November 22, 2023

Quote of the Week:

“Instead of worrying about what you cannot control,

shift your energy to what you can create.”

― Roy T. Bennett

Welcome to this week's newsletter! In this edition, we are featuring a recap of our recent caregiver webinar, "Create a Secure Future: Advance Health Care Directives," presented by Kristen Boney, Supervising Attorney at Legal Assistance for Seniors.

Click play to watch the recording below:

Resources: Legal Assistance for Seniors (LAS) and HICAP

Legal Services provided at LAS:

• Government Benefits (Social Security, SSI, CAPI)
• Senior Immigrant Issues
• Elder Abuse Prevention
• Kin Caregiver Issues
• Planning for the Future
• Health Care Coverage (Medicare & Medi-Cal)
• Housing (limited case-by-case basis)
• Services are free

HICAP: Health Insurance Counseling and Advocacy Program

• Provides assistance with Medicare and related health insurance products by offering objective information and counseling to help consumers understand their benefits and rights. Services are free.
• HICAP for appointment:  510-839-0393

Legal Assistance for Seniors: (510) 832-3040

333 Hegenberger Road, Suite 850

Oakland, CA 94621

Here’s the main point: Before it’s too late…

Be prepared for unexpected occurrences, such as accidents or illnesses 

Ensure that your wishes and preferences are known & respected

PLANNING DOCUMENTS can prevent elder abuse.

Even if you are healthy, or think of yourself as young and don’t see the need now… Take a moment to look at what can happen to anyone!

Also — it’s not so difficult, expensive, or confusing.  Here we go — taking it one step at a time: (take a deep breath — we’ve got you)… 

Advanced Health Care Directives (AHCD): What they do and don’t do…

• Allows you to appoint an AGENT. You don’t have to appoint an agent. And you can even state who you DON’T want to be your agent. You can appoint an alternative agent in case that person can’t do it, when it’s needed.  
• What does you AGENT do:  WHAT YOU TELL THEM YOU WANT THEM TO DO, if you can’t “speak for yourself” or you just want help speaking for yourself
• You can state what you do and don’t want for your health care.
• You can state what you want after you die — example organ donation, burial or not…
• Your agent can speak for you and act for you to in terms of your housing.
• It should be someone you trust to do what you want!

Even without an agent your Advanced Care Directive can state what you want:

• What kind of care do you want, or not want as medically advised. 
• What you want after you die to be done with your body.

These are choices you get from your health care team to deal with medical issues you are facing.    Obviously you can’t know, when you’re healthy, what you might face.  But here are the kind of choices you might have: (As Hamlet said, “to be or not to be…”)

Situations that are not expected or are not likely to change: (examples)

1.  End stage renal failure — aka — your kidneys don’t work. This could mean it’s a choice between dialysis or not surviving.

2.  You can’t swallow.  This could mean it’s a choice between permanent  feeding tubes or not surviving.

3.  Permanent ventilator, because you cannot breath on your own.

3.  You can’t understand your situation because of disease affecting your ability to understand — like moderate to severe dementia.  This could cause you to have to be moved out of your home, for example.

• There are many versions available:
• AHCD kit from California Medical Association for a small fee www.cmanet.org or 1-800-882-1262 
• AHCD form through CA Attorney General for free at www.ag.ca.gov/consumers/pdf/AHCDS1.pdf
• Five Wishes - https://www.fivewishes.org/ 
• Your health care provider may offer one

If you have any questions about filling out advance planning forms, consult with your doctor and/or an estate planning attorney: 

https://www.acbanet.org/need-a-lawyer/ or call (510) 302-2222 option 4

The POLST: This is a medical order, completed by you and your physician. (no court, no notary, just you and your doctor)…

What you put on your refrigerator door for if-or-when paramedics come to help you ,they know what you want! CPR or not… Once in the hospital it will also address other “life saving measures” versus “comfort care” only. 

This information can be (should be) in your Advanced Health Care Directives, also— discussed above here.

What is COMFORT versus LIFE SAVING MEASURES?

Medical care that is meant to…       

• Comfort is to make you “comfortable”
• Life saving care  is to “cure” you.

Something to discuss with your doctor!

For other issues besides medical/end of life that are important to plan for… like financial decisions! When you (the principle) can’t speak for yourself or you want help speaking for yourself… And similar to Advanced Health Care Directives — you (the principles) can appoint an AGENT.

Your agent will share decision making about your finances with you. It’s inexpensive and private to create such an agreement. You can make it as broad or very specific as you want. Make sure your AGENT is trustworthy.  This can easily be abused to not necessarily serve YOUR best interests.  see more details here below:

• “Making the agent's powers durable allows the agent to continue to act even if the individual loses mental capacity to make their own decisions.
•  Alternatively, an agent can have a springing power of attorney that takes effect when the individual becomes unable to manage their own finances. 
• The DPOA should specify how a third party (i.e., bank) would know the principal cannot manage their own finances. For example, a declaration from a doctor or friend could be attached to the DPOA. 
•  It can designate two agents, or one agent with one or more alternates in case the first agent cannot act.
•  The signature must be notarized to ensure that banks and other institutions will honor the DPOA.
•  If the agent is handling real estate transactions, the individual should record the DPOA at the County Recorder’s office.
•  You can revoke a DPOA by providing written notice to the agent.”

Wills and estate planning or trust. Who gets your stuff?

Without either a will or estate planning or creating a trust — your money, property, etc. will go to your “legal relatives”.

Who are legal relatives?: 

https://www.lawinsider.com/dictionary/relative-or-family-member

Solo press - How to make a will:

https://www.nolo.com/legal-encyclopedia/make-will-quick-checklist-29480.html

What is the difference between a will or a trust: here’s a link from NCOA (National Council on Aging):

https://www.ncoa.org/adviser/estate-planning/living-trust-vs-will/

Important: What to do with these documents once completed:

• Keep the original in a safe place where your loved ones can find it.
• Note: You may revoke or change an AHCD or DPOA at any time 
• Often AHCD kits have wallet cards to keep with you.”
• Put your POLST on your refrigerator. Make sure your medical team (hospital, etc.) has a copy.

CAPACITY: This can be understood as temporary or permanent.

How do you or anyone know when you can’t speak for yourself?

"In general, capacity requires the ability to communicate the decision by any means, and to understand and appreciate”

“If capacity is questionable, evaluation by a neuropsychologist can be advisable before the person signs any legal documents”

CONSERVATORSHIP:  Is related to capacity (see above).

“Conservatorship is a legal status in which a court appoints a person to manage the financial and personal affairs of a minor or incapacitated person. A conservator may also serve as a guardian who is responsible for establishing and monitoring the physical care of the individual and managing their living arrangements.”

Together, we can make a meaningful difference in the lives of

elders and the caregivers who selflessly support them.

DayBreak is committed to offering essential support to elders and caregivers navigating diverse difficulties. If you know a senior in need of our care and coordination services, or if you're aware of a caregiver seeking assistance,

encourage them to reach out to us at:

510-834-8314