Who Makes Health Care Decisions If You Can't?
Being able to make health care decisions for ourselves is so important to us, but what happens if you become incapacitated and are unable to voice your opinion? If you don’t have a health care agent or guardian in place, state law chooses who can make those decisions.
In an emergency, medical providers can take measures to keep us alive, but once the emergency has passed, the medical providers will look for someone to make the important medical decisions. If you are unable to make your own health care decisions, either temporarily or permanently, and you have nothing in place to allow someone else to make those decisions for you, then most state laws dictate who has the right to act on your behalf.
The list of surrogates who can make medical decisions for you usually goes in order of priority, starting with your spouse and adult children. Parents, siblings, grandchildren, and close friends may also be surrogates. These may not be the people you want making decisions for you, and not having your wishes spelled out can cause dissension among your family and confusion for medical professionals.
A few states (Massachusetts, Missouri, Nebraska, and New Jersey) do not have laws dictating who can act in an incapacitated person’s place. In those states, your family may have to go to court to get a guardian appointed. Even in states with surrogate laws, family members on the surrogate list may disagree over treatment and end up in court, asking the court to appoint a guardian. Guardianship is a legal relationship between a competent adult (the "guardian") and a person who because of incapacity is no longer able to take care of his or her own affairs (the "ward"). The guardian can be authorized to make legal, financial, and health care decisions for the ward. The guardianship process is expensive, time consuming and very restrictive, so it is almost always a last resort.
The best way to avoid the state choosing who acts for you or the difficulty of guardianship is to have a health care proxy (or health care power of attorney) in place. A medical power of attorney is a document that allows you to appoint someone you trust to act as your agent for medical decisions. By executing a medical power of attorney, you are authorizing your agent to carry out your wishes. Doctors and other medical professionals will defer to the person named in the document to act on your behalf.
Contact us to draw up a medical power of attorney.
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Cumberland Legacy Law
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Long-Term Care: It’s Never Too Early to Plan for You or a Loved One
If you’re in the 25 percent of US citizens reaching retirement age over this next decade, you may have heard that long-term care is about to skyrocket. It’s never too early to start looking at your options and planning for your future. According to the U.S. Department of Health and Human Services, 70 percent of people turning 65 will need some form of long-term care during their lives. Long-term care doesn’t necessarily mean giving up your sense of independence. The key is to research your options and plan for them. Cher-ished Care Senior Care Management presents some advice that can help you during the planning process.
Planning for Long-Term Care
When it comes to long-term care, there are different options ranging from in-home care to nursing homes that include round-the-clock assistance. For those not needing perpetual care, there are also adult day centers, assisted living facilities and continuing care communities. Some include such amenities as golf and social clubs, and their rates differ from state to state.
There are some factors that may help to determine the likelihood that you or your loved one will require long-term care:
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What is your family history? Are there any hereditary illnesses and conditions that could impact you? Did either of your parents have heart disease or dementia?
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Do you have family members who could provide care for you?
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What is your current level of health? Do you have any conditions, such as being overweight or having diabetes, that could lead to future impairments?
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Are you enrolled in Medicare? While it won’t pay for long-term care, enrolling in Medicare or a Medicare Advantage plan is important. If you need to enroll or make changes to existing plans, you can do that between October 15 and December 7.
Consult your doctor regarding what your future may hold health-wise based on your current health, lifestyle, and family health history. This may give you an indicator of the level of care you may need.
Planning for the Costs of Long-Term Care
How close are you to retirement? What are the savings or insurance programs available now to help pay for long-term care? How do you plan on paying for the costs of long-term care? While you may not need long-term care, it is essential that you integrate it into your financial and retirement planning.
If cash is needed to help pay for long-term care, you can consider a reverse mortgage. There are many pros and cons, so be sure to consider carefully before making a decision.
Reverse Mortgage Pros
First, a reverse mortgage gives you access to cash. Since there is no mortgage payment from a reverse mortgage loan, the money borrowed can be used to modify your home and make it more senior friendly. If you have access to cash through your reverse mortgage, you can refrain from tapping other retirement sources of income, such as your 401k, and taking Social Security before receiving your full retirement benefit.
The value of a reverse mortgage loan can increase. If you take out a line of credit from a reverse mortgage loan and don’t draw down on it, the amount of unused money will increase every year. A reverse mortgage line of credit grows at the same rate at which the loan accrues interest.
Reverse Mortgage Cons
On the other hand, fees involved with a reverse mortgage can add up. There’s the loan origination fee, mortgage insurance fee, appraisal fee, title insurance fees, and various other closing costs. This is not paid out of pocket, though; instead, it’s rolled into the loan.
You are required to pay back the loan if you move out of your home permanently. This means if you ever do need to enter a full-time care facility like a nursing home, the loan will become due.
Change is inevitable as you age, but the best plans are the ones you make now when you’re still in the driver’s seat. Whether you stay in your home or require 24-7 assistance, consider all your options and prepare for them financially. Having a financial plan now will not only protect your assets, but will give you and your loved ones priceless peace of mind.
Cher-ished Care Senior Care Management offers a wide range of services for our clients, including transition care, safety checks, community resources, and so much more. Please get in contact with us today calling 931-248-4400.
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How to Make Senior Care Decisions for Your Loved One
When a senior loved one begins experiencing problems navigating daily life, it’s time to start thinking about long-term care. Being proactive is key. If you wait until long-term care becomes an immediate necessity, you will be left scrambling to make difficult decisions all while learning to cope with the emotional upheaval of this major transition.
Now is the time to research your options, broach the subject with your senior loved one, and establish a long-term care plan that everyone feels good about. If you’re not sure where to start, consider working with a care manager from Cher-ished Care Senior Management Services for help finding local services, reviewing your senior living options, and coordinating the transition into assisted living.
Here are some factors to consider as you approach this difficult decision.
Determine Your Budget
Senior care can be expensive, and not everyone has the savings to cover the costs. Thankfully, seniors have access to funding options that ensure care is accessible on any budget.
First, check if your senior loved one has long-term care insurance or a life insurance policy with a long-term care rider. Another funding option is Medicaid, which is only available to seniors with limited income and assets. Since Medicaid eligibility and coverage vary by state, it’s important to research your unique situation. Unfortunately, Medicare will not cover the costs of long-term care. If your loved one is a veteran, look into the United States Department of Veterans Affairs (VA) Aid & Attendance pension benefit which can help cover the costs of assisted living.
Your loved one may also consider selling their home to pay for care. This is a good option in situations where seniors live alone or plan on moving into a care facility together with their spouses. To get started, help your loved one calculate the potential sale proceeds from their home. Just remember to account for real estate agent commissions, closing fees, taxes, and their outstanding mortgage balance.
Establish Your Loved One’s Care Needs
Before you start looking at different care facilities, take some time to assess the needs of your loved one. For example, if they are showing signs of Alzheimer’s, they may benefit from memory care in the future. List out the types of activities your loved one needs help with. Do they require round-the-clock medical care or just occasional assistance with a few household chores? Can they prepare their own meals, or do they need this service provided? Can your loved one drive or will they need access to reliable transportation? Answering questions like these will help you determine the best type of care for your loved one.
Consider Your Senior Living Options
Some of the most common senior living options include independent living, assisted living, nursing home care, memory care, and aging-in-place with the help of home care. Elizz explains that assisted living is typically good for people who need support with basic life tasks like meal preparation, cleaning, bathing, and medication management. Skilled nursing care, on the other hand, provides a much higher level of medical care and is better equipped to handle serious medical needs and cognitive impairments.
Remember Your Personal Limitations
While the majority of seniors want to age in place, this isn’t always possible. Seniors who age-in-place often rely on the support of family caregivers. If you live too far away or your personal life is just too demanding, consider your limitations carefully before taking on this responsibility. Caregiver burnout is very real and can have a lasting impact on your mental health.
Homecare and adult day care services can do a lot to help, but sometimes assisted living is the best option. Try to have an open and honest discussion with your senior loved one about your concerns so you can come to a decision that benefits everyone!
Few things are harder than making long-term care decisions for a senior loved one. As much as possible, try to plan ahead and keep your loved one in the loop. Whether it’s a parent, grandparent, spouse, sibling, or close friend, your loved one is bound to be grateful for your gentle support and understanding during this tough transition.
Are you looking for help with care management, care coordination, or transitional care for your loved one? Cher-ished Care Senior Management Services can help! Contact us at 931-248-4400 today!
Acknowledgement for this article goes to Hal Salazar. See other articles written by Hal Salazar at Elders.today
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The Alzheimer’s Caregiver’s Guide to Home Safety
Caring for a loved one with Alzheimer’s disease requires more than a big heart and spare time. To keep a family member with Alzheimer’s disease safe and comfortable at home, caregivers must make changes. This guide will help you create a home that’s safer for a loved one with Alzheimer’s disease.
As the Alzheimer’s Association explains, Alzheimer’s disease typically progresses in three broad stages. Caregivers can spread out home improvement expenses by making adaptations to accommodate each stage as it comes.
If you live a long distance from your senior loved one, care management and coordination services from Cher-ished Care can help make daily life easier. Call 931-248-4400 to learn more.
Early-Stage Alzheimer’s Disease
People remain largely independent in the early stage of Alzheimer’s disease. However, memory lapses and impaired motor function call for extra safety measures at home. This is the time to update your fire detection system with interconnected alarms and install smart home features that let you turn off the stove and lock doors from a distance. Caregivers should also take steps to reduce fall risk, like reducing clutter, widening pathways, securing cords and area rugs, and adding handrails, lighting, and slip-resistant strips along stairways.
Comfortability should be considered as well. Make sure that your loved one’s HVAC unit is functioning properly, and if cold or hot air is entering the home, you may need to contact window repair professionals. As you search for “home window repair near me,” be sure to review testimonials and reviews from past customers. While the average cost of window repair is $290, this will depend on how many windows you need fixed and the type of repair and window.
Middle-Stage Alzheimer’s Disease
Middle-stage Alzheimer’s disease lasts many years and encompasses a wide range of cognitive, behavioral, and physical changes. Patients become increasingly forgetful and need considerable assistance navigating the tasks of daily living. Maintaining a safe caregiving environment requires a number of changes.
To compensate for accelerating physical impairment, caregivers should install safety measures that include bathroom grab bars, a walk-in shower with shower seat, and an accessible ramp to the home’s main entrance. ADA-prescribed measurements provide a helpful basis for installing grab bars, ramps, and other safety features. Carefully measuring installations reduces the need for changes if the Alzheimer’s patient requires a wheelchair in the future.
This is also the time to prevent access to stairwells completely. Aim to create a home that permits single-story living. If necessary, rearrange so the Alzheimer’s patient’s bedroom and bathroom are on the main floor. That may require repurposing a communal space into a private bedroom, but it’s a small price to pay for keeping a loved one safe.
Caregivers can accommodate changes in visual perception by using color as a tool. Painting light switch plates so they contrast the surrounding wall, installing a toilet seat in a contrasting hue, and using slip covers to make light-colored furniture easy to find in a room are easy changes that make a big difference.
The middle stage of Alzheimer’s disease is also when troublesome behaviors like wandering and rummaging tend to manifest. Installing child locks on cabinets and closets is an easy fix for rummaging, while a home security system that includes door sensors is your best bet for preventing unsupervised exits.
Late-Stage Alzheimer’s Disease
In the late stage of Alzheimer’s disease, patients require 24/7 support from a caregiver. They have difficulty eating and walking, and they eventually lose mobility completely. This stage is often when families make the difficult decision to move their loved one into a care facility. For caregivers who choose to keep their loved one at home through the late stage, the focus shifts from safety to comfort. Caregivers can play music from their loved one’s past, offer comforting touches, and design a soothing environment with calming colors and noises. The National Institute on Aging offers practical advice for comfort and health during the late stages.
Sometimes, safe Alzheimer’s care at home isn’t possible. If your loved one’s needs surpass your ability to provide care, it’s not a reflection of your abilities as a caregiver. Alzheimer’s disease is a complex and challenging condition, and assuming the role of caregiver places immense financial and emotional strain on families. If you’re struggling to manage the demands of Alzheimer’s disease caregiving, reach out to a care facility to see how they can help.