Planning Before the Crisis
Who Should Be Planning and When?
Everyone over the age of 18 should have a plan. Planning should include the entire family and any support persons. These decisions are difficult, take time, and can change over time depending upon your age, medical conditions, marital status, etc.
Frequent discussions help; they may initially take place when it seems obvious (for example, at 18, after a wedding, or following the death of someone close).
The day after tax day (April 16th) is Advanced Care Planning Day so this may be a good reminder. It's also good to review your plan at every decade, as this provides a good time to reassess.
What Do You Need?
In general, people need three documents:
a Durable Power of Attorney for Health Care that includes a Living Will, also know as Advanced Directives,
a Durable Power of Attorney for Finances, and
a Will
The Powers of Attorney designate an attorney in fact who will make health care and financial decisions for you if you are unable to do so for yourself. The Living Will indicates the measures you would like taken to keep you alive. A Will designates your beneficiares for your money and property.
Who Should you Choose?
The people you choose as your attorneys in fact need to be aware of what the role entails and be willing to commit to that role, and the time it will take. Consider the most appropriate person. The person needs to be able to carry out your wishes even if they would not choose the same, especially with regards to the Advanced Directive.
With regards to the Durable Power of Attorney for Finances, this person needs to be a good steward of the money available. Ultimately, the person needs to have the time as this is a role that can take a lot of time - especially with regards to finances.
Location may also play a role in who you choose; while a lot can be handled from a distance, there will be times when the person needs to be with you. Keep in mind, the most appropriate person may not be the obvious person. If family members or good friends are unavailable, elder law attorneys may take on this responsibility.
It's generally suggested that you choose one primary person for each attorney in fact. They may be the same person for each, it depends on what works for you. It's not generally considered good practice to choose Co-attorneys in fact as this means that decisions have to be unanimous between them. This is where on-going conversations will make it easier for groups to work together when the time comes.
How to Have the Conversation
Pick a time when everyone is at their best. It's helpful to plan these conversations in advance in order to reflect and prepare ahead of time. These conversations are difficult but necessary. Some people find it useful to use a tool or guideline: the "Go Wish Game" and "The Conversation Project" both have tools to start the reflections and the conversation.
When having the conversation, be sensitive, respectful, and honest. Keep in mind that these are not an easy conversation for anyone.
Who should I share these documents with?
Once you've chosen your attorneys in fact, and the documents have been created, each attorney in fact should have a copy and know how to access the original. Provide copies to any secondary attorneys in fact and consider family members.
Your physician(s) should have a copy of your Durable Power of Attorney for Health Care. Your banks and financial institutions should have a copy of your Durable Power of Attorney for Finances. These institutions may also have their own form they need to fill out.
If either Power of Attorney changes, ensure that those who were provided copies initially have the most up-to-date versions and void the others.
What Information Should I Pull Together and How?
Organize important documentation, information, and passwords for your attorneyes in fact to have access to when necessary. The location of this information should be clearly identified and updated as necessary. Organizing this information can be done by creating a document on your computer and saving it on a flash drive. It is also best to save a hard copy in a locked safe that you and your attorneys in fact can access, when necessary.
Examples of important information include:
Health Documents: Power of attorney for health care, living will, EMS Care and Comfort Order*, copies of health insurance coards, list of current diagnoses and medications, list of physicians, and pharmacy of use.
Financial Documents: Power of attorney for finances, long term care insurance policy, investment paperwork, banking information, information on regular bills.
End of Life Documents: Last will and testament, trusts, prepaid burial information, list of your personal wishes for your executor and attorneys in fact to adhere to for end of life and following death.
*Each jurisdiction has their own "Comfort Care" type order that designates wishes at the end of life. Seach for it online or with the government social service organizations working with older adults.
Organizing important information may require the following:
Give a copy of your house key to a few trusted individuals and make sure they all know how to reach one another OR check with the building manager at your apartment or condo building to identify who you allow to have access to your apartment in the event of a hospitalization or other emergency.
create online banks accounts that allow your attorney in fact for finances to access and pay your bills online.
Check with your bank regarding what paperwork is required for the bank to recognize your power of attorney for finances and complete the paperwork accordingly.
Explore options of direct deposit for Social Security, pensions, etc so regular incomes continues in the event of an emergency.
Create online accoutns with the various compnaies that require regular billing (i.e., telephone, cable, insurance, etc) so your attorney in fact for finances can maintain daily money management in the event of an emergency.
Check with the providers mentioned in teh bullet above for their requirements for authorizing an exchange of information between the provider and your attorney in fact.
How a Care Manager May Help
A Care Manager may assist you in discerning who to consider for your attorney(s) in fact and how to set that up. care Managers can help you facilitate conversations among your family or support system. A Care Manager can assist you in gathering and obtaining the documents needed. Care Managers are often considered part of the plan, to assist in carrying out the wishes of the individual and provide support to the attorney(s) in fact.
This information is provided to you by Seabury Resources for Aging's Care Management Program. To learn more or speak with a Care Manager, call 202-364-0020 or email CMinfo@seaburyresources.org.
