Maneuvering the Labyrinth When Taking Care of a Loved One

Whether a spouse, parent, or any loved one, there is nothing more terrifying than being faced with the task of caring for someone in their declining years.  Durable Power of Attorney; Healthcare Power of Attorney; Miller Trust; Home Health Care; Skilled Nursing; Senior Living; Assisted Living; Medicare; Medicaid; state health systems; hospitals; social workers.  It is a never-ending litany of people, situations, rules, and money.  And you are at the center of it all, trying to decide how to best care for your charge, making sure all their needs are met, figuring out how to pay for it all, and usually on a very short timeline.  In many cases a hospital stay can turn in to rehab stay which then morphs into skilled nursing in less than a two-week time period. 

For most people, insurance is a blessing.  But in many cases, the time allotted for hospital stays, rehabilitation, hospital readmissions, and level of care is determined by the insurance company.  It is an endless stream of phone calls, emails, and second-guessing to come up with a reasonable plan that won’t bankrupt your loved one or you.

If you are asked to be a durable Power of Attorney and/or Healthcare POA, or find yourself in that role, here are a few things of which you need to be aware:

First, you hold many cards with that POA title. As the POA, you are responsible for all things financial for the person in your care.  Read the document very carefully to ensure you understand everything in it; check with the loved one’s bank to determine the best way to pay bills; and find all important documents, e.g. car title, mortgage paperwork, insurance information, etc.  It will help should you continue to care of your charge for a longer period-of-time.

Next, if you hold POA over health issues, be aware that that you control level of care, and the post-hospital situation, whether it be a rehab facility, returning home, or something in between.  Know this: hospitals just can’t “evict” someone, especially if they have no place to go.  You can control when your loved one leaves and where they go AFTER ensuring that they are ready to leave.  Have team meetings with those responsible for your loved one’s care.  Hospitals have specialists, either social workers or case managers, who will walk you through your options.  They will deal with the insurance companies and meet with you to explain those options.  If yours doesn’t do that, find one who will.

Finally, be diligent in seeking long-term care situations. This will take some leg work; and be aware that there are companies who will help you with a “search” for facilities, but then turn your information over to that respective facility’s sales team.  These companies contract for a fee from the facility, but do not directly work with you to find the right fit.  Also, investigate your state’s Medicare/Medicaid programs and what will and will not be covered.  Look into Miller Trusts or setting up a savings/trust account to place asset funds for future expenses such as home health, private nursing, or long-term care facilities. 

My knowledge was obtained through personal experience, and I learned things that the “professionals” didn’t know.  Never discount the knowledge of a friend or another who has experience in dealing with these issues.  Seek them out and ask questions.  Communicating your needs, knowing what questions to ask, and obtaining the answers that best fit your situation will ease the stress and strain on you, as well as your loved one. 

Cary Foust Street is the principal and owner of 2-Way Street Communications.  She has had the honor and privilege of taking care of her mother and other loved ones in their later years, as well as work with others to more ably communicate their questions and obtain answers to better care for their charges.