Know Your Parents’ Wishes for Aging Before a Medical Crisis Hits
Many adult children in the US live far away from their parents. Managing aging parents or in-law medical events can be a serious challenge without proper preparation and understanding of what your parents' wishes may or may not be, no matter where you live. Do you know what legal documentation your parents have in place regarding their medical care? Do they have advance directives that can help guide your medical decision-making process? Do you and your spouse openly discuss the situations of each other's parents?
Medical advancements increase the longevity for aging Americans, even those 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 regarding their aging parents’ potential medical crisis. It is advisable to organize and prepare for the health changes that inevitably come as your parents age.
More than ever, seniors are choosing to live independently and with autonomy regarding their life decisions. Even if your parents are in a well-run continuing care retirement community, there will come a day when their health will force a change in their lifestyle and living arrangements. Many parents will resist "help," which they may view to be “interference.” Whether they believe they are being a burden to you or they decline a geriatric care manager's services 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 for an honest discussion. If this is not possible due to COVID-19 restrictions, then virtual meetings are best, followed by phone calls.
Review what 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. The main health care related documents that should be kept current are the health care power of attorney, HIPAA and an advance directive/living will. If these documents have not been reviewed in at least 10 years, it is recommended that you call our office to set up a free consultation.
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 they take. Post-hospital fog and newly prescribed medications from an adverse health event can create confusion in an older parent. Ask about the parameters for health care intervention, such as dialysis and post-hospital during the time of COVID-19.
Explain to your parents that being released from a hospital for a non-life-threatening, yet serious health episode is usually followed by the need for a care manager, at-home nursing care, or companion care. This additional care should not fall to a spouse if the parents live together. A spouse has their own 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 own well-being.
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 in a retirement community. Wherever it is your parents live, their first desire will likely 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 parent needs in their home setting will go a long way towards 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 on your parent.
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 one in charge? Is this designation formally documented? Managing sibling relationships is key to avoiding family conflict. Also, understand your parents' financial arrangements. It is likely that your 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. If you’d like to discuss ways we can help, please don’t hesitate to reach out.
To discuss your estate planning and long-term care Medicaid planning options, call (402) 614-6400 today to schedule your free consultation with one of our experienced attorneys. Visit our website at www.ElderLawOmaha.com.