Legal Planning: A Guide for Caregivers
By: AGING ARKANSAS Newspaper
So many of us care for a loved one---in our own home, around the corner or many miles away. This can be a very rewarding act of love. But caregiving can also be full of frustrations, stress and expense.
You are not alone. At least 22 million Americans provide care that is essential in keeping an older family member living in dignity, at home and with the maximum degree of independence. About 80% of all care received by older Americans is provided by family members.
Aging Arkansas believes information is essential for effective, satisfying and healthy caregiving. This month, Aging Arkansas begins a new monthly feature---Family Caregiving. Each month we will focus on a specific aspect of the choices and challenges facing caregivers. This month we focus on the legal and financial aspects of caregiving. Even if you have taken care of these matters, this is an area that needs regular review, updating, adjustment or major change from time to time.
In coming months look for information on relieving caregiver stress, long-distance caregiving, home and community-based care options, support groups, respite care, caring for a dementia patient and end-of-life issues.
As always, we welcome your comments and suggestions on this new section.
Reprinted, with permission, from AGING ARKANSAS newspaper.
Legal Planning a Must
When Alzheimer’s disease or other progressive dementia strikes, the patient and the family must prepare for the inevitable legal and financial changes that lie ahead. A diagnosis of Alzheimer’s disease does not mean that the person is unable to make decisions. Early in the course of the disease, the patient may be capable of participating in legal and financial planning to protect the future management of his or her care and assets.
It is vital that the patient, primary caregiver and other members of the family obtain professional and legal advice without delay. Laws vary from state to state, as do the needs of each patient and family. There is no one plan or approach that is right for everyone.
Planning for the future for a person with dementia or other debilitating illness can be an upsetting process for both the patient and caregiver. A fundamental principle is to allow the patient as much control as possible. The patient should assist in selecting the person (s) who will assume management of legal and financial concerns when he or she is no longer able.
Even after there has been significant impairment, keeping the patient abreast of important decisions will help him know that things are being done according to his plans.
Effective legal planning depends on open communication between family members. A family meeting with the legal advisor or a counselor can make the process easier to manage.
A good starting point is to collect legal and financial documents for both the patient and the caregiver. (See article on next page for a complete list of what you’ll need.)
There are several legal issues that should be considered as soon as the patient is diagnosed. It is important to locate an attorney who either specializes in elder law or is familiar with the related issues and family situation. A local chapter of the Alzheimer’s Association can provide referrals to attorneys who specialize in these areas.
The first step in legal and financial planning for a person with dementia is an agreement as to who will legally act on behalf of the patient. There are several ways to accomplish this: durable power of attorney, durable power of attorney for health care decisions, trust or living trust.
An article below explains each of these arrangements in detail.
Provided by the Alzheimer ’s disease and Related Disorders Association, Inc.
10 Tips for Caregivers
1. Protect your own health If you don’t take care of yourself, you won’t be able to continue to be a caregiver. See your doctor regularly, get screened for stress and depression, get plenty of rest, eat balanced meals, exercise regularly and accept help from others. You are important.
2. Talk with others - Join a support group. It’s a great time to talk with others who are caregivers, to share problems, solutions and concerns. Have a close friend you can talk to.
3. Get some training - Attend a caregiver training class. You’ll learn the proper methods of hands-on care and about other issues related to effective caregiving. Contact the Area Agency on Aging (AAA) nearest you for information about workshops and training events.
4. Be flexible - If your job and caregiving responsibilities conflict, talk to your supervisor about flextime or other ways to rearrange your schedule to allow time for caregiving. Try to let go of some activities or duties.
5. Become informed - Talk to a professional health care worker about your loved one’s illness or disease. Search your library or the Internet for in-depth information. Your local library has computers available to the public for accessing the Internet. Find out all you can about your loved one’s illness or chronic condition. Knowledge will empower you to be a better caregiver.
6. Take a break - Use respite care services. These services will allow you to take regular breaks, conduct business and provide time for yourself. Contact your AAA for respite services. Ask for and accept help from friends or neighbors who can stay with your patient. Even an hour to yourself can make a great difference in your ability to be effective and to continue to provide care. You need a break more than you realize.
7. Call your Area Agency on Aging - Learn about In-Home Care options for help at home. Typical services include personal care, homemaker, meals on wheels, transportation, emergency response system and hospice. Many caregivers hire their own workers privately or pay an agency directly to provide the care. Your loved one can receive help with bathing, dressing, feeding, toileting and light housekeeping. The AAA can evaluate your older relative’s situation, determine the level of care needed and help arrange for services. Find out if your family member is eligible for any of the wide variety of services offered by the AAA. Many of these services are available on a fee schedule based on income. Establish a contact at your local AAA today. Toll-free numbers are on pages 22 to 25.
8. Learn about Out of Home Options Adult day care services, assisted living facilities, residential care facilities, retirement Housing and nursing home care are all options for care. Your local AAA can explain these options to you.
9. Become aware of hazards - Make your home safe for your loved one. Be aware of fire hazards such as stoves, other appliances, matches, lighters and cigarettes. Watch out for loose rugs, cluttered pathways and inadequate lighting. Adjust the water heater temperature setting to prevent burns. Install bathroom grab bars and non-skid rugs. These are just a few safe home suggestions. Call your local AAA for more information on how to safety-proof your home.
10. Wondering where to start? Evaluate in writing both your short-term and long-term needs as a caregiver. Start by listing those things you might need help with now and in the future. For example, a short-term need might be to move your mother’s bed downstairs. A long-term need might be transportation to get your mother to the doctor once a month.
Next make a list of all the informal supports (family members, friends and neighbors) and how each person can help. Repeat this process for formal supports such as home care agencies and transportation services. It is important to set a time frame for any action that needs to be taken. Having a plan for both formal and informal supports and implementing that plan will greatly reduce your stress as a caregiver.
Provided by the Arkansas Association of Area Agencies on Aging
Facing the Financial Challenges of Caregiving
Any number of situations can leave you responsible for unexpected dependents such as caring for aging parents or becoming a parent to your grandchildren.
While unexpected caregiving presents some unique challenges, especially for people nearing retirement, it can also be rewarding. Consider these steps if you find yourself with new caregiving responsibilities.
Update your financial goals. No one has to tell you that your financial situation has changed when you assume caregiving responsibilities or add new dependents. A financial advisor can be a valuable resource as you plan you strategies for a new set of financial goals.
Consider different investments for various goals. Your new financial goals probably have different time frames and cash flow requirements. Investing money in separate accounts for each objective will help you select suitable investments.
Maintain control of debt. Saying you’ll eliminate debt from your life may not be a realistic goal. It may be more achievable to steer clear of new debt---especially long-term obligations. The larger house that may provide a little more breathing room may offer less comfort than staying put and paying down a smaller mortgage. Consider what your family really needs rather than desires when making major purchasing decisions that require substantial financial commitments.
Review options for parent care. Keep an open line of communication with parents who may increasingly need your help. While you may assume that caring for them in your home is the best option, they may have other ideas. Re-assess your situation frequently and involve your siblings in decisions you make on your parents’ behalf. They involvement can help you work toward mutually-desired goals.
Look into financial aid for college early. If you find yourself with a second family, you may find they are eligible for financial aid that wasn’t there for your first set of college-bound youngsters. Contact prospective colleges to learn what forms of assistance are available and how to apply for them. Estimating the aid you’ll receive will help you plan for you share of the costs.
Don’t forget about yourself. While caregiving is a selfless act, an important responsibility remains looking after yourself-both emotionally and financially. For helpful information, visit the National Parent Information Network’s web site at www.ericps.ed.uiuc.edu/npin. For grandparents raising grandchildren support groups see the AARP web site at www.aarp.org/confacts/health/grandsujpport.html.
If you’re still working, make sure your retirement plan remains a high priority among your financial objectives. Your 401(k) or other company-sponsored plan is possibly the best way to accumulate tax-deferred savings and obtain an immediate tax break (pre-tax contributions reduce your taxable income).
Despite the challenges, many people caring for an aging adult or raising a second family report feeling a greater purpose for their lives. As your new lifestyle evolves don’t forget that a sense of humor and a solid financial plan for the future may be the two things you can’t afford to be without.
American Express Financial Advisors
Other Resources for Caregivers
AARP - www.aarp.org
Alzheimer’s Association - www.alz.org
Family Caregiver Alliance - www.caregiver.org
National Alliance For Caregiving - www.caregiving.org
Home Care Companion - www.homecarecompanion.com
The Arkansas Bar Association Lawyer Referral Service - 375-4605 (Little Rock) or toll-free 800-482-9406
Have a Records Scavenger Hunt
By Edward Schulte
Ever been on a scavenger hunt, where you go from place to place looking for a variety of items? There is a list of information you need to collect in order to get financial assistance, proper healthcare and to help your family and caregivers arrange for your care more easily, quickly and affordably. It’s helpful, beneficial and a practical search that can make a measurable difference in the life you live, particularly during your retirement years.
Start your scavenger hunt today. Maybe you know where most of your healthcare and financial records are. But check this list and see if you have everything. Get a notebook and start making notes. Label everything clearly so it will be easy for family members to use, should the need develop. If you are gathering information for two persons, make a column for each person. Write the following headings on the left side of your paper and start filling in the blanks. If this is your first “hunt,” it may take several months to establish all this information. Be persistent.
Personal Information
1. name, middle name, maiden name, nickname
2. phone(s), cell phone, beeper, fax, e-mail
3. Social Security number
4. Medicare number
5. Medicaid number
6. military ID number
7. driver’s license number
Contacts and Support System (names, addresses and phone numbers)
1. family
2. neighbors and friends
3. clergy
Healthcare Information and Support (names, addresses and phone numbers)
1. primary doctor
2. specialists
3. pharmacist
4. medications (name, reason for use, side effects and reactions)
5. dentist
6. optometrist, ophthalmologist
7. audiologist
8. hospitals and out-patient clinics
9. in-home caregivers
10. social service agency contacts or case managers
Important Documents and Records
1. checking and saving account(s)
2. stocks and bonds, other investments
3. mortgage obligations and deeds
4. trusts
5. real estate (residential and commercial)
6. tax returns for the last five years
7. business information and partnerships
8. pension information
9. description of employee benefits
10. lists of art, antiques, jewelry, collectibles
11. personal household inventory
Insurance Information
1. homeowner’s insurance
2. car insurance
3. renter’s insurance
4. health insurance
5. life insurance
Bills, Loans and Liabilities
1. utilities (gas, electric, phone, cable)
2. medical expenses
3. taxes
4. loans (home, car, boat, personal, business)
5. credit cards
6. obligations and pledges (personal, charity)
Directives
1. Advance Directives
2. Living Will
3. Powers of Attorney (healthcare, financial)
4. Will
5. funeral and burial plan
Personal Records
1. birth certificate
2. marriage certificate
3. divorce decree
4. contracts
5. real estate
If you can come up with most of the items on this list and have assembled your information in a file or notebook, you are well-prepared for the paperwork requirements of everyday life. You have just made life easier for you and for anyone who wants to help you.
Mr. Schulte writes for the Kansas Senior Press Service
Legal Terms Explained
By Raymon B. Harvey, JD
Q. What is a Power of Attorney?
A. A Power of Attorney is a legal document. In it you (the principal) give someone else (the agent) the authority to act for you. The authority you give can be as broad as narrow as you want. It usually deals with financial or medical decisions. Since you give this authority, you can also take it away.
You must be competent in order to sign the document. That is, you must understand that you are giving someone else the authority to act for you, who that person is and the extent of the authority.
Q. What is a Durable Power of Attorney?
A. A normal Power of Attorney stops if you become incompetent. If you want someone to be able to help you if you become unable to make decisions (incompetent) about your personal finances or your health, a normal Power of Attorney will not help. The Power of Attorney must be “durable” in order to do this. The word durable means that you want the authority to continue should you become incompetent. In either case, the authority stops at your death.
Q> Who can be my agent?
A. Anyone 18 or older, who is competent, can be your agent. Another term for agent is “attorney in fact.” You should choose someone who is trustworthy and reliable. Do not choose someone who is irresponsible or has a history of money problems.
Q. If I am an agent, what can I do?
A. You can be given the authority to do almost anything. However, you are limited to what the Power of Attorney or Durable Power of Attorney specifies. There are some actions you cannot do, such as vote or execute a will for the person.
Q. I only want someone to be my agent if I become incompetent, can I do this?
A. Yes, generally your Durable Power of Attorney would start when you signed it. You can delay this by state that your agent’s authority is effective if you become incompetent. This is called “springing” powers because they spring into action when a specific event occurs.
Q. What is the difference between an agent under a Power of Attorney and an executor?
A. An executor is someone who takes care of your estate after your death and is appointed in a probate proceeding. Your Power of Attorney agent can only act while you are alive.
Q. Who needs a Will?
A. A Will or Last Will and Testament is a document that addresses the distribution of your property after your death. In order for a Will to be legal, it must be properly drafted and executed. Many people avoid making a Will because they think one is only needed by people with a large estate. This is not true. Anyone who owns any “real property” (house or land) or any personal property (bank accounts, furniture, jewelry, car) has an estate. In all these cases a Will should be made. In a marriage, spouses each need a separate Will. A lawyer who does estate planning can advise you of your options.
Q. If I have a Durable Power of Attorney, can my agent make health care decisions?
A. Only if the document permits it. Sometimes a Durable Power of Attorney that covers health care is called a Health Care Power of Attorney or Durable Power of Attorney for Health Care. It allows your agent to make health care decisions if you are unable to do so.
Q. What is a Living Will?
A. A Living Will is a statement about the kind of medical care a person would or would not want if they were in a terminal condition and unable to speak for themselves. There are standard forms available from hospitals or nursing homes. You can also create your own statement regarding end-of-life care. Regardless of the form you choose, the living will must be a written document. It must be signed and dated by you and witnessed by two persons who are not related to you or responsible for your medical care.
Q. Is a Living Will the same as a Durable Power of Attorney of Health Care?
A. A Durable Power of Attorney for Health Care allows someone to make medical decisions that is generally broader and usually includes decisions as to the type of treatment. A Living Will, however, is a “death with dignity” document. It reflects your wishes as to the termination of medical procedures if you are terminally ill or permanently unconscious and incompetent.
Q. What is a trust?
A. A trust transfers money or property from one person to another, with certain conditions attached. A trust is managed by a third person and it continues in effect until its conditions have been met. Trusts are especially helpful for those with considerable assets. They are fairly expensive to set up and manage.
Q. When is a conservatorship needed?
A. The financial tools described above assume you are competent and can give consent to the arrangement. If a family member is incompetent, the family can petition the court to name a conservator to manage the assets. Other family members are notified and have the right to support or object to the petition. The court hears medical testimony before making a decision. Conservators are monitored by the court, which makes sure the assets are managed in the individual’s best interests.
Mr. Harvey is an elder law attorney practicing in Little Rock.
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