In our nation's health care system, having proper, up-to-date documentation on file with providers, or having copies ready to provide to first responders, can mean the difference between life or death in an emergency.
Paperwork is also necessary to ensure that every member of your senior loved one's care team — from doctors, nurses and therapists, to the pharmacist, to all the family caregivers who will be helping out — are on the same page and working together.
When your partner, aging parent or other older loved one moves into a residential memory care community like The Episcopal Church Home, there are a variety of documents that it will be critical both for you — the primary family caregiver — and for the personal care home to have on file.
Today, let's talk about what those documents are and how to get them completed and filed in the right places.
1. Durable medical power-of-attorney
As your loved one's dementia or Alzheimer's disease progresses, he or she will eventually lose the ability to make informed medical decisions.
If there is no spouse able to make decisions on your loved one’s behalf, another member of the family will need to serve as medical power-of-attorney (PoA). But that power isn't automatically delegated. It needs to be designated up front in a legal document.
Ideally, your aging loved one will have thought about this, asked someone in the family to serve in that capacity, and made sure that the person who will serve has signed the medical PoA form (sometimes also called a "health care proxy" document).
Be aware that a standard power-of-attorney designation is invalidated if the designator becomes incapacitated. In that case, your parent or older relative will need to have his or her lawyer draw up a variant called a "durable power-of-attorney."
Copies of that form need to be filed with all the providers on your loved one's care team — any hospital, doctor's practice, specialist's practice, nursing care service, etc. — and with the memory care home.
The person who serves as PoA will need to have a copy of the document and needs to be able to provide certified copies to any new providers or first responders. Your loved one's attorney should also keep an original copy of the form on file.
2. Durable financial power-of-attorney
Like the medical PoA form, a financial PoA form is used to designate the person or persons who may make financial decisions and/or transactions on your loved one's behalf. Again, the personal care home will need a copy, as will the person who serves in that capacity.
Copies will need to be filed with all the financial service providers and banking institutions your loved one does business with, too, so that the financial PoA can access the accounts.
Some financial institutions may require your loved one to fill out proprietary forms. They may also be reluctant to honor a PoA document that was signed a long time ago that is now considered "stale." The reasoning: A person who is trying to take advantage of a senior's incapacity might present an old form, when in fact the senior might have later changed his or her mind and changed the PoA.
The best way to head off any questions is to talk with your parent — ideally, before he or she has ever been diagnosed with dementia or illness — about the necessity of having proper powers-of-attorney documentation complete and up-to-date and go with him or her to the banks to file the appropriate forms.
Every few years, they should be re-signed, to assuage any questions that might arise about their validity.
3. Living will
Your elder loved one should also communicate his or her health care preferences and wishes in writing, before dementia prevents him or her from being able to communicate them in person. A living will is the way to do so.
Via a living will, your loved one can designate whether life-saving measures should be taken based on different medical scenarios and prognoses.
For example, an elder who does not want to be kept alive on artificial support for prolonged periods of time could state so in a living will, thus freeing physicians and family members of hand-wringing and heartbreak if his or her condition deteriorates.
A do-not-resuscitate (DNR) order can be noted in a living will. Your loved one could also designate those providers from which he or she would accept care. Those designated providers can include personal care homes and memory care homes.
Again, ideally, your loved one and his or her designated medical PoA will have conversations up front about care preferences, so that the family will know what those preferences are in an emergency. But they need to be documented; if they aren't, a physician is not obligated to act on a family member's say-so.
4. Updated financial will (and maybe also a living trust)
Every adult who owns assets should have an updated will, whether he or she has a lot of wealth or just a little. But seniors who have a lot of wealth to manage, or even just a significant amount of retirement savings, should probably also look into setting up a living trust.
Like a living will, a living trust helps to communicate your loved one's wishes for managing his or her finances, if he or she isn't able to communicate those wishes in person. Essentially, it's designed to make it easier for the designated financial PoA to manage money on his or her behalf.
Have additional questions about transitioning your loved one from home to memory care?
We have answers for you.
Click here to download Making Sense of Dementia, a special report by our Episcopal Church Home memory care experts on what to do when a new dementia diagnosis is made.