The gift of preparation
Dialogue and documentation to help you provide the care your loved one desires … and plan for your own needs in the future
As a caregiver, you’ve seen firsthand the shifts that come with aging and understand the greater need for support we’ll all likely need as we grow older – from help with daily tasks to assistance making significant decisions.
You’ve probably also realized that supporting your loved one relies on having an understanding of their preferences about medical care, personal belongings and end-of-life decisions, as well as documentation so you can help fulfill their wishes.
You may have even considered ways your family member could have planned better or have noted what you would want in a similar situation.
Consider these steps to ensure you have the information you need to provide the best possible care … or to help others understand your needs as you reach your later years.
Start with some questions
To get a dialogue going, consider questions around quality of life – the things that will define how we live as we age – before there’s a critical reason. Since not many us enjoy talking about (or even acknowledging) a time when we may not be at our best or will have to watch someone important to us lose abilities that made them who they are, it can help to break these conversations down.
For example, consider:
Who: Who will you spend time with? Who will take care of you should you need help with daily living activities or simple home maintenance items? What if you need more extensive care?
What: What are your health limitations? Does our family have a history of medical conditions? What would treatment cost with Medicare or Medigap insurance?
Where: Where do you want to live? Will your home need to be modified? What other options are available and what do they cost?
When: When are you planning to retire? Will you have enough saved to live the lifestyle you desire?
How: How will you get around? Do you want to live near places and people that are most familiar to you? Who can help you with transportation?
Put it in writing
As you have conversations – or have experiences that bring wants and needs to light – document, document, document. Here’s a look at some of the paperwork of caregiving, with an eye toward what your loved one needs now, and what you’ll need later.
Contact authorization form – Authorizes a third person, say a financial advisor or attorney, to communicate with a designated contact person if there are questions or concerns regarding health status, including mental capacity.
Last will and testament – A legal document used to distribute property to heirs, specify last wishes, name guardians for minors, and identify who is responsible for managing the estate and implementing wishes. Every adult needs one, or the state will step in to make these types of decisions.
Separate writing/tangible personal property memorandum – A separate writing/tangible personal property memorandum can be used to supplement a will. This document dictates distribution of small tangible personal property items such as jewelry, collectibles and artwork. It can be separate from a will and can usually be changed without requiring an amendment, although it would be referenced in the will.
Durable financial power of attorney – A durable power of attorney gives someone authority to handle financial and legal decisions. Of course, the person selected needs to be someone who will represent your best interests.
Living trust – In many states, a living trust can be used to transfer assets and personal property in an orderly and more private manner than a will, and can even stipulate provisions for the bequests. It also can help avoid a costly and stressful probate court process and may offer substantial tax benefits.
Durable medical power of attorney – A healthcare proxy or durable power of attorney (sometimes known as an advanced directive) is a person who makes medical decisions for someone who is not capable of doing so. That person will need relevant health information, so it’s wise to make sure there’s a HIPAA provision that gives physicians permission to disclose medical information to the appropriate parties.
Living will and medical directives – An estimated 70% of Americans have no written directives outlining how they’d like to be treated should they need life-sustaining medical treatment. A living will specifies what type of medical treatment is acceptable to sustain life if one is terminally ill or in a vegetative state. Medical directives apply if a person is incapacitated or unable to communicate wishes for treatment.
POLST form – A Physician Order for Life Sustaining Treatment (POLST) is for those with serious illness or frailty to specify preferred healthcare treatment in an emergency medical situation.
DNR/DNI order – A doctor’s order that tells all other medical personnel not to perform CPR if you go into cardiac arrest (Do Not Resuscitate) or place a breathing tube (Do Not Intubate).
HIPAA form – Allows medical providers to release health records to those given consent. Keep in mind that any adult should have one. Even parents aren’t privy to medical information once a child turns 18.
Policies of protection
Life insurance – Life insurance helps ensure that loved ones will be financially protected after a death.
Disability insurance – Most disability policies replace a percentage of earned income when the policyholder can’t work due to illness or injury.
Long-term care insurance – Designed to pay for the cost of care in a variety of settings, including a nursing home. Long-term care policies vary widely in their coverages, limitations and exclusions.
Beneficiary forms – For insurance policies, retirement accounts and some other assets, the beneficiary form prevails over the will. So whoever is named will receive those assets unless the form has been updated.
Letters of instruction – An informal, non-binding way to share any wishes not covered by a will (e.g., the needs of minor children or whether to donate organs). Unlike a will, letters of instruction remain private.
Ethical will – An ethical will preserves family history and imparts important values, life lessons and faith to the next generation.
List of contacts – A detailed list of people to contact in certain circumstances, including family, friends and the professionals who oversee legal, financial, insurance and health matters.
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