it is so important to have your requests in writing and documented with your health care provider and your family.
A living will is one type of advance directive. Living wills vary from state to state and can be revised and updated.A living will is a document that expresses a person’s wishes for medical treatment. A living will is part of the advanced directive along with the durable power of attorney. This document will allow a person to express whether they want to receive life-sustaining treatments in the event of a terminal illness or accident in which they are injured or otherwise become debilitated. A living will does not replace a will so it is important to understand that each of these documents is a very unique instrument.
As a caregiver it is essential that your loved ones have expressed their wishes in a legal document. This will decrease the chance of confusion and stress for your family if your loved ones become incapacitated.
Some of the issues that should have considered are what treatments that they will decide to have. These may include such things as food and water via an intravenous device, medical directions that impact the end of life and medical machinery and other techniques that may extend their life through artificial means. Medicine and health care have progressed to the point where a person can be kept alive for a long period of time but may not have any quality of life. It is up to the individual to decide what quality of life means to them personally.
Each state will have different requirements to it is crucial to find the document that your state requires and follow the instructions implicitly. You can find your state’s form on the U.S. Living Will Registry.
American Bar Association
U.S. Living Will Registry State specific forms
U.S. Legal Forms Overview of living wills
Legalzoom Living will/Health Care Directive
Your loved ones should prepare both a living will and a durable power of attorney. When combining both into a single form it is then called an advance directive. This document takes effect when the patient becomes terminally ill.
A living will is a written statement outlining the type of health care preferences your parent’s or loved one desire if they become debilitated or incapacitated. A living will differs from a will in that it outlines the type of health care that the person does or does not want to receive.
Incapacitate means to disqualify or deprive somebody of effectiveness or to make someone legally ineligible. Usually a doctor will make this decision and the power of attorney will take effect. That is why it is important for the person’s medical care providers to have a copy of their medical requests.
As a caregiver or family member, it is important that you know that your the loved one does have a living will and know where the document is located. It will give them and you peace of mind in knowing that they have made their own decisions about their wishes. Knowing your loved one have made decisions based on their wants releases you and your family from having to make these decisions during a stressful period of time.
A durable power of attorney allows the person to appoint someone that is trusted to be a health care agent. They are called attorney-in-fact for health care, health proxy or surrogate. This person will be put in charge of making health care decisions so it is important to pick the right person. The person to be the health care agent should be one that is trustworthy to make the decisions that they would make if they could. The elder or loved one should also have chosen someone that they can talk to openly about what it is that they want.
When choosing a proxy or surrogate certain attributes should be considered such as the person being assertive and strong willed. There may be resistance from family members and the medical world when it comes down to making sure that the wishes are followed. The proxy needs to completely respect the wishes even though they may not agree with their requests.
A living will and a durable power of attorney are parts of the advance directive and do not replace a will. It is important to have all three because they serve different purposes.
Other resources:
Nolo The Living Will and Power of Attorney for Health Care
National Institute on Aging Aging Research & other information on Power of Attorney for Health Care.
AARP Is a Living Will Enough?
This week begins a six part series on wills, trusts, powers of attorney, in both financial and health care matters, as well as living wills and advance health care directives.
The first topic is concerning durable power of attorney for finances. Money is a topic that no one wants to talk about but is very important to discuss to assure continuity of care. When it comes to financial security, it is crucial that plans be made beforehand for power of attorney. This is a safety net that can be put in place in case your loved one becomes infirmed or incapacitated and cannot make decisions that will be in their best interest.
There are many types of powers of attorney, limited power of attorney, general power of attorney, durable power of attorney, springing power of attorney and financial and medical powers of attorney. You and your loved ones should decided which makes more sense to pursue. You can do this with or without an attorney although it really depends on how comfortable you and they are about making this decision without one present.
A durable power of attorney is a document that appoints an agent to manage the person’s financial affairs if they become debilitated. As a caregiver this will be extremely important to your loved ones. You and they will feel confident that they are taken care of if you are not able to at some point in time.
A durable power of attorney will help your family to not end up in court waiting for a court proceeding to determine how your parent’s finances will be handled. Their property and assets will be able to be transferred in a shorter period of time and also leaves the elder able to make the decisions about who gets what and not a court of law.
Durable means that it is lasting and will not automatically end if your parent becomes unable to make financial decisions. There is also a springing power of attorney that allows your parent or loved one to keep control over their finances until doctor judges them incapacitated and then it springs into affect.
The person must state that it is durable in order for it to become effective. The person that the elder chooses to represent them and their finances is called an attorney-in-fact or agent. This person is given authority to manage their financial affairs if they become incapacitated. This document will give them legal authority to act on your parent’s behalf.
Placing this in motion may give your loved ones peace of mind. They will have control over what they have worked hard for and assured it will be doled out the way they requested so that the important people in their life will share in their hard work.
Links to other resources
Nolo Power of Attorney
AARP Understanding Power of Attorney
Legal Zoom or Legacy Writer Easy to use forms if you are going to do it yourself
American Bar Association
When it comes time for your loved ones to receive assistance with tasks that they cannot accomplish as easily as they could previously, it may be time to hire a home service to help them out. One of the concerns for the elderly and their family is having a stranger in their home.
Here are some things you may have heard about home health aides or companions from the elders family:
- “I just wouldn’t feel right having some stranger there all the time.”
- “I don’t like the idea of paying someone just for sitting there.”
- “How do I know if they’re really qualified?”
- “When it comes to personal hygiene, it embarrassing and I feel helpless.”
- “I don’t like to allow strangers in my home. I hear all of those stories on the nightly news about break-ins and robberies.”
Elderly parents may take a similar view. If living alone, they may view the introduction of an aide or companion into their home as a form of trespassing. After all, it is a stranger. They may have nothing in common with them; nothing on which to build trust and 
nothing to outweigh feelings of discomfort and vulnerability.
With aging parents who are still able to get around fairly well, the problem may be not so much in an inability to do things as in a reduced ability to remember to do them. Loved ones who are otherwise capable and responsible can become frustrated, depressed, and even withdrawn when they begin to slip up in keeping appointments, returning phone calls, or buying something at the store.
Some elders still live independently don’t require the services of home health care. They can still get around, prepare meals, and attend to essential household tasks. They may, however, suffer from loneliness. What they need is companionship; someone to drive them to and from appointments, to accompany them to the grocery store the theater, or just to engage them in conversation on a topic of interest to them.
The home care worker can take an active role in a client’s day, offering stimulating conversation or just a quiet presence, ready to lend a hand when needed. They take their cues from the client and from their own assessment of what the circumstances require. Their knowledge and experience gives them a good sense of the kind of presence they ought to be at any given moment.
Home care services can provide companionship, transportation for shopping trips and recreational activities, accompany clients to the doctor’s office, make phone calls to arrange for home repairs or to check into the terms and help with paperwork. Soon, the elder will come to appreciate the value of having an extra pair of helping hands.
Often elders can stay in their homes for longer periods of time if they are given some assistance. Statistics show that most people want to stay in their homes as long as possible. Home care is a consideration if family and friends cannot be there to assist in daily needs.
Transportation becomes difficult when the elder person gives up their license or cannot drive due to impairments. Planning for outings, visits and having someone to take them to appointments, meetings, lectures, classes, bingo, worship services will help them stay active.
Morning wake-up calls and evening bedtime calls can be assuring and gives the caller a chance to check in and get a sense of how the elderly person is doing.
Often writing and handling paperwork can be taxing. Having a home care worker mail letters, assist with answering correspondence and help in the bill paying can relieve stress that can build up when the tasks seem too overwhelming to the elder.
Crafts, hobbies and gardening should be encouraged and with assistance they can still enjoy the things that make them happy. It keeps their mind active and feeling productive gives one a purpose for getting up in the morning.
Home Services
It’s often the light housekeeping and small home repairs that are not covered in most home care services. Changing a light bulb or nailing in loose nail only takes a minute but it may not be something the elderly person feels that they are not able to do. It also prohibits having to have strangers come into their home and gives them a sense of safety.
Other tasks:
- Changing linens & bedclothes
- Drop off & pick up dry cleaning
- Assist with shopping & errands
- Pet care
More often than not, elderly people who live alone forget to eat or don’t feel like cooking a meal. The preparation and clean up that goes along with it may take too much effort so having someone come in to plan, prepare and clean up afterwards will promote good nutrition and assure good health. The home care service can also assist in preparing the grocery list, shopping and assisting with meal choice for particular dietary needs.
Personal Care
Assistance with grooming, clothing selection, bathing, medication reminders and hygiene assistance are very important to one’s outlook on life. When a person feels as if they look good their self-confidence is better.
As you can see, the benefits of having a home care service are many and will not only help the elderly person live a productive life but will also bring peace of mind to the family.
What other services would be important to help an elder remain in their home?
