Thursday, 30 May 2019 13:35

What Legal Paperwork Do I Need to be a Caregiver?

When it comes to a loved one's healthcare, the law is very strict about who can receive status updates, participate in conversations with medical professionals and make medical decisions. Of course, these policies are meant to protect our sensitive information, but they can also cause problems for family caregivers. Just because you are family doesn't always give you the right to "be in the know".

So what does a caregiver need to be able to have the ability to make decisions on their loved one's behalf if need be? Well, first of all, the best thing to do would be to get the permissions established BEFORE they're needed in order for them to be the most effective. Unfortunately, many families don't realize that any special paperwork is required for them to take over their loved one's care. Being unprepared can be stressful for everyone involved...  Charlie Brown

 Without the necessary paperwork, you might be unable to access medical information or unable to direct your loved one's care if they cannot make their own decisions. In a worst-case scenario, you would have to go to court and petition for guardianship to obtain the legal power to direct your loved one's care. It can be time-consuming and expensive!

So, you will need a Power of Attorney. Also known as medical power of attorney, a POA, or a health care proxy document. Possibly a separate financial POA also. (This just simplifies things with medical vs financial) This is a legal document that enables a person to appoint a trusted relative or friend to handle specific healthcare decisions on their behalf. A POA document grants access as well as the ability to make medical decisions for their loved one. It is crucial because it gives a trusted person the power to manage their loved one's healthcare in the event they become incapacitated. There is a catch, though. This document must be prepared while a person is still mentally competent to grant an agent these powers.

It is important for the person to trust that their POA understands their healthcare and financial goals and will act in their best interest. Then, this is where the next legal document comes in.

An Advance Health Care Directive. This is commonly referred to as a living will. An advance health care directive lets people record their wishes for end-of-life care before a medical crisis strikes. With a living will, a person's loved ones don't have to agonize over difficult medical decisions. This essentially spells out instructions for a POA to follow when making end-of-life care decisions. A living will may indicate specific treatments a person does or does not want to be performed under certain circumstances. This document should specify whether resuscitation should be attempted if breathing stops, whether artificial life support should be used and whether a feeding tube should be inserted. Also, Dialysis if their kidneys no longer work, organ and tissue donations for transplantation, donating their body for scientific study, and comfort care or palliative care.

A POLST, or Physician's Order for Life-Sustaining Treatment, is a doctor's order that is different from a living will, and focuses on immediate treatments. It means EMT's and hospitals must do what the POLST specifies. It is recommended for terminally ill or very frail seniors who have made their end-of-life wishes clear. Because a living will isn't a medical order, it can't tell EMT's and hospitals what to do. Even if resuscitation or other end-of-life choices are specified, they can't be honored during an emergency. Standard emergency medical protocols must be followed unless a doctor's orders say otherwise. Living wills are more useful in non-emergency situations like when someone is in a hospital or skilled nursing facility. A living will and POLST work together and should be kept together and handy.

A DNR or Do Not Resuscitate order is a signed medical order written by a doctor. It tells health care providers and EMT's NOT to do CPR on your loved one if they stop breathing or if their heart stops beating. The DNR is ONLY a decision about CPR (cardiopulmonary resuscitation) It does not affect any other treatments such as pain medicine, other medicines, or nutrition. There are two types of DNR's - a pre-hospital DNR and a hospital DNR. Make sure if your loved one is in-home care or assisted living care, that you have a pre-hospital DNR on hand. A DNR can only be honored if people know it exists, so it should be kept handy with the living will and POLST information.

Once a healthcare emergency strikes, it is usually too late to prepare these documents. To avoid unnecessary stress and confusion, talk to your family members about getting their affairs in order. It is important for all adults to discuss their personal wishes with loved ones while they are still healthy.

An elder law attorney can discuss individual questions and concerns, prepare these legal documents, and provide advice on additional legal planning tools that may be useful for your family's circumstances.

A living will make sure that your loved one's wishes will be honored and puts their minds at ease. Having these conversations and thinking through important decisions before a crisis prevents additional stress, guilt, and conflict during already difficult times.


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