Editor’s note: November is National Caregiving Month, so we are bringing you a series of articles, one each Monday, that focuses on helping advisors guide their clients on issues relating to caregiving for parents and other loved ones. Client versions of these articles will be included in Horsesmouth’s Savvy Caregiving program&v=1y4mthkf2su32yfynnoumzqs.
Life happens. As much as we like to plan and prepare and research all the alternatives, sometimes that is just not possible. Ideally, everyone has in place a caregiving plan for aging loved ones, covering all medical, financial, legal, and personal issues. But for many families, this is not the case. Sometimes a caregiving crisis occurs before they are ready. Share with your clients these practical, immediate first steps they can take in this situation.
1. Set up good communications
The primary concern, of course, is that the loved one is receiving adequate medical care. If the caregiving crisis has arisen unexpectedly, this likely means that the care recipient is in the hospital. It is vital to set up good communication between the family’s primary caregiver, the medical professionals, and the rest of the caregiving team.
The default primary caregiver will likely be living near to the loved one. He or she needs to be active in communicating face-to-face with doctors, nurses, and other staff at the hospital. Ask the following questions, adapted from “Returning Home Guide” from HomeInstead, a home health care provider.
- What is the patient’s current condition? What are short- and long-term prognoses?
- What are future warning signs that my loved one will need help?
- What condition will the senior likely be in when released?
- What type of equipment and care will my loved one need at home?
The primary caregiver also needs to communicate to the rest of the caregiving team. Even if an official “team” is not yet in place, it is essential to include the entire family and others who provide emotional support in this challenging time. No one can handle the stress alone.
2. Prepare to receive the loved one after hospital discharge
Social workers and case managers are invaluable during this time. They are professionals who provide counseling, guidance, and assistance to both the senior and caregiver. If there aren’t any on staff at your hospital, contact your local Eldercare Agency to find help.
You can ask these helpers many questions that you might not feel comfortable taking up a doctor’s time with—for example, non-medical concerns.
- What will my loved one’s insurance cover?
- Where do I go to find the right resources?
- What are my options for care after hospitalization?
The first 30 days after a senior is discharged are the most dangerous for relapse. Make sure that a support system is in place to help them recuperate. The level of support depends on the senior’s condition. Types of assistance include home health care, home non-medical care, or temporary stays in nursing homes. If the loved one is returning to his or her own home, make sure that it is a “safe home” and well-stocked with food and personal necessities. For more information, see “Returning Home Guide.”
3. Ensure Power of Attorney and Health Care Agent Are in Place
Once the immediate danger is past, it’s time to start looking to the future. A Power of Attorney (POA) is a legal document in which the care recipient gives a chosen representative the right to make decisions in the event of legal incapacity—or, when the care recipient can’t make decisions on his or her own. There are various types of POAs, which can last indefinitely or be restricted to a limited time frame, cover all responsibilities or only predetermined tasks, take effect immediately or only when set qualifications of incapacity are met. Seek out an attorney for this step.
A Health Care Agent is similar to a POA, but particularly for health care decisions. An Agent acts as a proxy for incapacitated persons in the event that they are unable to make decisions on their own. Therefore, the Agent needs to be someone who knows the care recipient well and understands his or her values and quality of life preferences.
4. Plan for long-term care financially and practically
It may not be possible to continue the arrangements made immediately after a loved one’s hospital discharge for the long-term. That means it is time for the entire caregiving team, including the care recipient, to sit down and discuss the future. There still needs to be a primary caregiver, but this may not continue to be the default person living near the senior at the time of hospitalization. Consider the following issues, among others:
- Where does the care recipient want to live?
- How many activities of daily living does he or she need help with?
- What is your budget? (Medicare does not cover long-term care. Is there other insurance?)
- Who in your caregiving team is available and willing to be a caregiver? Do you need to hire in-home help?
- What services, medical and non-medical, can you take advantage of?
5. Begin comprehensive overview of finances, legal documents, and personal wishes
Finally, you need to be sure that all elements of a caregiving plan are in place. Enlist the aid of financial advisors, accountants, attorneys, and anyone else you may need to put together a comprehensive plan for your loved one’s remaining years, however many that may be. Check that everything is up to date including a will, trusts, beneficiaries on retirement accounts, medical records, donations, and more.
A caregiving crisis may have taken your clients unaware this time, but it doesn’t need to happen again.