Ask a care manager: The importance of getting the documents in place

It’s never easy to think about what will happen to a loved one in the future but not having direction or the proper documents in place can make it a challenge when the need arises particularly for the person who is trying to help.

My mother recently became a widow and is looking to me to help her which I’m willing to do. Her memory isn’t very good and she keeps forgetting to pay her bills and attend to her banking. She insists she can do it herself but I’m worried because her memory seems to be worse than ever. What should I do?

Trusting someone else to help with financial issues (even an adult child) is a big decision particularly for an adult who has taken care of things for years on her own.

It may very well need to happen but by working together on paying the bills, going through the mail and going over the banking together may help her trust your motives. I would suggest you begin by doing this together with the idea that a Power of Attorney for financial decisions be discussed and completed while her memory difficulties are minor.

A wife writes in that she has to make all the decisions in her family due to her husband’s diagnosis of advanced Lewy Body disease. Her husband was the financial wizard in the family, she writes and she is feeling less than competent in handling their affairs. Who should she work with to understand their financial situation?

It’s important to understand what you have before you look for advice. There are several priorities to address first:
1. Know where the bank accounts are, what kind they are and what the balances are.
2. Locate any/all C.D.s, money market accounts, stocks/bonds, investments.
3. Have a good working knowledge of monthly income and the source(s).
4. Know exactly what bills come in, what they are for, and how much is paid out each month for expenses.
5. Write down all of the above information to share with a professional financial advisor.

If you do not have an advisor already, consider hiring one that is a certified professional financial advisor and bills for his/her time by the hour.

You may want to consider utilizing another type of advisor who is paid by commission for the product(s) he sells. Consider asking friends/family for a good referral. Interview this person and be sure you feel you can work with this person and understand the contractual relationship between you. Consider asking the opinion of an adult child who has a good understanding of the financial issues for you and your husband.

My sister has asked me to act as her agent for her Durable Power of Attorney for Healthcare (DPOH). The problem is that she lives in a different state and if/when she needs my help, I may be unable to fly to her side. Is it still possible for me to assume this role and take on this responsibility?

The Durable Power of Attorney for Healthcare (DPOH) may be called by a different name in another state i.e., Living Will, Five Wishes, etc. but if the individual named as the agent is willing to serve as the person’s “agent,” it can be handled long distance if need be.

Copies of the document with the correct documentation and witnesses should be kept with the individual with a copy sent to the agent with names and telephone numbers of the individual’s physician (who should also have a copy) and the likely health facility that will treat this individual in the future.

It’s also a good idea to have a second person as an alternate particularly if the first “agent” predeceases the individual beforehand.

How do I find the forms for Durable Power of Attorney for Finances and Durable Power of Attorney for Healthcare (DPOH)?

Most hospitals and doctor’s offices will have blank copies of Advanced Directives for Healthcare Decisions (DPOH) as they are also called.

You can also download the blank forms online or purchase them at an office supply store. This document can be completed at home with two disinterested parties witnessing the signatures.

Note: A disinterested party is someone not listed as an “agent” in the document. Special rules may apply when the individual is in a hospital or a skilled nursing facility.

The document must be notarized with a long-term care ombudsman or attorney present to assure the individual’s competency.

In many cases when a family consults with an attorney to draw up a will or trust, a separate document may also be included that is entitled, Durable Power of Attorney for financial matters.

Before looking to execute this type of POA, make sure one doesn’t already exist in past legal paperwork. An attorney should be consulted to initially execute this type of document.

I’m quite healthy now and really don’t need anyone to help me with my financial or health decisions. If I go ahead with these documents now, will someone else be making decisions for me even now?

No, both the DPOH for health and the DPOA for finances are documents that are put in place so a trusted “other” can make the decisions about critical healthcare and financial decisions when you are incapacitated and unable to make them yourself.

It’s a very good idea to have the discussions early with your trusted “agents” who can be family members or friends so they will know what your wishes are if/when they are called upon.

Do I have to get both of these documents (DPOH — for medical decisions & DPOA — for financial decisions) prepared at the same time?

No, in fact it’s common that a person will complete the DPOH for medical decisions as a result of the doctor’s office giving you the form or having a hospital stay.

A person can make changes to the DPOH at any time or draw up a new one indicating another person as the “agent.” However, this document will stay current as long as you wish it to stay the same.

DPOA can be drawn up with an attorney at the Senior Center or with an attorney of your choice and again, will remain current as long as you don’t wish to make changes.

It is important however, to make sure copies of these documents are shared with those indicated as your “agents” as well as healthcare providers. New copies must be shared as well.

What happens if I have a stroke or am incapacitated and don’t have these documents in place. Who makes the decisions?

If a medical emergency arises and you’re not able to tell the doctor your wishes, the medical staff will go ahead with all extraordinary measures under the law to treat you.

If you have some express wishes about the extent of the treatment measures you’d want, having them in writing is the only legal way the physicians can abide by your wishes.

The same is true for financial and legal affairs.

If you have no one in place to pay your bills and attend to your financial affairs, it may be necessary for someone to go to court and petition for a conservatorship to have the legal authority to take over.

Having these documents written and taken care of ahead of time just makes the situation go smoother for you and everyone else involved.

My partner and I are not married but want to execute powers of attorney for healthcare issues and finance for ourselves and each other. Is this possible?

Certainly. A Durable Power of Attorney for either healthcare (DPOH) or finances (DPOA) is an individual document whereby one person gives decision-making ability to another whenever he/she is incapacitated.

It doesn’t have to be a spouse but needs to be a person that you trust will act in your best interests. The forms can be completed as described.

Carol S. Heape, MSW, CMC, Fellow is executive director/CEO of Elder Options Inc. serving the Sacramento Region/Placerville/South Lake Tahoe since 1988. elderoptionsca.com
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