Legal Preparations for Caregiving
The documents and discussions you should complete early — before a crisis hits
It always surprises me how many people do not have health and financial legal documents in place in case of emergency or death. I know it's easy to procrastinate when a task can be so confusing and daunting, especially when you may already be swamped with caregiving duties. But you don't want to find yourself struggling over complicated legal matters when there's a crisis and tensions are high.
When my sister suddenly became gravely ill after cardiac arrest, I thought I had up-to-date, witnessed electronic copies of her legal documents. I discovered that I didn't, and I had to search through her house — incredibly stressful on top of the strains of shock and deep grief. I realized how important it was to be prepared. That's why in my book, AARP's Juggling Life, Work and Caregiving, I included a chapter that describes the important steps.
Below is an excerpt regarding the first step:
Talking with your loved ones about plans and wishes
Discuss these matters early and often — before a crisis occurs. If your loved one hasn't taken the steps outlined here, you'll need to help them do so. Some topics you'll want to address with them:
- What plans and legal documents they already have in place and how to access them
- Who they want to make financial and medical decisions on their behalf
- Whether they would want life-sustaining treatments if they had a terminal condition
- How they would like the end of their lives to be handled
- What their preferences are for funeral, burial and memorial service arrangements
- Whether they want donations in their name in lieu of flowers, and if so, to what organizations
- What they want done with their property after their death
Sometimes, even when approached with sensitivity and respect, loved ones resist discussing such personal matters and plans. Know that you can only do your best to help them. If they refuse to accept assistance or share information but can still make their own decisions, you may not be able to do anything. In that case, be there for whatever help they allow you to provide and choose to act differently in terms of your own long-term planning. Often it helps to bring in an objective third party, such as a counselor, doctor, lawyer or mediator.
Once you've had the talk, make sure key legal documents are in place, including:
Medical legal documents
Advance directives include a variety of legal documents that provide direction for future (in advance of need) health care treatment, including who will be able to make decisions for us if we are unable to do so. Advance directives may include:
- Power of attorney for health care or mental health care: Designates who can make health decisions for us when we are unable
- Living will (also known as health care instructions): Informs physicians, family and others of our wishes for medical treatment if we become incapacitated. I am a fan of the Aging with Dignity 5 Wishes living will approach because it is very user-friendly for those creating their living will.
- DNR (do-not-resuscitate orders): Also known as a "no code," a DNR can be created only by a doctor in consultation with a patient or with a health care agent (power of attorney).
- POLST (physician orders for life-sustaining treatment): These work in tandem with advance directives but are medical orders for specific medical treatments for people who have an illness. Not everyone needs a POLST, and it may be known by different names in various states, including POST (physician orders for scope of treatment), MOLST (medical orders for life-sustaining treatment), COLST (clinician orders for life-sustaining treatment), SMOST (summary of physician orders for scope of treatment) or SAPO (state authorized portable orders); some states have their own programs and state-specific names.
Financial and estate-planning legal documents
- Power of attorney for finances: Designates who can make financial decisions when we are unable.
- Digital power of attorney: Designates who can manage our digital assets (websites and blogs; email accounts; digital photos and videos; social media; e-statements and online access to bank, investment, brokerage accounts or credit cards; and passwords associated with these accounts).
- Wills and living trusts: Outline estate planning.
While it's always a good idea to consult with an attorney in your state who specializes in family law, estate planning or elder care law, there are some documents you can create yourself. See AARP's Advance Directives guide to download your state's advance directives forms.
You'll find more detailed descriptions of these documents — as well as info on how to find a legal professional to help, how to manage others' finances and health care, and much more — in my book, including a special section on tips for challenging family conversations.
Amy Goyer is AARP's family and caregiving expert and author of Juggling Life, Work and Caregiving. Connect with Amy on amygoyer.com, Facebook, Twitter, in AARP's Online Community and in the AARP Facebook Family Caregivers Group.