Getting Your Affairs in Order

Introduction

Meet Rita

Rita has been married to Mark for nearly 50 years, and he’s managed their finances the entire time. Since Mark has been diagnosed with Alzheimer’s, he’s gradually gone from making occasional errors when balancing the checkbook to having difficulty keeping track of monthly bills. Rita not only feels overwhelmed with her daily care responsibilities, but she’s also worried about what’s going to happen when Mark can’t participate meaningfully in financial decision-making. She’s not even really sure she knows what bills should be paid or when they are due.

 

Meet Karen

Rita’s been talking to her friend Karen, who’s been living on her own since her husband died a few years ago. She fell in the bathroom and broke her hip a week ago and is now recovering in a rehabilitation nursing home. When Rita went to go visit Karen, she learned that even though Karen’s daughter lives halfway across the country, she has still been able to pay her mom’s bills and handle any questions she has about Medicare.

That’s because Karen and her daughter made a plan about what should happen in case of an emergency. 

  • Karen put all her important documents in one place and told her daughter where she could find them. 
  • She gave her the name of her lawyer, as well as a list of people he could contact at her bank, doctor’s office, insurance company, and investment firm. 
  • She made sure she had copies of her Medicare and other health insurance cards. 
  • She added her daughter’s name to her checking account and safe deposit box.
  • Karen made sure Medicare and her doctor had written permission to talk with her daughter about her health and insurance claims.

In this guide, you’ll learn: 

  • How to talk to your parents about their finances and wishes for the future 
  • How to organize important documents 
  • How to prepare for a sudden emergency 
  • How to assess your loved one’s situation 
  • How to make changes to unsafe areas in the home

You’ll also get several worksheets that you can  complete with the help of your parents. The first is a personal record of where your loved one keeps their important documents. The second is a tool so you can keep all of your parents’  medications and dosages up to date. This way, you can keep a single record of your loved one’s most critical information in one designated place so you are  prepared  in an emergency.

Getting Your Affairs in Order

Chapter 1: Key Documents Your Parents Need to Communicate Their Wishes for the Future

It may be a difficult conversation to have, but as your parents get older, you will need to start talking to them about their finances and their wishes for the future. Gathering this information up front lets you get the right plan in place so that you aren’t scrambling to gather documents and make important decisions when a parent unexpectedly becomes ill or injured.

There are key legal documents every adult — especially seniors — should have in place to plan how their affairs will be handled in the future and to make sure their wishes regarding their end-of-life plans are clear. They help minimize conflicts and confusion with your family and health care providers if your parents become seriously ill or when they die.

If your parents are reluctant to tell you how much they are worth or to reveal the contents of their will, let them know that your main concern is to know where to find important records in the event something happens. You can’t predict when something might happen, so preparation will help in making legal and medical decisions for your loved one.

Here are the key documents you need. Keep in mind that these documents have names that sound alike, so make sure you are getting the documents you want. Also, laws vary state by state, so find out about the rules, requirements, and forms used in your state.

Will

A will lets your parents name the people they want their money and property to go to after they die. It also allows them to designate an executor to ensure their wishes are carried out and allows them to name guardians if they have minor or dependent children.

 

Revocable Living Trusts

Like a will, if your parents own real estate or have considerable assets, another option they may want to consider is a revocable living trust. This allows your parents’ estate to avoid the time and expense of probate (the public legal process that examines estates after death) and helps ensure their estate’s privacy.

 

Bank Account Access

You’ll want to get a good idea of your parents’ current source of income. If your parents have investment income or a pension plan, get account details, and find out where they keep important documents. This is also a good time to ask if they are working with a financial planner or other adviser and to get contact information if they are.

Your parents may want to make you or another loved one an authorized agent — but not a joint owner — of their bank account so that they can act for them in an emergency. They may also want to give your authority to have access to their safe deposit box.

 

Durable Power of Attorney for Finances

This allows your parents to designate someone they trust to make financial, tax, and legal decisions on their behalf if they lose their decision-making capacity. Typically, a durable power of attorney for finances goes into effect as soon as it is signed; however, a date or event in the future can be specified, such as when a doctor certifies that their patient has become unable to make financial decisions. If your parent becomes unable to manage their finances on their own and they don’t have a durable power of attorney for finances, the court will appoint someone to manage their financial affairs as a guardian or conservator.

 

Advance Directives for Health Care

This general term describes a variety of documents about health care wishes, including living will, health care directive, health care proxy, health care power of attorney, and durable power of attorney for health care decisions. The two documents that spell out your parents’ wishes regarding their end of-life medical treatment are a living will and a health care power of attorney.

A health care power of attorney is a special kind of durable power of attorney that lets your parents authorize a loved one to make medical decisions on their behalf if they become unable to. More limited than the health care power of attorney, a living will tells doctors what kind of care your parents want to receive if they become incapacitated.

If they have not made these arrangements, ask them who they’d like to take the lead on decision-making if the unexpected happens. It’s important to let them know that you will respect their wishes and support their choices so you can have an honest discussion.

With these documents in order, you and your loved ones can rest assured that their assets are safely accounted for and their health care wishes will be met.

Chapter 2: How to Organize Important Documents

Another one of the important things to do when planning for the future is to identify and organize important documents. First, it’s important to get a handle on where to find your loved ones’ personal information. Use this chart to write down complete information about each and record where everything is kept.

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Medication List Chart

Next, use this chart to keep track of the medicines your loved one takes. In the Notes section, also include information about drug allergies, blood type, preferred pharmacies, primary care partners, and insurance.

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Notes

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Put a copy of all your parents’ important papers and copies of legal documents in one place. You can set up a file, put everything in a desk or dresser drawer, or list the information and location of papers in a notebook. Check each year to see if there’s anything new to add.

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Chapter 3: How to Prepare for a Sudden Emergency

Disasters can happen at any moment, and if your family isn’t prepared, they can quickly and completely disrupt normal living.

If there were an evacuation order, does your mom know the recommended route from where she lives? If she doesn’t drive, what are her transportation options? What would your dad do if his basic services — water, gas, electricity, or communications — were cut off and local officials and relief workers weren’t able to reach him right away?

Scary thoughts, right? Fortunately, planning ahead can help reduce anxiety. Here are three steps you can take to make sure you and your loved ones are prepared for emergencies and sudden disasters, just in case.

 

Create an Emergency Plan

The first step is to make sure that all relatives and friends know what is happening in the event of an emergency. Create a phone call chain in which your loved one makes an initial call to one person and they, in turn, call the next person and so on. Make sure everyone has the current home, work, and cell phone numbers of the people they’ll need to contact in an emergency. Post these emergency numbers near all your loved one’s phones, and make an extra copy for them to keep in their wallet.

Remember: In some emergencies, telephone lines might not be working, so also arrange for someone to check on your loved one at the time of a disaster.

Next, get a community disaster and emergency plan for your loved one’s area, and learn where they might turn for medical care or emergency supplies of medications. Then, in case they have to evacuate their home, designate a meeting place where your loved one can wait and relatives can find them. Plan the best and quickest escape routes out of their home and evacuation routes out of their neighborhood, and practice an escape drill every six months.

If your loved one doesn’t own a vehicle or drive, find out in advance what their community’s plans are for evacuating those without private transportation, or make arrangements with a neighbor who would drive them.

If your loved one has chronic health problems, consider ordering them a medical ID bracelet or pendant that can be engraved with important medical conditions, allergies, medications, and emergency contacts.

 

Stock an Emergency Medical Kit

Being ready for an emergency means having the supplies you would need. An emergency medical kit should include:

  • A three- to six-day supply of your loved one’s medications
  • An up-to-date medication list
  • Any medical equipment they might need, such as blood sugar monitoring equipment, hearing aids and hearing aid batteries, or an extra pair of eyeglasses
  • Copies of medical records
  • Copies of Medicare, Medicaid, or other medical insurance information

 

Make a Disaster Supplies Kit

A disaster supplies kit should include your loved one’s medical kit equipment as well as things they would need to survive safely in their home until help can arrive. Store the supplies in a few easy-to-carry containers, such as a backpack or duffel bag, or a container that has wheels. Be sure the bag has an ID tag. Review the contents at least every six months or as your loved one’s needs change. A disaster supplies kit should include: 

  • Enough water to last three to six days (at least 1 gallon per person per day) 
  • At least a three-day supply of canned and dried foods that won’t spoil and don’t require cooking 
  • A manual can opener 
  • A flashlight
  • A battery-powered or hand-cranked radio 
  • Batteries 
  • Waterproof matches 
  • Knife 
  • Resealable plastic bags and tin foil 
  • Disposable cups, plates, and utensils 
  • Basic cooking utensils 
  • Emergency whistle 
  • Cell phone with chargers or solar charger 
  • Local and regional maps 
  • A complete set of clothing per person 
  • One blanket per person 
  • At least $50 cash 
  • Emergency contact list 
  • Basic hygiene products, such as soap, toothpaste, toothbrushes, sunscreen, hand sanitizer, and toilet paper 
  • A first aid kit  

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Chapter 4: How to Assess Your Loved One’s Situation

As your parents age, it’s important to develop a plan to accommodate changes their health and function. Although you may support their desire to live independently, you probably have concerns about their safety and well-being. One way to help resolve these conflicting emotions and determine if your parents need assistance is through a home safety assessment.

Some families hire an experienced professional to lead them through a comprehensive review of their loved one’s mental, physical, environmental, and financial condition. However, you can also conduct an assessment on your own.

 

Keep Your Eyes Peeled in the Kitchen

Rapid weight gain or loss can be a sign of serious medical problems or a sign that your loved one is having trouble preparing food. Many conditions, including depression and cancer, can cause weight loss, and a person who is having trouble getting out to shop or remembering how to cook can lose weight. Common causes of weight gain include diabetes and dementia, and someone with money troubles may choose fewer fresh foods and more packaged goods.

You’ll want to evaluate food, nutrition, and kitchen safety.

Here are some things to look for: 

  • Do they keep a well-stocked pantry and a variety of fresh fruit and vegetables? 
  • Is there expired or rotten food in the refrigerator? 
  • Can they easily operate a microwave? 
  • Can they prepare a meal without assistance? 
  • Do they have a healthy appetite? 
  • Are they able to buy groceries independently? If not, are they using a grocery delivery or a meal delivery service? 
  • Are they aware of foods that may interact adversely with their medications? 

 

Look Inside the Medicine Cabinet

For many seniors who have chronic diseases, taking a daily medication is essential for maintaining health and quality of life. As the number of drugs taken increases, harmful interactions can occur. More medications means increased risk of negative interactions. Because drug-related medical problems are so common in older adults, it’s important to ensure you and your loved one stay on top of what they are taking and be watchful for changes in symptoms.

You’ll want to pay special attention to their medications and health status.

Here are some things to look for: 

  • Have they visited a dentist, optometrist, or physician in the past year? 
  • If they wear glasses, are their glasses in good shape? 
  • Do they show any signs of poor vision such as squinting or sitting too close to the TV? 
  • Are they maintaining a healthy, consistent weight? Have you noticed any weight loss? 
  • Are you aware of what medications and supplements they are taking? 
  • Are they taking medications properly and as directed?

 

Watch Them Get Around the House

The changes that occur with aging can lead to problems with a person’s ability to move around. Muscle weakness, joint problems, pain, disease, and neurological (brain and nervous system) difficulties — common conditions in older people — can all contribute to mobility problems. The No. 1 mobility problem that older people experience is falls. One in three seniors over 65 experience a fall every year, and even minor slips, trips, and falls can lead to major trauma in older adults. When you’re at home, observe your parents’ mobility and functioning.

Here are some things to look for: 

  • Are they able to walk independently indoors and outdoors?
  • Do they have a steady gait and appear stable when walking? 
  • Are they able to retrieve mail and newspapers safely? 
  • If there are stairs in the home, are they able to walk up and down safely? 
  • Are they able to get in and out of bed safely? 
  • Are they free of signs that may indicate a recent fall such as bruising or scratches? 
  • If they use a cane, walker, or scooter, are these aids in good shape and being used effectively? 
  • If they are still driving, do they have a current driver’s license?
  • If you have driven with them recently, are they driving safely? 
  • If they are not driving, are they able to easily arrange for transportation as needed?

 

Do a DIY Home Inspection

Although your parents might enjoy owning a home, the upkeep may be more than they can handle. From shoveling the sidewalk after a snow shower to changing a light bulb in the hallway to mowing the lawn, home ownership can be stressful on people as they age.

Talk to them about whether they’d prefer to live in a place where they won’t have to worry about housework, maintenance, and upkeep, and pay special attention to house and home safety.

Here are some things to look for: 

  • Is the home well-lighted, easy to navigate, and free of fall risks, such as open extension cords and loose rugs? 
  • Do interior stairs have railings on both sides? 
  • Are working night-lights placed appropriately throughout the house? 
  • Are the electrical systems functioning properly and safely?  
  • Is the house reasonably clean and tidy?
  • Is the house stocked with dish soap, laundry soap, and other cleaning supplies? 
  • Are the trash bins picked up and managed properly? 
  • Are the fire extinguishers, carbon monoxide detectors, and smoke detectors functioning? 
  • Is there a phone or emergency call system easily accessible in all rooms? 
  • Are the pets being cared for adequately?

If you have already have an inkling that your mom or dad is having trouble with everyday life, this assessment will help you spot common problems. And if you notice something is off, consider getting their doctor involved. They may share your concerns about your parent’s safety at home, explaining what seems to be wrong and suggesting options for fixing it, without risking a strained relationship.

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Chapter 5: How to Make Changes to Unsafe Areas in the Home

Each year, nearly 1 million people over age 65 are treated in hospital emergency rooms for injuries associated with the products they live with and use every day, according to estimates by the U.S. Consumer Product Safety Commission. Many of these injuries result from hazards that are easy to overlook — but also easy to fix.

It’s important to make sure you and your loved one are aware of the potential dangers and prepare accordingly.

 

Prevent Falls

Falls are the leading cause of fatal and non-fatal injuries for older Americans, yet most of them can be prevented. Check all lamp, extension, and telephone cords around the house. Cords stretched across walkways may cause someone to trip, so arrange furniture so that outlets are available for lamps and appliances without the use of extension cords.

Also, check all rugs, runners, and mats, which are often the cause of trips. Remove rugs and runners that tend to slide, or apply slip-resistant backing or place rubber matting under rugs. If your loved one has difficulty with walking or balance or has fallen in the past year, talk to their health care provider about having a special falls risk assessment.

 

Protect Against Fire

Older adults have an increased risk of dying in a fire, according to the U.S. Fire Administration. Many fire injuries and deaths in homes are caused by smoke and toxic gases, rather than the fire itself. Smoke detectors provide an early warning and can wake your loved one in the event of a fire, so purchase a smoke detector if they don’t have one, and check and replace batteries twice a year.

Space heaters can cause fires or serious burns if they cause your loved one to trip or if they are knocked over. Make sure heaters are at least 3 feet away from anything that can burn, such as curtains, bedding, or furniture, and make sure your loved one turns them off when they leave the room. Also, encourage your loved ones to roll back long, loose sleeves or wear short sleeves when cooking, as long sleeves are more likely to catch fire than are short sleeves.

 

Avoid Bathroom Hazards

According to the Centers for Disease Control and Prevention, every year about 235,000 people over age 15 visit emergency rooms because of injuries suffered in the bathroom, and almost 14 percent are hospitalized. Not only are wet, soapy tile and porcelain surfaces especially slippery, but also water temperature above 120 degrees F can cause tap water scalds.

Have grab bars installed in the shower and near the toilet to make getting around easier and safer, and put rubber mats in the bathtub to prevent slipping. Encourage your loved one to always check the water temperature by hand before entering the bath or shower.

 

Prevent Medication Mistakes

Medications that aren’t clearly and accurately labeled can be easily mixed up. Taking the wrong medicine, or missing a dosage of medicine you need, can be dangerous. Be sure that all of your loved one’s medicines are stored in their original containers and that they are clearly marked with the contents, doctor’s instructions, and expiration date. If your loved one struggles with small print, ask your pharmacist to put large-print labels on their medications to make them easier to read.

Always remember that no matter how organized you are, the plan will have to change as you go along — and that’s OK. Having the conversation in the first place — and understanding the needs, wishes, and dreams behind it — will help ensure a meaningful and caring future for you and those you love.

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The Best Laid Plans Require Preparation

As those you love advance in age, there is often a role reversal when it comes to who is caring for whom. This comes with an assortment of obstacles to overcome, from declining health to financial troubles to potential natural disasters. There is no way of knowing when something may happen, so it is important to acknowledge these potential hazards and exercise proper planning. With that, you and your loved one will be ready to face any challenge and know how to act in an emergency.

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