This article was published
in the December 16, 2015, edition of
Life care planning is a unique method of elder
law where attorneys work together with other professionals, perhaps
a nurse or a social worker, to help our clients find, get and pay
for the care that they need. So while the attorney is focusing on
the legal documents and maybe reviewing contracts and applying for
benefits, the elder care coordinator is helping the senior and their
families find the care that they need and oversee that care
provider, not to supervise them, but to coordinate that care to make
sure that everything fits together for that person to get the care
that they need.
While it is never too early to plan
for the future, certain external events should definitely serve as
triggers to move Life Care Planning higher on our to-do list.
Basic Planning Documents
While every adult should have designated who can
make medical and financial decisions on their behalf when they are
not able to do so, fewer than half of us have valid
Attorney and Health Care Directives in place. Family gatherings over
the holidays provide the perfect opportunity to raise this subject.
If adult children are not comfortable asking their parents whether
they have these documents in place, the children can start the
conversation by talking about how they are in the process of
identifying the people they will be naming as agents in their own
If you know that your parents have prepared
these documents, it is a good idea to suggest that they take a look
at them again to make sure they would still accomplish their
original objectives. For example, are all of the agents named in the
documents still living, healthy and willing to serve? If your
parents’ wishes regarding end-of-life care have changed, does the
healthcare agent know what they would want? You can assure your
parents or other family members that they don’t need to answer these
questions to you, as long as they are thinking about them and making
the necessary changes as a result.
Seeing loved ones over the holidays whom we have
not seen in a while provides a good opportunity to assess their
capacity. While a person who seems a little more forgetful, or has
received a diagnosis of Mild Cognitive Impairment, is not
immediately incapable of expressing an informed opinion about their
own care, it is a warning sign that they and their family should put
plans in place to provide the care that the person will likely need
as the disease progresses.
Long Term Care
The realization that a loved one requires
Long Term Care, either because
of a catastrophic event such as a fall or a stroke or the
progressive decline resulting from a condition like Alzheimer’s
disease, is the situation that most often causes a family to begin
Life Care Planning.
If we know the person is no longer safe at home,
we may consider whether assistance with dangerous activities, such
as showering and driving, and assuring that the person takes their
medications and receives proper nutrition will be enough, or whether
that person needs to move to an environment that provides more
It is not possible to think about the necessary
level of care without also considering how to pay for it. Does the
person have a Long Term Care insurance policy, against which it is
now time to make a claim? Do they have their own assets, which
restructured to maximize cash-flow and liquidity? Might they be
eligible for Veterans’ Benefits that can offset some of the cost of
care? And if the family needs to consider
Medicaid, now or in the future, what is the impact of other
financial decisions that we might make?
While all of these discussions can be difficult,
we know that the sooner the plans are put into place, the greater
the variety of options are available to help our parents find, get
and pay for the care that best meets their needs.
Goodman focuses her practice on Life Care Planning for seniors
and their families. She has been recognized as a Certified
Elder Law Attorney by the
National Elder Law Foundation.
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