LONG-TERM CARE “CONVERSATION CHECKLIST” FOR FAMILIES AND SENIORS

Having a conversation about long-term care with an aging loved one can be difficult. Initiating a conversation can be awkward or uncomfortable for family members or care-givers. Although it is impossible to know what the future will bring, ROB GOLDMAN LEGAL SOLUTIONS, your local Elder Law Firm, offers the following hints and checklist that may help to begin a conversation about housing options with your loved one.

1. Determine if it’s time to think about long term care facilities.
Reasons to seek long-term care vary from person to person. In addition to potentially offering a more comfortable and safer environment for the aging loved one, long-term care may be necessary for the mental and physical health of the caregiver.

To ensure your loved one is able to contribute to his/her future, introduce alternate housing options as early as possible, even before it becomes necessary. Ask your loved one questions about lifestyle or health-related challenges.

2. Understand this usually this is an evolutionary process.
To minimize resistance and facilitate recognition of the need for increased care, continue the conversation over time by sharing your observations and concerns, including any of the following physical and mental symptoms:

Physical Symptoms:

• Are they able to move around easily given the physical layout of the home? For example, are stairs, carpet, bath/shower or door handles obstacles for mobility? Is the heating and lighting adequate for any sensory impairments including hearing, sight and circulation problems?
• Are they experiencing balance issues, especially when changing positions? Are you concerned about them falling.
• If they fell, are you confident he or she would be able to call for help? Is there a reliable source to respond to a call at all times?
• Is your loved one repeatedly complaining of physical aches and pains?
• Are they experiencing frequent incontinence? Can they attend to the problem when this happens or is help needed?
• Do they have difficulty dressing, bathing or with personal hygiene such as hair and foot care?
• Is your loved one experiencing frequent, significant sleep disturbances?
• Are they capable of cooking or preparing healthy meals?
• Have operating gadgets or appliances such as the can opener, stove or telephone become difficult?
• Have household chores become a burden? Is vacuuming, sweeping, taking out the garbage, cleaning the dishes or bathroom being done in timely ways?
• Are finances such as bill payment, deposits, and investments being handled in a timely manner?
• Is your loved one still driving? If so, are you concerned about his/her and others wellbeing? Is public transportation a safe and viable option?
• Are prescribed medications obtained and taken as indicated consistently?

Mental Symptoms:
Is your loved one demonstrating personality changes, including but not limited to:

• Frequent irritability?
• Insensitivity to others?
• Disoriented to place and time?
• Aggressive behaviors?
• Repetitive behaviors?
• Communicating with inappropriate language?
• Is your loved one socially withdrawn and not able or not wanting to get together with friends or family? Are there signs of depression?
• Do they express negative comments about him or herself?
• Are they demonstrating an inability to make decisions or making poor decisions?
• Is your loved one able to understand communication or instructions from others?

3. Schedule a family meeting
A family meeting can move the topic of long-term care to a more focused discussion that can lead to a plan. Here is a checklist for planning your family meeting:

• Determine the family members that should be involved directly or indirectly in decision making. This may include extended family members, close friends or paid caregivers. Always include the person if he/she is capable of taking part in any decision making.
• Consider including an independent third party to play the role of mediator. This could be a minister or other member of the clergy, a social worker or case manager.
• If necessary, find a neutral place to hold the meeting.
• Prepare an agenda to help you stay focused. It may include:
• A medical update
• Sharing of feelings about the illness and caregiving
• Daily caregiving needs
• Financial concerns
• Who will make decisions
• What support role each person will play
• What support the primary caregiver needs
• Next steps moving forward

4. Continue to involve family.
The move to a long-term care facility is an immense transition for any family, so it’s important to involve everyone relevant to the person:

• Reach out to siblings to secure their input and support. For example, share online information about long-term care facilities to secure greater involvement and participation.
• Is there is an unequal financial or time burden to one family member? If so, acknowledge the distribution of resources and discuss a strategy for achieving a balance that appeals to everyone.

Good communication reduces the risk of family friction, suspicion and mistrust.

5. Continue to engage your parent or loved one.

 
• Have ongoing conversations at times when your loved one is feeling best and there are few distractions.

 

• Introduce the idea of an overnight visit to a long-term care facility or an extended afternoon visit to get a feel for the various available options.

 

6. Begin researching long-term care options in your area.

• Go to SnapForSeniors.com to access a nationwide senior housing database.
• Enter your city, state, zip, county or address and begin researching options by category of housing.
• View the listing details or contact the facility to ask questions and schedule a site visit.
• Read comments from consumers on the listing if available.
• Ask the facility you visit for a copy of their last annual licensing survey report.
• Contact your local senior ombudsman to get perspective from a local trusted resource.
• Check references from existing or prior residents or families.

7. Consult with an Elder Law Attorney.
Elder law attorneys are estate planning attorneys with a concentration in addressing the estate planning needs of seniors. Services typically involve more than simply preparing documents. An elder law attorney can provide valuable guidance with regard to quality of life planning to enable the senior to continue to live at home for as long as possible, review important considerations regarding planning for financial protection and disability, attaining and preserving eligibility for Medicaid long term care benefits, and many more related issues. Given the complexity of the Medicaid laws, the high cost of assisted living and nursing home care, and the stress one has to cope with as care services become increasingly difficult, it makes sense to get the elder law attorney involved as early as possible in this process. That will help you to make informed decisions and avoid potentially catastrophic financial consequences.

Contact us now to schedule an appointment to discuss your long term care needs.

Typically, the court will appoint the same person to serve as to guardian of the person and guardian of the property, but may appoint separate guardians. Much depends on the facts and circumstances. Whenever the is a family dispute over who should be guardian the risk of the court appointing a third party increases and, all the more so, where there are concerns of financial and/or physical abuse. Since it is not unusual for people to exaggerate or embellish the facts, an experienced guardianship attorney may be able to nip many problems in the bud.

Contact us now to inquire about your guardianship rights.

Generally, if the court is satisfied that the petitioner is a suitable person to be appointed guardian, such determination being considered separately with regard to guardian of the person and guardian of the property, the petitioner will be appointed legal guardian. However, the court may decide to appoint someone other than the petitioner, including a complete stranger to the family, such as an attorney, to serve as guardian and may appoint different people to serve as to guardian of the person and guardian of the property. Therefore, it is important to go to court prepared.

Contact us now to inquire about your guardianship rights.

The procedure or process for becoming a legal guardian first requires a determination as to whether the alleged disabled person needs guardianship of the person or of the property or both, – more often it is both. A petition for guardianship needs to be filed in the circuit court for the county in which the alleged disabled person resides, supported by two physician’s certificates verifying the cause, nature and scope of the incapacity in conformity with court rules. Various other documents needs to be filed and the appropriate parties served. Then the case is set in for a hearing. Prior to the hearing, shortly after the case is filed, the court appoints an attorney to represent the interests of the alleged disabled person, who investigates and files a written report with the court. The court may or may not require the petitioner to testify. The appearance of the alleged disabled person often is waived. The court determines whether bond is needed and if so how much. After a guardian has been appointed, the guardian must attend a court sponsored seminar on the duties of a guardian. A fiduciary report needs to be filed with the court after the hearing and annually thereafter providing a detailed accounting of the disabled person’s assets and income, duly verified.

Contact us now to inquire about your guardianship rights.

Contesting a guardianship can be highly stressful and costly, but when a loved one’s health, safety and financial security are in jeopardy, one has to do the right thing and act swiftly. The first step should be to consult with an experienced guardianship lawyer to evaluate the situation and provide guidance as to how to proceed. How one proceeds depends on the stage of the proceedings. The earlier one retains legal counsel the more options one may have to resolve the conflict in a sensible, cost-effective manner.

Contact us now to inquire about contesting guardianship for your loved one.

Any competent person over 18 years of age may serve as legal guardian absent facts that persuade a court that such person is unsuitable to serve as guardian. Legal guardianship is a serious matter and one should have an understanding of the nature and scope of one’s obligations as guardian and have understanding and compassion for the disabled person. People who are going through their own life crises, such as serious health issues, financial or marital difficulties, substance abuse problems, and so forth probably should not be taking on this responsibility, but much depends on the circumstances. Get legal counsel as early as possible.

Contact us now to inquire about becoming a legal guardian.

Because this is a complex area, the first step should be to consult with an experienced guardianship lawyer to evaluate the situation and provide guidance as to how to proceed. Stress and misguided good intentions, not to mention those who have ill-intentions, may easily cause major family rifts and set in motion an expensive legal battle that might be avoided with the assistance of someone experienced in these matters.

Contact us now to discuss power of attorney for your loved one.

Although there is no legal requirement that one be represented by legal counsel, it is prudent to do so. The process can be involved for someone who does not deal with these matters on a regular basis. Moreover, there often are important legal and strategic planning considerations that ought to be considered before one proceeds with a guardianship. If nothing else, investing in a comprehensive consultation with an experienced guardianship lawyer can help save you considerable time, stress and avoid costly mistakes. Bear in mind that you are usually dealing with the intimate subject of taking over control and responsibility for another human being who, even if suffering from moderate to advanced mental incapacity, still has feelings and fluctuating moments of understanding. Moreover, there are other areas of law that often have to be dealt with, such as estate planning, tax planning, marital property rights, and very importantly, Medicaid law. Mismanagement of the disable person’s planning for disability, in particular with regard to eligibility for public benefits, can very serious and possibly subject the guardian to personal legal liability and could even result in criminal prosecution. Long story short, don’t short-change yourself or the disabled person by cutting corners. You need to find out what you need to know and do things right!

Contact us now to inquire about setting up guardianship.

Generally, a durable general power-of-attorney, if adequately drafted, enables the agent or attorney-in-fact, to act on behalf of the incapacitated person, like a guardian would and thus guardianship is not necessary. However, if the person who gave the power-of-attorney is cognitively impaired and refuses to cooperate, guardianship may be necessary. Also, if the power-of-attorney document does not provide the authority needed to do certain things, guardianship may be necessary. The court always has authority to appoint a guardian over the protests of a person named as power-of-attorney if the court believes it necessary.

Contact us now to inquire about power-of-attorney rights and responsibilities.

The ability to understand the nature and effect of a power-of-attorney is critical, but there are other factors a court requires to evidence sufficient mental capacity. Mental incompetency or incapacity can be a complex area where different standards of incapacity may apply depending on the context. A person may have significant cognitive impairment and yet be able to understand certain things that meet the legal standard of competency to make a Will or sign a power-of-attorney. Other factors, such as stress, depression, medications, and so forth may cause temporary distortions of mental capacity. An experienced guardianship lawyer or elder law attorney may be very helpful with mental capacity determinations. Someone who is frail and physically unable to manage his or her affairs might be need guardianship even if mentally competent.

Contact us now to inquire about mental illness power-of-attorney.