What is my role as a caregiver for an older relative or friend? If you are the designated caregiver you must remember to always respect the rights and wishes of the relative or friend under your care. Ask yourself: What does my relative or friend want? How would my relative or friend decide?
You cannot just take charge without the person's permission.
This brief description of legal documents may help you, in your caregiver role, assist family members to make more informed choices about their medical care and financial directives.
ADVANCE DIRECTIVES A generic term for a group of documents that are prepared prior to needing help or care. If the person is unable to communicate their health care wishes this information explains and enforces their requests. Some documents require the person designate an "agent" (an individual authorized by the person to make decisions on their behalf under certain guidelines with or without limitations) to carry out their decisions. The person signing an advance directive must be able to understand the nature of the document being signed.
LIVING WILL Allows the person to identify which medical procedures and interventions they want or do not want to be performed. It is used when they are unable to make their own decisions due to a terminal condition, irreversible coma or persistent vegetative state. A Living Will may be part of a Health Care Power of Attorney or a separate stand-alone document. NOTE: It is important to ask your doctor about the meaning of all terms, treatments and the implications of your Living Will. It is intended to guide treatment decisions if the person cannot express their choices.
DURABLE HEALTH CARE POWER OF ATTORNEY Allows the person to choose someone (called an "agent") to make future health care decisions based on preferences expressed by the patient. It can include specific treatment protocols and limitations that direct the health care team.
NOTE: A Medical or Health Care Power of Attorney gives the "agent" authority to make medical decisions, unless the person specifically includes limitations. It only becomes effective when the person becomes too ill to make or communicate decisions. The "agent" can make decisions until the person recovers. At which time, the "agent" is no longer authorized to make decisions. Health Care Power of Attorney is revocable by its creator.
PRE-HOSPITAL MEDICAL CARE DIRECTIVE
Informs and permits emergency medical personnel not to resuscitate the person. By signing the Orange Card, the person has given consent to not have equipment, drugs or devices used to restart their heart or breathing. Presenting this document to emergency responders means that the person is ready to die and death may result. NOTE: The Pre-Hospital Medical Care Directive is a standardized form that must be printed on orange paper and signed by a physician to be valid. A recent photo of the person should be attached to the form.
DURABLE MENTAL HEALTH CARE POWER OF ATTORNEY
Allows the person to appoint an "agent" to make future mental health care decisions if unable to do so. It permits the agent to initiate some form of mental health treatment that would otherwise require client action. The Mental Health Care Power of Attorney may be revocable even if the person is incompetent. NOTE: This document may be helpful for someone with mental illness or a disease related dementia that may require institutional mental health services in the future. Mental health institutional placements are not covered by a regular Health Care Power of Attorney and require a court proceeding. Preparing the Mental Health Care Power of Attorney can facilitate or allow treatment without the formal court process.
FINANCIAL POWER OF ATTORNEY Allows the person to appoint an "agent" with the required authority to manage financial matters including business and property decisions. A Financial Power of Attorney gives the "agent" specific instructions and/or limitations only to benefit the person initiating the document. The "agent" cannot benefit from the Power of Attorney unless specifically stated in the document.
Additional factors that may be considered include:
GUARDIANSHIP A result of a legal action requiring a court proceeding that removes decision making power from the subject of the guardianship and transfers it to the guardian. The guardian is appointed by the court to make personal decisions for the incapacitated person.
CONSERVATORSHIP A result of a legal action requiring a court proceeding. The appointment by the court, after a hearing, of an individual or corporation to manage the financial affairs of a person who can no longer manage his or her own property or financial matters.
FIDUCIARY A person who accepts the responsibility for taking care of the needs or property of another person for the benefit of that person. Public Fiduciary - A County official that has statutory responsibility for guardianship of persons who require a guardian or conservator and have no one to assume this role. Private Fiduciary - A certified or licensed Fiduciary that serves as a personal guardian or conservator.
NOTE: If the patient has chosen an "agent" as a health care power of attorney or has a court appointed guardian for health care decisions they would serve as the patient's surrogate.
ALL OF THE ABOVE DOCUMENTS ARE MEANT TO BE COMMUNICATED AND SHARED WITH FAMILY MEMBERS AND APPROPRIATE PROFESSIONALS. THEY SHOULD BE STORED IN AN EASILY ACCESSIBLE LOCATION AND NOT LOCKED IN A SAFETY DEPOSIT BOX OR FILE CABINENT.
More detailed information on Advance Directives is available free from:
Pima Council on Aging 8467 E. Broadway Blvd. Tucson, Arizona 85710-4009
(520) 790-7262 www.pcoa.org
Arizona Office of the Attorney General,
Life Care Planning Information & Documents
(602) 542-2124 www.ag.state.az.us
Federal Trade Commission www.ftc.gov/bcp/menu-seniors.htm Click on: Aging Parents and Adult Children Together
To locate an Attorney to help you prepare or review your Advance Directives, contact: National Academy of Elder Law Attorneys 1604 N. Country Club Road Tucson, Arizona 85716
(520) 881-4005 www.naela.com
Pima Council on Aging
PATHFINDER: A Guide for
helping older relatives or friends make more
informed choices about medical care and/or
financial decisions
Prepared for Pima Council on Aging by the Arizona
Center on Aging, the University of Arizona®