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You are very wise to ask this question now, at a time when you are still able to express your wishes and intentions.
People who outlive their trusted friends and family members have several options when considering who to designate as a surrogate (a person who steps into your shoes and manages your finances). Here are 3:
1 - You can establish a Trust that is managed by a financial institution. Banks and trust companies in your state may have a minimum account size, but if the value of your assets are high enough, and the trust company accepts your account, a trust officer would be responsible to manage your income and expense payments.
2 - In my state (Massachusetts) the state has provided funds to local charitable agencies, such as Jewish Family Services, and they provide social workers and attorneys who manage Probate Conservatorship accounts and Guardianships services for people who have no close family members, or people who are caught in the middle of family conflicts.
3 - Your state may have Pooled Trust account services available from a charitable organization that administers funds for people who are unable to manage their own funds. However, the charitable agency will probably require authority from your state's Probate Court in order to step up and serve your needs.
Talk with an elder law attorney in your area as soon as possible. Your local senior center or elder services agency can help you find an attorney to help.
My thoughts and prayers are with you. Here is a number to Caregiver Homes they might be able to help you. They send a caregiver into the patients home to care for them. It is state funded and very little cost to you if accepted into the program. 978--621-3184. I wish you the very best!
@Kitty106, if you can afford it I would recommend a professional fiduciary or other professional. Some geriatric care managers can also be your POA.
Your financial POA will end up overseeing most aspects of your care as dementia progresses. As JohnnyJ notes, it is often a LOT of work and I've often seen friends get overwhelmed in this position. (Family members get overwhelmed too.) Professionals have an easier time as they know the ropes, plus they are being paid to do the work.
If you don't have family, it usually simplifies things to have the same person be financial and medical POA.
In my own state of California, doctors are NOT allowed to be medical POA for their patients. You will need to find out what restrictions apply to your state.
Otherwise, I agree with the other posters' suggestions re planning ahead and leaving guidance as to what types of care to prioritize once you've declined further. A doctor named Stanley Terman has a website (Caring Advocates) that specializes in living wills for people with dementia; this might be helpful to you.
I am sorry for your diagnosis and admire you for being proactive about your situation.
JoAnn 29, God Bless you for your work on your Mom's house!! My folks farm only had 40 plus years of accumulation, and still it was a Big job. Kudos for sticking with it until it is sold. Prayers are with you as tasks become more like drudgery, the longer we do them!! So Hang in there!!
Johnny J. God love you. What an unselfish thingvto do. I just couldn't do again what I have had to do for Mom. Cleaning out a four bedroom 125 yr old farm house was not easy. My Mom kept everything. My sister died 20 yrs ago and my Mom brought her clothes home from 2 states away. I gave a lot away. Still have house to sell. Then I need to find a place for my nephew who has disabilities. After all is said and done, I don't want to handle anyone elses life but me and husbands.
I was given the POA for my long time friends finances and health care since they had no children nor close relatives. We had known each other for 40 some years, shared the same faith, worshipped together, vacationed together. There was no one near in their life to turn to other than me. The wife's second cousin in another state became second POA and another friend, who really didn't want to do this, 3rd. He lives near by and can cover for me when I am out of town. It is a lot of work, but it has worked well. The wife had been diagnosed with frontal temporal dementia and the husband has short term memory issues and can't take care of himself. I like very much the writers who are simplifying their life and getting rid of things. My friends were caught off guard with this turn of events and going through their things has been a long process, though not totally unenjoyable. When I find things from their past and learn more about them, it only deepens my appreciation for who they were. The wife only lasted a little over two years from when I was made their POA--there was no way to stop what was happening to her brain. The husband may live a long time yet--he is physically healthy at age 90--and I am just happy I have him placed in an excellent memory care facility that monitors him several times every day and makes sure he gets his meds on time and goes to meals. He thinks he is doing just fine and does't need the attention, but accepts it. I have another couple of month's work to do in their condo before it is ready to sell. After that, I am expecting life to be a little easier for me.
I have been dealing with my Mom in the hospital then rehab. Dealing with these "professionals" has been tiring. It's a long story but even though the hospital had Moms meds and confirmed them with me an important med was dropped during her stay in the hospital. Even though this med showed on her discharge papers to rehab, they chose not to give it to her because...she hadn't had it in the hospital? I had a care meeting 10 days after Mom was admitted to Rehab at which time I found out she wasn't on her thyroid med and hadn't been since the 16th of Oct. My Mom has Graves and this med keeps her numbers in the good. I am trying to find out why it was not ordered. And why I wasn't told about it. Her levels have been checked and TG they R good. Her med has been resumed. I'm telling you this so you will constantly ask. Don't assume because they have her med list, it's followed. Since my Mom is being doctored on a regular basis for her Graves I don't feel another dr. should stop a med without consulting the doctor who sees her regularly.
You can have a lawyer but make sure your Medical POA is plain with your wishes. Ex: no feeding tubes, no extreme measures like hooking you up to a breathing tube. Make sure ur medical POA is on record at all ur doctors offices and any hospitals you may go into. Make sure that drs and hospitals have a DNR order in place. Have it available for EMTs. Putting a friend in charge would be nice but POA is a lot of responsibility to put on anyone, even a child. A friend would need to be a lot younger. I find at 67 I'm tired of dealing with all that is involved with POAs.
I live in California - each state may be different - but I 1st of all have a Revocable Living Trust into which I titled all of my assets. Currently I am the Trustee. When/if I am no longer able to handle my affairs or am deceased I have a professional fiduciary who will become my successor trustee. She is a member of PFAC (Professional Fiduciaries Association of California). They are licensed and bonded. I also have caregivers for my pets named. She also has my medical POA if I become unable to do it my self. I have no family that I would trust with any of this - and it is also a huge responsibility that a lot of people would not want. My fiduciary will be paid from the trust funds. By having the caregivers named (whether for me or for my pets) they can go to my lawyer - or court if necessary - if the fiduciary is not doing her job and request a change to another PFAC fiduciary. I feel it is the safest way to have my wishes carried out (I also have everything spelled out in trust documents as to my care, pets care, disposal of assets, etc. so there is no doubt on anyone's part what I want) Beware of having a bank do this as they will not manage your care just your assets.
Hi kitty, bless you. I am alone too, and there's a post I copied and saved this summer because I found it so useful! Posting there, attributing the member ruthieruth - hope some of it will be useful to you.
Time to plan the endgame... ruthieruth on AgingCare.com July 2016
I am in a similar situation. I don't have Alz but have memory issues and lots and lots of physical disabilities. What I did is made a Will and Advanced Directive and an Alzhiemer advanced directive...even if it's not "legal" in my state, it covers a lot of the "wants" and I attached it to my advanced directive that is legal. It lets my wishes be known. I also completed the Compassion and Choices paperwork in a way that suits my preferences, regarding Right to Die. I think, whether Pro or Con, it's important to state MY WISHES, because sometimes doctors get funky and try to play God with insurance, and dole out care based on what they think is covered, VS what is actually covered, and what a person wants. So i got very specific and wrote it down. I also made a video explaining everything. I made a different video for my caregivers..This is how i like my hair brushed, This is what i like to eat. Like a series of training videos. These are the topics i covered: Food and diet Medications (I take this one with food. I know the doc said this, I do it like this....) Groceries Shopping Clothes and Laundry Passwords and Financial Accounts (I also dictated permission to my bank to let the person who is pay on death have permission to close the account even if some of the paperwork was not exactly correct...etc. Don't know if this will work, but i explained it.I have filled out a financial POA....) I did a video of explaining what i do for fun, a bit of my family history, etc..all of the things a person would need to know to care for me is on video. What kind of toothpaste i use....etc etc etc. mentioned the video in my ADvanced directives. I also made a video that explained, for instance, when my friend had a stroke and needed a feeding tube, I don't want that. that i am OK with this treatment in this situation etc...as many as i can think of, and my reasons why. It might sound kind of creepy, and I didn't do it all at once, but once i got it done, i felt really at peace, like I could stay in the present minute and not worry too much about the future. I also sold a LOT of my stuff. Took pictures of it, but simplified. Saves on caregiving costs. in terms of the actual person to name on the DPOA, i started hanging out on some of these websites where young millennials hang out and watched for the smart ones, that I basicaily agreed with, who don't back down easy, and are good advocates. Finally asked one or two of them to be a final advocate for me, and to watch my videos. Introduced these people to my friends, and doctors, had them fingerprinted, and referenced. I mean, what the heck. Didn't know my first grade teacher either. Leap of faith. I talk to my doctors A LOT. And yes, my attorney. Hope I go in my sleep, quietly and peacefully, like my grandpa did. Not kicking and screaming like the folks in the backseat of his car......:) good luck to you.
Garden Artist. I was not advertising. I was offering viable solutions that would save time and energy. My intentions were to offer resources. I offered three comprehensive information including websites on solutions that most people are not aware exist in this area. Aging Life Care Professionals and Daily Money Management is not well known to many. They have websites with listing of those who can support her in her location. I have no idea where this person is located and I am certain it's not where I operate. It is likely that IKOR does not have an office where she is located. This person needs assistance and I provided a comprehensive list and how to access the services she requested that were not mentioned by other posting on the thread. Most people appreciate having professional insight on their situation, not just from those who are navigating a complex situation themselves. If you check my history I often respond and do not mention my affiliation but in this instance it felt pertinent to the discussion because most people were offering general solutions. I offered specific solutions that would save time from jumping through hoops with the county area on aging and with attorneys that are usually only generally aware of some of these options. I will receive no personal benefit from offering any of the solutions I offered.
I am sorry you now have dementia, but the fact you are writing us tells me you are still of sound mind to appoint someone to handle your affairs. If you trust your bank, then you can appoint the agent for the bank. For your medical wishes, you can appoint your doctor, or a trusted friend. Make sure you get all of your wishes IN WRITING and NOTARIZED. Since I am the youngest sibling left, I may have the same problem since I intend to living longer than my 3 sisters, so I am going to take my own advice. Best wishes Kitty!
If there is an IKOR office in your area www.ikorglobal.com. They do Geriatric Care Management and Daily Money Management acting as POA. The website for A Geriatric Care Manager aka Aging Life Care Professionals has a listing for all areas of the US http://www.aginglifecare.org/. Geriatric Care Managers handle the Care and routine living concerns. A Daily Money Manager will handle financial area their website also has listing of people who will act as Financial POA. I recommend IKOR because IKOR handles both areas medical, care related and routine financial area.
Just so you know I think you are a rockstar. 88 years old navigating dementia, searching the Internet and calling the shots in your life. It's really awesome that you are accepting the diagnosis, understanding it and calling the shots. I admire you. I own an IKOR office in Pittsburgh and I adore clients like you. I can tell that you will get the help you need. You're on the right track. You're in my prayers.
My aunt wanted someone close by to her and trustworthy. Her kids only met one of those and I am an hour away. She appointed a long time friend who she used to work for for both DPOA and HPOA. This has worked well for us. She does the work but always keeps me informed and asks my input for anything major.
Kitty -- Consult an attorney who specializes in elder matters. They will tell you whether they can do it, or suggest someone who can. So far, you are functioning will for someone with dementia. I am 85, and have appointed my older son to be in charge of my financial and medical future. I wish you the best of everything.
I am likely going to be in this same position some day. My first move would be to ask my attorney if my close friend is no longer able and my husband gone. The county you live in usually has an agency on aging that could possibly help direct you. I wish you the best of luck and many good years still. {{Hugs}}, Katie.
Brandy, there must be some type of resources there. Is moving to a more populated place an option? Check your Area Agency on Aging. These offices are on a regional basis. It may be in your county or a neighboring one. Often they are in offices with the Council of Governments. Asking your attorney is also a very good idea. Often, they get quite expensive and should you get to the point of needing care it would add up fast.
Have you looked to see what sort of senior care living options are available?
I live in the backwoods. Where would I find a geriatric care manager? We don't have things like that here. Ask my atty about it? I am to see a lawyer soon.
I would find a geriatric care manager. They can help find an appropriate place to live should the time come. They can help identify a financial POA as well. Ask for recommendations from trusted friends.
Kitty, I understand fully your situation. I have no siblings thus no nieces nor nephews, and I have no children. I am close to some cousins but they are senior citizens themselves, and also have no children.
Right now my sig other is my financial Power of Attorney. If something should ever happen to him, then there is a CPA who has a small firm, so I would elect him to be my financial POA or anyone in his firm. Of course, payment would be made out of the estate for time used.
I'm sorry for your diagnosis, it has to be scary wondering what's ahead for you. POA does not have to be family. You may have a trusted friend, a financial advisor, or if you have someone do your taxes, you could ask them. You say you do not have family, do you mean to say that there are no cousins or nieces or nephews even? If so, one of them might be willing to serve in that capacity for you. Please let us know how you are doing, for as long as you can. Bless you.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
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I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
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This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
People who outlive their trusted friends and family members have several options when considering who to designate as a surrogate (a person who steps into your shoes and manages your finances). Here are 3:
1 - You can establish a Trust that is managed by a financial institution. Banks and trust companies in your state may have a minimum account size, but if the value of your assets are high enough, and the trust company accepts your account, a trust officer would be responsible to manage your income and expense payments.
2 - In my state (Massachusetts) the state has provided funds to local charitable agencies, such as Jewish Family Services, and they provide social workers and attorneys who manage Probate Conservatorship accounts and Guardianships services for people who have no close family members, or people who are caught in the middle of family conflicts.
3 - Your state may have Pooled Trust account services available from a charitable organization that administers funds for people who are unable to manage their own funds. However, the charitable agency will probably require authority from your state's Probate Court in order to step up and serve your needs.
Talk with an elder law attorney in your area as soon as possible. Your local senior center or elder services agency can help you find an attorney to help.
978--621-3184. I wish you the very best!
Your financial POA will end up overseeing most aspects of your care as dementia progresses. As JohnnyJ notes, it is often a LOT of work and I've often seen friends get overwhelmed in this position. (Family members get overwhelmed too.) Professionals have an easier time as they know the ropes, plus they are being paid to do the work.
If you don't have family, it usually simplifies things to have the same person be financial and medical POA.
In my own state of California, doctors are NOT allowed to be medical POA for their patients. You will need to find out what restrictions apply to your state.
Otherwise, I agree with the other posters' suggestions re planning ahead and leaving guidance as to what types of care to prioritize once you've declined further. A doctor named Stanley Terman has a website (Caring Advocates) that specializes in living wills for people with dementia; this might be helpful to you.
I am sorry for your diagnosis and admire you for being proactive about your situation.
I have another couple of month's work to do in their condo before it is ready to sell. After that, I am expecting life to be a little easier for me.
Time to plan the endgame...
ruthieruth on AgingCare.com
July 2016
I am in a similar situation. I don't have Alz but have memory issues and lots and lots of physical disabilities. What I did is made a Will and Advanced Directive and an Alzhiemer advanced directive...even if it's not "legal" in my state, it covers a lot of the "wants" and I attached it to my advanced directive that is legal. It lets my wishes be known. I also completed the Compassion and Choices paperwork in a way that suits my preferences, regarding Right to Die. I think, whether Pro or Con, it's important to state MY WISHES, because sometimes doctors get funky and try to play God with insurance, and dole out care based on what they think is covered, VS what is actually covered, and what a person wants. So i got very specific and wrote it down. I also made a video explaining everything.
I made a different video for my caregivers..This is how i like my hair brushed, This is what i like to eat. Like a series of training videos.
These are the topics i covered:
Food and diet
Medications (I take this one with food. I know the doc said this, I do it like this....)
Groceries
Shopping
Clothes and Laundry
Passwords and Financial Accounts (I also dictated permission to my bank to let the person who is pay on death have permission to close the account even if some of the paperwork was not exactly correct...etc. Don't know if this will work, but i explained it.I have filled out a financial POA....)
I did a video of explaining what i do for fun, a bit of my family history,
etc..all of the things a person would need to know to care for me is on video.
What kind of toothpaste i use....etc etc etc.
mentioned the video in my ADvanced directives.
I also made a video that explained, for instance, when my friend had a stroke and needed a feeding tube, I don't want that. that i am OK with this treatment in this situation etc...as many as i can think of, and my reasons why.
It might sound kind of creepy, and I didn't do it all at once, but once i got it done, i felt really at peace, like I could stay in the present minute and not worry too much about the future.
I also sold a LOT of my stuff. Took pictures of it, but simplified. Saves on caregiving costs.
in terms of the actual person to name on the DPOA, i started hanging out on some of these websites where young millennials hang out and watched for the smart ones, that I basicaily agreed with, who don't back down easy, and are good advocates. Finally asked one or two of them to be a final advocate for me, and to watch my videos. Introduced these people to my friends, and doctors, had them fingerprinted, and referenced. I mean, what the heck. Didn't know my first grade teacher either. Leap of faith.
I talk to my doctors A LOT.
And yes, my attorney.
Hope I go in my sleep, quietly and peacefully, like my grandpa did. Not kicking and screaming like the folks in the backseat of his car......:) good luck to you.
Of course you recommend IKOR - that's your screen name and most likely you work there. Who do you think you're fooling?
I've reported your post.
Just so you know I think you are a rockstar. 88 years old navigating dementia, searching the Internet and calling the shots in your life. It's really awesome that you are accepting the diagnosis, understanding it and calling the shots. I admire you. I own an IKOR office in Pittsburgh and I adore clients like you. I can tell that you will get the help you need. You're on the right track. You're in my prayers.
Have you looked to see what sort of senior care living options are available?
Right now my sig other is my financial Power of Attorney. If something should ever happen to him, then there is a CPA who has a small firm, so I would elect him to be my financial POA or anyone in his firm. Of course, payment would be made out of the estate for time used.