Your living will does not serve as a last will and testament for the distribution…
The US has a large number of adult children who live far from their parents. No matter where you live, managing your aging parent’s or in-law’s medical events can be a challenge without proper preparation and an understanding of what your parents’ strategy may or may not be. Are you aware of what legal documents your parents have in place regarding their health care? Are there advance directives that you can use to make medical decisions? Do you and your spouse openly discuss the circumstances of each other’s parents?
Medical advancements facilitate aging Americans’ longevity even with comorbidities such as high blood pressure, diabetes, kidney disease, atrial fibrillation, and other health issues. Hospitals can typically fix non-life-threatening conditions easily enough, but what happens when a parent is released to return home? Are you prepared? Is there a plan? Many adult children tend to practice avoidance, denial, and wishful thinking when thinking about their aging parents’ behalf in a potential medical crisis. It is advisable to organize and prepare for the changes that inevitably come to your parents’ health.
More than ever, seniors are choosing to live independently and with autonomy about their life decisions. Even if your parents are in a well-run continuing care retirement community, there will come a day when their health forces a change in their lifestyle and living arrangements. Many parents will resist “help,” which they may consider more as interference. Whether they believe they are being a burden to you or decline a geriatric care manager’s service due to “cost” concerns, most older people do not want others interfering in their private affairs.
The goal is to find a way to help while still affording your parents the dignity and respect they want and deserve. To achieve a comprehensive plan on your parents’ behalf, travel to them in an honest discussion. If this is not possible due to COVID-19 restrictions, then virtual meetings are best, followed by phone calls as hearing loss typically makes communicating useful information difficult. Even with a screen, a face-to-face connection allows a parent to read lips, which is a typical strategy for older people experiencing hearing loss.
Review what the legal paperwork your parents have and make sure it is in order. Many documents have a signature from many years ago, and things may have changed. If there is no designation of a medical power of attorney, be sure there is a document naming a “personal representative” to address restrictions outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This document allows the waiving of privacy concerns that permit access to a parent’s medical information while the parent is in the hospital.
Create an up-to-date list of all your parents’ doctors. The list should include medical contact information and all medicines (prescription or otherwise) that the parents take. If their general physician is not a geriatric specialist, it will help to find them one. Post-hospital fog and newly prescribed medications from an adverse health event can create confusion in an older parent. A geriatric doctor will know how to look for and resolve these types of issues. Ask about the parameters for healthcare intervention, such as dialysis, post-hospital during the time of COVID-19?
Explain to your parents that being released from a hospital for a non-life-threatening, yet the serious health episode is usually followed by the need for a care manager, at-home nursing care, or at least companion care. This additional care should not fall to a spouse if the parents live together. A spouse has their unique role to fill as well as personal health challenges with which to contend. Heaping an increased responsibility for spousal health care upon them may be damaging to their health.
Before an unforeseen medical crisis can occur, identify several qualified agencies in your parents’ hometown. Review each agency and candidate carefully. It is easier to integrate a suitable candidate at the outset than having the chaos of retaining and releasing multiple workers. Remember that a candidate who works for one parent may not be another parent’s preference in the future. Maintain a strong relationship with the agency provider. They are an essential resource, and you will probably need them in the future.
Take the time to learn the specifics of your parents’ healthcare and living arrangements. Coordinating your plan of response is contingent upon whether your parents live independently, in assisted living, or a retirement community. Wherever it is your parents’ live, their first desire will be to go home after an unexpected hospitalization. The desire to return home is a universal truth. Knowing the agencies that can quickly provide the type of care your parents need in their home setting will go a long way to a successful transition. The road to recovery may require a few weeks of nurse visits, physical or occupational therapists, or simply companionship. The faster you can meet the need, the easier it will be for your parents.
If a full recovery is not possible, what will be your plan to address the new status of their normal? How much more medical oversight and assistance will they require? Know that in these instances, a parent can quickly spend through Medicare allotments afforded for temporary care. If they do not have long-term care, and many aging Americans do not, you will have to find ways to help them receive the care that they require.
If there are multiple adult children, is there an expectation that all siblings share information and work on the problems at hand, or is the one in charge? Is this designation formally documented? Managing sibling relationships is key to avoiding family conflict. Also, understand your parents’ financial arrangements. Most parents will ask about the cost of any new healthcare service being arranged and decline using it. It is hard for a parent to spend down the money they worked their entire life to amass.
Knowing your parents’ aging strategies will not address every issue you might encounter because they may not have all the necessary decisions and documents in order. You can only work within the authority they choose to provide. As attorneys, we can help identify gaps in their planning and recommend ways to fill those gaps so everyone can have peace of mind. We hope you enjoyed this article. If you would like to discuss a personal legal matter, we would be happy to talk. Please contact our Canton office at 330-588-6115.