Elder Attorney vs Advanced Directive?

Suka9

My DW has EO at 52.  I would like to make sure things are in order while she is still able to.  She is willing to sign an Advanced Directive with a notary public that I got from her primary doctor.  Is that the same thing as what an Elder Attorney would do to give me power of attorney? 

I'm very happy that there is so much useful information on this site.

SusanB-dil

Hi Suka9 - welcome to 'here', but sorry for the reason

They are not the same. What the doctor gave you is most likely for medical power of attorney and medical directives. That is needed for medical decisions and HIPAA accesses, but do get DPOA. (durable power of attorney)  DPOA is better than POA.

Suka9

Thank you!  I will definitely look into that.

MN Chickadee

The advanced care directive may give you access to her medical records and to know her wishes for decision making and end of life stuff, but you want an air-tight durable power of attorney drawn up by an lawyer. You will need it for banking and financial institutions and if you ever have to move her to a long term care facility against her will, and much more. An elder law attorney can also help with financial planning to protect you (and if you have children) to the best extent possible. Since you are young this is really important, you have a lot of good years left so you want good financial planning for her long term care, whether that is in your home or in a facility or both at varying times. Get advice from an attorney in your state since Medicaid rules vary by state. They can also advise on getting social security disability or any other benefits she may be entitled to.

SunnyAB

An Advance Directive is about her wishes for end of life care. It is not a healthcare POA or a HIPAA authorization. You need: 

1. Advance Directive: so you know her wishes and medical staff knows her wishes if you are not available. 

2. General HIPAA authorization: that you can provide to ANY healthcare provider in order to discuss her medical situation. 

3. Healthcare Power of Attorney AKA Healthcare Proxy: gives you the power to make healthcare decisions for her in the event that a doctor determines she is incapacitated and unable to make her own healthcare decision. 

4. Durable Power of Attorney: This allows you to represent her in financial/business matters. The "Durable" means that it is still valid even if she is incapacitated. 

Although it's not technically necessary to have these forms drawn up by an estate attorney or elder care attorney, you will likely get a better quality document. The meeting will also give you an opportunity to discuss things like how you will pay for her future care while also maintaining some financial security for yourself. 

Suka9

Thank you.  This is very helpful.

FineWineNJ

Hi Suka9.

You are smart to start managing your wife's affairs early.  

It may be a little costly, but you should definitely seek out an elder law attorney.  As others here have advised, you need a "durable" POA so you can manage ALL matters relating to your wife's needs (medical, financial, etc.)  

You also need the Advance Health Care Directive, including a DNR section to ensure your wife's wishes are legally documented.  

Additionally, have the attorney draw up her Will.  Make sure your DW names you as the Funeral & Disposition Representative so you have authority over her funeral arrangements (not all Wills include this important section).  Why is this last point so important?  Because your rights as POA end upon her passing.  I learned that from the second elder law attorney I hired!  

Finally, learn all you can about Medicaid.  Most people don't know that Medicare does NOT pay for long term care (LTC) in assisted living or skilled nursing.  Only Medicaid covers LTC, and there are very specific rules to qualify.  Bottom line, find a great elder law attorney and learn all you can.

Finally, if there are others who need to be involved in decision-making (siblings, children, etc.), make sure everyone is consulted and on the same page.  

Wishing you and your wife all the best.

PlentyQuiet

My DH has EO as well. In addition to making sure I could manage the things I needed to (DPOA etc) I also thought about the worst case scenario. 

I have 2 kids, 18 and 20, and if something were to happen to me then they would need to step in to care for their dad. I spent extra time with the CELA making sure it would be streamlined for adults with comparatively little adult life experience. I have a file with my current financial roadmap, important contact numbers, a note on how to be DH's fiduciary (a lot of rules for money if medicaid is a possibility), and finally a note from us both that states that they are not to sacrifice their lives for his care. If that means MC placement instead of staying at home so be it. That last one is signed by both of us as a way to try and ease some of the future guilt they may feel. 

The CELA was really helpful in getting me to think through possible outcomes, what was needed, and to get a solid plan in place. 

Suka9

Very helpful!  Thank you.

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