Emergency and hospital staff in most states are still required to give CPR or ACLS if a separate DNR doesn’t exist. To make sure your wishes or those of a loved one are carried out, you must have a DNR signed by your physician. You cannot create this form on your own; you must obtain an official form from a physician’s office. You must also have a copy of this form on file at each medical facility or on your person (or the person for whom you are caring).
These legalities may seem overwhelming (and perhaps a bit depressing), but they are vital to ensure that the wishes of you or your loved ones are carried out. Having these documents in place will also make an already stressful situation easier on caregivers.
Many of these documents are available online, but experts recommend consulting an attorney, as laws and terminology differ by state. A professional can guide you and your loved one through the process, explain the options, and answer questions along the way. They may also help your loved one consider and plan for situations he or she hadn’t thought of before. Elder care attorneys specialize in elder law and, therefore, can be especially helpful for seniors who are putting their affairs in order. The National Elder Law Foundation (nelf.org) can help you find a local attorney. If possible, be sure to select a certified elder law attorney. The cost of preparing these documents is generally affordable, but if fees are a concern, many communities offer free or low-cost legal resources.
Once these documents are completed and filed, it’s important to share the contents and location with all parties involved. Spouses, adult children, or other caregivers should know where the originals are kept and have personal copies. Also, before appointing a POA, be sure that person understands the wishes of the care recipient and is willing to accept the responsibility. Finally, it’s a good idea to review these documents every year or so, as things change.
Other Important Documents
In addition to advance directives, it’s necessary for caregivers to know how to locate and gain access to a long list of essential documents that belong to the person for whom you are caring.
Once you have located these documents, it’s recommended that you make copies (be sure to copy both sides) and store originals in a bank safe-deposit box or portable fireproof box. Copies can be kept at the care recipient’s home, but as caregiver, you should keep a file cabinet or binder with copies of these important documents for easy access. They can also be kept in electronic files as long as they are backed up. Additionally, copies of certain legal documents, such as wills, trusts, or advance directives, should be kept at an attorney’s office. Remember, a copy of a healthcare directive and DNR should be kept on the person (purse or wallet), as well as on file at the physician’s office and other medical facilities.
Checklist of Important Documents
Source: pbs.org/caringforyourparents (in conjunction with AARP)
Visit www.sprypub.com/Caregiver to download.
Again, this list of documents may seem daunting, but chances are many of these papers are already filed appropriately. It’s simply a matter of familiarizing yourself with them. If you do have to track certain documents down, it’s far better to do it before they are needed, such as during a health crisis or after a sudden death. The last thing you want to be doing is searching through drawers and closets trying to locate necessary information.
The Money Talk
Like many women of her generation, my mom had always let my dad handle the finances. She knew where things were and what accounts they had, but deferred bill paying and investment management to her husband. So, it was no surprise that she needed help assessing her financial situation. And because she really didn’t have a good concept of expenses, her initial reaction to her net worth was “my, that’s a lot of money.” It’s true that after a lifetime of hard work and prudent savings, my dad had left my mom financially comfortable, but she was far from wealthy. Once we listed her sources of income (a pension check that would stop coming in a few years and a small social security check), along with her monthly expenses (including very high health insurance costs), she began to see that “a lot” was a relative term. Furthermore, we estimated that her savings had to last for possibly 20 years or more (her mother lived well into her 90s, and at the time, there was no reason to believe that my mom wouldn’t do the same), and may have to cover costs such as home health aides and other care not paid for by insurance. When projected out over the next two decades, it became clear that wisely managing her money would be essential.
Thankfully, she was eager to downsize and move closer to us, and she had no problem with me helping her create a budget (both of these things can be very difficult for aging parents). She was shocked by the high cost of, well … just about everything, including housing, utilities, and even groceries, and therefore gladly accepted some financial advice. She gratefully let me pay the bills, but kept control of her checkbook and reviewed monthly bank statements. Of course, we didn’t agree on everything. For instance, my mom had a soft spot for children and animals (like myself) and could not say no to those sad photos of hungry children and abused animals that arrived in the mail several times a week. She began writing checks to every organization that sent a request! We finally compromised by having her choose the two organizations that meant the most to her and making annual donations. For the rest of the year, she was instructed to throw all other requests in the trash, unopened. We had other minor disagreements along the way, but overall, when it came to the “money talk,” I emerged unscathed—but that’s not always the case.
A Sensitive Subject
You may have noticed that many of the documents on the checklist involve finances. For some caregivers, bringing up the subject of money can be more awkward than discussing end-of-life wishes. Let’s face it—money can be a sensitive topic. Many seniors are not comfortable discussing their finances with their adult children and vice versa, and even spouses can find it difficult to bring up. First off, the older generation never talked about money—it was considered a private issue. In addition, creating a will is a reminder of one’s mortality and brings up possible controversies over who gets what. It can also be seen as yet another loss of independence—giving someone access to your life’s savings can be scary! But these discussions are necessary and, once started, may actually reduce tensions and ease worries. Moreover, it’s vital that caregivers have a clear picture of the care recipient’s financial situation and review it regularly. This is the starting point for determining what type of care and living arrangements