Massachusetts Estate Planning and Elder Law

Geriatric Care Managers - An Important Part of the Team

When caring for an elderly loved one, a team approach is often best.  Each player - the doctors, nurses, home care providers, attorneys, financial planners and caregivers all their their roles. The New York Times has a recent article about Geriatric Care Managers, who are often an integral part of the team when working with elders.

As the article explains:

...many family members don’t know how, or live too far away, to find and manage help for aging parents. That’s where geriatric care managers come in. They serve as guides through the fragmented care landscape, connecting clients with local services, assisted-living facilities and a wide network of paid caregivers, elder law attorneys and financial advisers. They help families find living options, assess the abilities of older people, write care plans and sometimes hire and supervise home help.

Geriatric Care Managers, or GCMs, can help evaluate a situation and make recommendations for the best type of care - whether in home, at a day program or in a facility.  They can then coordinate that care to make sure that nothing slips through the cracks, and that nothing is being duplicated.  GCM's are usually social workers or nurses and are generally very knowledgeable about the resources for elders in their communities.  The clients I've had who have worked with GCM's have appreciated their assistance and expertise - whether they worked with them on a long term basis or just for a few visits. 

You can locate a geriatric care manager in your area by going to the National Association of Professional Geriatric Care Managers website, or by asking your attorney, home care provider, or other allied professional for a referral. 

Joanne Koenig Coste Podcast - Sustaining Hope Amidst Alzheimer's

The Patriot Ledger has an article about the Hingham Alzheimer's Event which contains a podcast by Joanne Koenig Coste about staying positive and in the moment while living with and loving someone with Alzheimer's Disease.  She stresses the importance of accepting where the person is now, and what they can do, rather than dwelling on who they used to be, and what they can't do.  Click here to listen.

Thanks to Sue Sheibel at the Patriot Ledger Blog, A Good Age, for posting about this. 

Teleseminar - How To Be Your Own Generational Coach

AgeWise Living is offering an 8 week tele-seminar on becoming your own generational coach.

This tele-seminar is for you if you are caring for a loved one and are having some of the following issues:

	Are you a member of the "sandwich generation" -- squeezed between raising children and caregiving responsibilities for your parents, in-laws, or other aging loved ones?
	Stressed and struggling with your eldercare issues?
	Do you lie awake nights worrying about them?
	Are they consuming your time and draining you financially and emotionally?
	Are eldercare issues creating problems at work and at home?
	Are conflicts with siblings or other family members sabotaging your efforts and undermining your relationships?
	Are you spending hours searching for solutions to your critical eldercare issues only to have your aging loved ones refuse to cooperate or even discuss them with you?
	Do you feel like your life is out of control?

Even if you can't attend the live phone calls, they will be recorded so that you can listen to them at your convenience. You also get a private coaching session with Barbara every week, her book on How To Be Your Own Generational Coach, and lots of other resources.    This is another great way to care for yourself as you are caring for others. 

Free AgeWise Living TeleSeminar - Wednesday Night

AgeWise Living offers free monthly teles-eminars on a variety of topics for caregivers and children of aging parents. 

Barbara Friesner is hosting a seminar on Wednesday March 12, 2008 at 7pm eastern time on Helping Your Loved One Get What They Want and What's In Their Best Interest.
Click here for details and the call-in number. 

You can listen to past seminars by clicking here, including a great one on sibling relationships. 

Even though Barbara is in New York, she does all of her generational coaching by phone, so she can help families throughout the country. 

Caring for the Caregiver

Whether you are caring for an aging parent, small children, or just yourself - everyone can use time for themselves to regroup and recharge.  One way that I like to recharge is with a short yoga practice during the workday.  Stacey Shipman of Let It Flow  has a great 10 minute Yoga At Your Desk podcast which will leave you feeling refreshed and ready to face the rest of your day. 

Because of the physical and emotional stress of caregiving, caregivers need to make sure they take care of themselves, too.  As they say on airplanes, you have to put on your own oxygen mask before helping the person next to you.  So think of this practice as putting on your own oxygen mask and breathe!

What are you leaving behind? Thoughts on decluttering as part of planning.

I posted recently about the health effects of clutter on the person living with the clutter.  However, the effects of your clutter live on even after your death.  This blog, Confessions of a Hoarder, has a post describing the process of trying to declutter an estate after a person's death. 

The author describes how her mother, a member of the American Association of University Woman, was often called to help clean out someone's estate that had been left to the AAUW.  They had to prepare the house for sale, and in doing so they had to clear out decades-worth of things that had been collected by these people who had generously left their estate to the charity. 

The author's mother offered these tips to aging people, as well as their adult children as they decide what to keep and what to recycle, give away or throw away:

1. Do not save months and years of magazines, with a thought towards donating them. 
   
   

   Collections of magazines, such as Life or Look, usually have no value as libraries have copies in their archives. National Geographic and The New Yorker, for instance, are available on CD-ROM. Professional journals are usually available on-line these days. Newspapers, magazines, and other periodicals collect moisture, become mildewy and/or moldy and attract other unhealthy pathogens.

2. If you have collectibles that you want people to inherit from you, think about giving the item sooner along with the story behind it. 
   
3. Identify all keys with tags or labels.  Safe deposit box keys should have the bank name, branch and box listed on them.
   
4. Photographs of unidentified people are usually thrown out if donated to a charity, and are much more valuable to family if they have the identity, date and relationship listed on them. 
   
   It only takes a few generations for the identity of people in photographs to be lost, so if you are looking through unlabeled pictures with an older family member, take some time to ask them who the person is, what they were doing, where they were, and who they were related to. Which is more meaningful, a label that says "Joe", or one that says "Uncle Joe, Joe Sr.'s son, age 19, 1942 in front of his store front in San Francisco."  This type of project is a good one for younger generations to help out with, and can lead to more stories and memories being shared and passed down. 
   
5. Identify flowers, plants, trees and houseplants if you know what they are.  These can be useful for prospective buyers, who may want to know how to continue to care for them.
   
6. Broken, rusted or otherwise unusable tools have no value. Consider having them repaired or throwing them away.
   
7. Identify circuit breakers.
   
8. Clearly mark where the main water shut-off valve it.  Houses that are left vacant can sometimes have pipe-freezes and knowing where to shut off the water coming into the house is vital to stopping the flood.  The plumber can usually find it, but the water should be shut off ASAP in the event of a pipe freeze. 

Many times my clients who are dealing with the estate of a loved one have commented to me about things their mother, father, aunt or uncle saved, and have wondered aloud what made them hold on to so many things.  They often resolve that they will not subject their children to the same onerous task of clearing out their house when the time comes. 

Are there things you are saving because you think they might be of value? Do you need help decluttering and clearing out your house? Are you trying to figure out how to approach your parents about their clutter?  You might try starting with some books on the topic,  and then gently offering to help. Remember that people are often very attached to their clutter (and their sentimental items) so you can't just start throwing things away that don't belong to you, but you can start a conversation and offer to help get things in order. 

Stories of Harm - Health Care Quality Videos

My friend and former colleague Nicola Truppin of Health Navigator Partners sent me the link to the Health Care for All blog which has a recent post about people who were harmed while getting medical treatment at prominent Boston hospitals, either through misdiagnoses, medical errors or preventable infections.  There are 3 videos - each 3 minutes long - in which each woman describes what happened to her.  Click here to see the videos and read the post. 

The goal behind these videos and the work being done by Health Care for All's  Consumer Health Quality Council is to bring awareness to the problem and advocate for quality improvement and patient safety in health care. 

Family Caregiver Handbook - Free Online Resource

The MIT Workplace Center has recently published a Family Caregiver Handbook, which is available for free viewing on-line.  The handbook deals with such matters as Financial and Legal Issues, Home Health Care & End of Life Care, Caregiver Support, Housing and Transportation, and How to Get Involved.

The book serves as a gateway to the resources available to families and caregivers.  Rather than providing a lot of substantive information, the handbook gives a summary of the issues (such as a summary of MassHealth programs, or the different types of respite care available for caregivers) and then provides the contact information for local and national groups, associations, and government agencies that can provide the necessary services.

This handbook is a great resource  for  seniors, their caregivers and professionals who work with them. 

Setting Goals, Not Resolutions

People like to set resolutions for the New Year - lose weight, spend more time with family, get their estate plan in order, put finances in order.  But resolutions always seem to fade by February. Maybe it's because they are too vague, too big, too unwieldy. Why not set goals instead, with mini-goals along they way to get you there?

If your goal is to get your finances in order, start with tracking your spending.  You don't need anything fancy, a notebook or spreadsheet on your computer will be fine.  Next, keep track of all your bills and income. When you have a month or so of expenses tracked, and all of your bills in one place, contact a financial planner to help you make sense of it all, and put a plan in place for moving forward. This might involve investing your money in a certain way, obtaining appropriate insurance policies, even setting up a college fund for your children. 

If your goal is to "get your affairs in order", again, start small.  First, sit down with your spouse or partner and decide what you want to accomplish.  It might be making sure someone is appointed to care for your children if you are unavailable, or having someone be able to make decisions for you and manage your finances if you are unable.  Perhaps you want to protect your assets, or provide for a child with special needs, or maybe you just want to make things simple for your family if you pass away. 

After you've thought about your "big" goals, think about who the people are that you trust and who you'd want to handle things in the event you are unable.  It might be that you and your spouse choose each other as the primary agent named in your documents, but that you each choose different alternates.  That is fine.  In addition, you can choose different people to manage your finances, make health care decisions and become the guardian of any minor children.  The important thing is that you are choosing people you trust, and who will be able to handle the responsibilities. 

Once you've decided who you'd like to appoint and what your vision for the future looks like, or even if you've just narrowed it down a little, you should contact your attorney to meet and talk about your plans. Your attorney can review your current situation and your goals and let you know what you need to do to achieve them.  Before you know it, you'll be on your way to having your estate plan in place and you can move on to working on your other goals like reducing stress and getting in shape. 

Health (and other) Effects of Clutter

The New York Times had a recent article on the health effects of clutter.  The article points out that if you can't find your shoes, you certainly won't be able to go walking, and if you can't find your medications or other instructions from your doctor that could be harmful to your health as well. 

In addition to possibly harming your health, clutter could make it difficult for your loved ones to help you in a time of crisis.  If you are admitted to the hospital urgently, and a copy of your health care proxy is needed so that someone can communicate with the doctor, you don't want your family to have to search through piles of paper or lots of unmarked boxes.  Additionally, in the event of your passing, your family should be able to easily locate your estate documents such as a will or trust, burial plans, any insurance policies you have and information about your bank accounts and real estate. 

Why not set a goal to get your paperwork in order for the New Year?  A simple fireproof box from an office supply store (make sure you either leave it unlocked or tell your family where to find the key), along with some folders and labels will make quick work of the job.  You can then rest assured that in the event of an emergency, your family can concentrate on what matters - you, and not be endlessly searching through your clutter. 

Important Coversations to Have with Loved Ones

With the holiday seasons coming up, many people will be traveling home to see parents or aunts and uncles. At this time, you may notice that things have changed since you last saw them.  While it can be difficult to talk about changes, and to see them in yourselves and your loved ones, it's important to realistically assess the situation. 

Some things to talk to aging relative about (or to check-in with yourself about)

• are medications up to date, and in clearly labeled bottles?
• where are important documents like powers of attorney, health care proxies, financial information and computer passwords kept? Have they been updated recently?
• have they (0r you) been to the doctor for a complete physical within the last year?
• check to see if stairs and decks are in good condition, doorways are well lit, that there's nothing that could be tripped over.
• do shower rails or raised toilet seats need to be installed?
• is the food in the refrigerator out of date or spoiled?
• are they (or you) able to get out and do things they still enjoy?

You don't have to have a formal sit down to check in on these things. Just keep your eyes and ears open and don't be a afraid to speak up whether you are the adult child noticing things are changing, or you are the parent who is in need of some assistance.

If you find that you or your relatives are in need of legal assistance, call me at 781-749-2284.  If you are in need of other assistance check out the links to the right under "Resources." 

Free Alzheimer's Coaching Services

Part of the difficulty of having a loved one with Alzheimer's is adapting your own actions and expectations to the changing behavior of the person with Alzheimer's.  A coach can help you with that.

Thanks to funding from a Title IIIE Older Americans Act Grant, Alzheimer Coaching Services is able to offer up to three in home coaching visits free of charge.  These visits are available in Braintree, Cohasset, Hingham, Holbrook, Hull, Milton, Norwell, Quincy, Randolph, Weymouth and Scituate.

There are no income or age restrictions for this service, and no referral is required.

Coaching can help you:

• Understand the disease or condition causing the memory loss
• Understand the behaviors cause by the disease/condition.
• Learn how to respond to behaviors in a way that values the person and restores meaning and purpose to life.
• Learn how to maintain and enrich family relationships throughout the disesase.
• Learn about resources to ease care partnering. 

For information and to sign up, contact Beverly Moore at 617-233-1145. 

Planning for the holidays when a loved one has Alzheimer's

The holiday season is coming upon us (or is already upon us if you count the Red Sox being in the World Series a holiday).  If you have a loved one with Alzheimer's or other memory issue, some traditions may need to change in order to make things easier (and safer) on yourself and your loved one. 

If you are caring for a loved one at home, they can often still assist with the cooking and baking, with some adjustments.  Instead of expecting them to remember the recipes or help at the stove, give them a distinct direction such as chopping the carrots, or measuring the nuts, or dropping cookies onto a tray.   People with Alzheimer's often have trouble initiating an action, but can carry it out if prompted.  This allows them to remain involved.

Try to keep the decorations at a minimum.  Flashing lights and lots of clutter can be confusing to people with Alzheimer's.  Also try to keep the gatherings to a small size, and don't have too much background noise like music or TV, which can be disorienting. 

If your loved one is in an assisted living or nursing facility, consider holding a small celebration there instead of bringing your loved one home, if her doctors think a visit home might be too overwhelming.  And rather than having a lot of people show up at once, consider having just a couple of people at a time, and stopping if your loved one seems to be getting too tired or agitated.

And don't forget to take care of yourself. If you are the primary care giver of a relative with memory loss and you usually host Thanksgiving or your family expects you to go all out for New Years but you just don't have the energy - feel free to just say "no."  Ask them to help out before they ask you to play hostess (in addition to your role as nurse, companion, taxi driver, medication dispenser, appointment scheduler, personal care giver, etc.) 

Make sure you are getting enough exercise, enough rest and enough time for yourself and your other priorities.  Take advantage of respite care or day care programs in your area, and think about attending a local care giver support group.

There is a care giver event at Sunrise in Plymouth on Thursday November 1, 2007. The event starts at 5:30 and goes until 8:30.   There will be dinner and entertainment and the feature speaker will talk about  Emotional Freedom Technique, Guided Imagery and there will be reiki demonstrations.  To attend, you should RSVP at 508-584-1561 x272,   

Source: CNN Health Library

When Do you Buckle Your Seat-Belt?

Do you buckle your seat belt when you get in the car?  It's easy, doesn't take much time, and you know you'll be protected in the event of an accident. 

Do you figure that since things are fine now, you'll wait to fasten your seat belt until you feel the car start spinning out of control? Unless you have the reflexes of Superman, you probably won't have enough time. 

Or do you just never buckle your seat belt and figure that your family and other professionals can handle things in the event of an accident, because you are just too busy to do it now. 

What does this have to do with estate planning? Well, other than the fact that you hopefully have your plan in place in the event of an accident, it seems that my clients fall into one of these categories when it comes to planning for the future.

There are those who want to be prepared, and who get their plan done in a few visits.  They don't have to worry about what will happen to them or their loved ones in the event of a crisis.  They have had time to carefully think through their decisions, and make sure everything is just how they want it.  They are calm when they come to see me, and relieved when they leave.   They have their seat belts securely fastened and can enjoy the scenery. 

Then there are those who put off planning until it is almost too late.  They are leaving the country in 3 days and only have time to do a Wills, Powers of Attorney and Health Care Proxies and not the Trust and other planning that they wanted to do.  Or their mental capacity is slipping and the time they have to plan, before someone else needs to handle their affairs, is very limited.  What they have is better than nothing, but it will leave some complications for their loved ones to deal with in the event of their death or incapacity.   The expenses are higher, the risk of running out of time is greater.  They are stressed out when they come to see me, but mostly relieved when they are done. 

Then there are those who make no plan.  These are the saddest cases.  There has been a crisis in the family and instead of being able to concentrate on their parents or other loved ones, the children are visiting the attorney to try to sort out the legal mess.  They are trying to figure out what their parents have so that they can pay for their care, or apply for Medicaid for them.  Maybe they are having to go to Court to get a guardianship over their parents so that they can sell the house or handle the finances.  Maybe there are siblings who don't get along and can't agree over who should do what, and it's back to Court to let the judge decide.  Things that could have been decided when the parents were competent, are now being fought over.   Adult children who have their own lives and families to think about are having to jump through ten hoops to accomplish the same thing that would have been completed with a simple task had their mother or father or aunt or uncle executed a Power of Attorney.

These clients are sad, stressed, worried, angry and scared when the come to see me.  As we work through the issues at office visits, home and hospital visits, trips to Court and telephone calls the burden starts to lift, but the feeling of relief does not come as soon or in the same way as if there had been a plan put in place when there was time.

If you are ready to stop thinking about it and start planning, please call me at 781-749-2284.

Quality Rating Tool for Massachusetts Nursing Homes

Choosing a nursing home for yourself or a loved one, either for a short-term stay after a hospital visit, or for a more permanent placement can be overwhelming.  You can talk to your neighbors, get recommendations from doctors and look on-line for facilities in your area. But how do find out about the quality of the facility?

The Massachusetts Department of Public Health provides a Quality Rating Tool for Nursing Homes for the public.  This Quality Rating Tools provides information in 5 areas which is gathered by the DPH during surprise visits to facilities: Administration, Nursing, Residents Rights, Kitchen/Food Services and Environment.  (I have put this link in the sidebar under "Resources" so you can easily find it again.)

You can search for nursing homes here and get information on choosing a nursing home.   The site also provides suggested topics and questions to ask when evaluating a nursing home. 

Tools like these are important because you can't always judge a facility just by the way it looks.  However, if the facility does not look or smell clean, and if the residents seem poorly cared for that is probably an indication that you want to look somewhere else. 

If you need help evaluating a nursing home either because you aren't sure what to look for, or if you live outside of Massachusetts and you are trying to find placement for a relative here, there are geriatric care managers and other professionals who can assist you in the evaluation of the facilities, so you can make the right choice for yourself and your loved one.

"It's like a second job"

This is what one of my client's children said to me last month as she and I were leaving the nursing home after visiting her father.  It is indeed like a second job, although instead of getting paid, you are the one who is paying - in time away from your job, your spouse, your kids, in the emotional toll of having to parent your parent whose health and mental status may be declining, and in trying to navigate the maze of medical terminology, health insurance or public benefit requirements and coverage guidelines. 

There are places to turn for assistance when the stress of care giving gets to be too much.  Your local Aging Services Access Point has care giver support groups, and they can direct you to other groups in your area as well. 
Old Colony Elderly Services
South Shore Elder Services
800ageinfo.com  For all other towns in Massachusetts

Moving Parent to a Different State - Make Sure to Review Estate Documents

If your parent is moving to a different state, or you are moving your parent here from out of state, one of the first things you should do is have an elder law attorney review their Durable Power of Attorney, Health Care Proxy and Will or Trust to make sure they conform to the requirements of the new state, and take into account the changes that might be down the road.  This is especially important if you moved your parents here because of declining health.

Delaying getting these documents in place can cause significant problems down the road if your parent's health declines to the point where they are no longer capable of signing new documents, or if they need nursing home care and the appropriate plans have not been made. 

The elder law attorney can also serve as a good resource if you need  recommendations for home care for your parents, adult day programs, assisted living facilities or other services. 

Living With Alzheimer's Disease

The New York Times recently had an article about living with Alzheimer's Disease after diagnosis but while the person is still able to carry on conversations, and go about their daily life, although with small but growing differences.   

One important step to take during this time, is to make sure that you have you Health Care Proxy, Living Will, Durable Power of Attorney and Will or Trust set up.  You should also have conversations with your loved ones about your wishes. 

You and your family may also wish to attend a support group for people with early stage Alzheimer's and their care givers.  Some of the support groups are listed here: http://www.alzmass.org/supportgroupleaders.htm  and others can be found here:
http://www.caregiver.com/regionalresources/states/MA/support/plymouth.htm

Love Matters

My friend, Ann Quinlan, of Healthy Aging Matters has written a guest post today, in honor of Valentine's Day.

LOVE MATTERS
Ann V Quinlan

During this month of February florists, chocolate and card vendors move into action and become instamatic cupids and messengers of love.  As Valentine’s Day approaches their job is to get that order delivered and keep the shelves well stocked with sentimental verses. While this ‘red letter’ day draws attention to romantic love, love in all its forms is all around us. Scientist have discovered that the mere witnessing of a loving act changes our chemistry, lowers our blood pressure and inspires us to act in a more loving way too.  An open loving heart connects us to a larger world. When we walk under a clear night sky filled with stars we are touched, moved and inspired by nature’s abundant gifts of love. When we share joy, compassion and laughter we are elevated to the experience love in action.  Much great art, poetry and music, inspired by romantic love, fills museums, art galleries, libraries and concert halls, throughout the world.  One of The Seven Wonders of The World, The Taj Mahal, was inspired by the love of one man for one woman.  When love appears, by design, intention or surprise our steps become lighter, the clouds drift away and our world takes on a golden hue. When we are feeling pain or hurt the caring love of a close friend helps us heal. While reflecting the joy of our own experience of love we begin to see only love, everywhere.  When you finish reading this, take a moment and think of someone you have not seen for a long time.  See their image and send them love.  This simple exercise will open your heart and lighten your step. 

Happy Valentine’s Day!

So, Your Kids Want You to See an Elder Law Attorney?

Many of my clients come to me by way of their children. Their adult children start worrying about their parents “getting their affairs in order” and they call or email me, maybe they even make the appointment.  You may find this helpful, you may find this meddlesome, or somewhere in between.  But they are just looking out for you, as you have always done for them. 

Some important things to keep in mind.

•    There’s more to getting your affairs in order than deciding who gets your stuff when you die. The more important consideration is figuring out who’s going to help you manage things while you are still alive, but need assistance or are unable to act on your own behalf.  Then you can figure out who’s going to get (or not get) your stuff when you die.

•    If we meet, I can review your current situation, answer all of your questions, give you information about what steps I recommend for you, what everything means, what the alternatives are and what the cost will be.  How we proceed is completely up to you. 

•    I can come to your house.  Many of my clients have difficulty getting out, or maybe they are just more comfortable meeting at home, since that is where the big box of papers is. Whatever the reason, if you need a home visit, just let me know.

•    If you hire me, anything you tell me remains confidential (even from your children, even if they made the appointment, even if they are paying my bill.) I will be your attorney, not your children’s.

•    Drawing up your Will, Trust or Durable Power of Attorney can be a relief – you are done with the process, and unless there is a significant change in your circumstances the documents will be good for years to come.  Plus, your kids will stop bugging you about it. 

More on Caregiving from a Distance

Has your mom taken her medication today? Did the nurse show up at your dad's on time? Did your aunt fall?  If you live next door or down the street, you can easily find this information. But if you are at the other end of the state or across the country it's more difficult to know without making 37 phone calls a day.

A recent article in the New York Times offers some suggestions of products and services to help keep an eye on your loved ones even though you are far away.

Some of the products are computerized pill dispensers, motion detectors to tell if someone hasn't gotten out of bed, or if the outside door has opened, and even electronic questionnaires which ask the elder how they are feeling  that day and record their blood pressure and weight.  This information can be monitored by the children, and by nurses who can be on alert for changes in behavior or health status.

The article also talks about how geriatric care managers can be a great resource for helping with some of the tasks of taking care aging parents. 

Free Teleseminar on Communicating Across Generations

Age Wise Living, a generational coaching company has two recorded seminars on their website called "You're Not Hearing What I'm Saying" which deal with communicating across the generational divide and communicating through the emotion. 

This coaching can be useful when trying to figure out how to broach difficult subjects with your aging parents - from helping them keep track of their finances and medical records, to suggesting they move into an assisted living facility. 

The company is based in New York but the coaching can be done over the phone, and the teleseminars can be attended from anywhere in the country.

Trying to Help from 1500 Miles Away

Many of my readers, and some of my client's children, are in the unfortunate position of trying to locate services and provide support for their loved ones who live very far away. While it can be easy locate home care providers, day centers, and assisted living facilities on the internet, it can be very difficult to determine whether these are the appropriate fit for your loved one.  You need someone local who can be your eyes and ears, and who already knows the various providers and facilities and can give feedback based on the experiences of their clients, not just what is contained in the marketing materials.

Often what you need to do is pick up the telephone and speak to someone in person.

I recently had the experience of trying to find some assistance for my aunt (that's her on the left, many years ago) in Florida. I know from my work up here that elder law attorneys can be a great resource for locating all other types of services, so I asked around to see if any of my colleagues knew an elder law attorney in Florida.  I was very lucky to be referred to Jack Rosenkranz in Tampa, who has a wonderful care coordinator on staff, Brooke Crumrine. I spoke to Brooke and she was immediately able to set my mind at ease and provide me with information regarding home care providers and other resources in her area, including the different programs that Florida offers to help pay for some of the care.

It's comforting to know that Brooke and Jack are there to help my uncle find and evaluate the resources, and help him make the most of the available programs, so that my aunt can have what she needs. And, it's nice to know that I am often able to do the same thing for those people whose aging loved ones live far away from them, but close to me.

Guardianship - Authority and Responsibility of the Guardian

In general, the guardian has complete control over the financial, medical and personal decisions of the ward. This includes where the ward will live, how the ward's money is spent, and making routine medical decisions for the ward. A ward has no more authority to make these decisions for themselves. 

The guardian also has the responsibility to account for all of the ward's income and expenses. In the beginning of the guardianship, the guardian files an inventory with the Court of all the wards assets, and after that the guardian files an annual accounting with the Court showing how much money came in, where it came from and where it went. At the end of the guardianship, the guardian must file a final accounting with the Court.

Being a guardian is  a big responsibility, and not one to be taken lightly. If there is time to plan before a crisis, you can save so much time and money, and prevent a lot of family conflict, by having some straight forward documents executed that spell out your wishes.  If you think your aging parent needs a guardianship, your lawyer can work with you to accomplish that. What plan do you have in place in the event of your own incapacity?

Guardianship of An Aging Parent - the Process

Having to consider a guardianship over an aging parent is difficult, although sometimes necessary.  In most cases, if someone has a comprehensive durable power of attorney drafted and a health care proxy in place, that should do away with the need to pursue a guardianship. However, if the appriopriate documents have not been drafted, or if they are insuffucient to meet the needs of the elder, a guardianship may have to be sought. 

A guardianship is a legal relationship whereby the Probate and Family Court give the guardian the power to make personal and financial decisions for the ward (the person who is no longer competent.)  A guardian can be appointed when someone is incompetent due to mental illness (including dementia or Alzheimer's disease), mental retardation, or physical incapacity.

Below are some of the steps that must be taken. 

First, you should have your parent or loved one  evaluated by a physician to determine if, in fact, they are unable to care for themselves.  In some cases, such as when someone has had a stroke and is completely incapacitated, this may be clear, whereas in other cases, such as someone with memory loss, it may be less clear whether the person is still able to handle their own affairs. 

If the physician determines that the proposed ward is unable to care for themselves, you would then need to file a petition in the Probate Court requesting that a guardian be appointed. Two petitioners must sign the petition, and the proposed guardian must file a bond with the Probate Court.  The Court will require that the proposed ward and their heirs receive notice of the petition.   The Court sets a date by which anyone, including the proposed ward, may object to the guardianship. Then, a hearing is held and the judge decides whether a guardian should be appointed. 

A temporary guardian can be appointed for 90 days, or a permanent guardianship can be establish. A guardianship lasts until the ward can establish that he or she is competent,  the ward passes away, or the guardian resigns or passes away or is removed by the Probate Court.