How to Get Power of Attorney for Elderly Parents
The Caring Generation® – Episode 36 May 6, 2020, On this caregiver radio show, caregiving expert, Pamela D Wilson, talks about How to Get Power of Attorney for Elderly Parents—Helping Elderly Parents Make Decisions. Guest Dr. Dawn Buse, Director of Behavioral Medicine for the Montefiore Headache Center in New York, shares research about Migraine Headaches.
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How to Get Power of Attorney For Elderly Parents Radio Show Transcript
00:04 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation with host Pamela D. Wilson is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
00:48 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation radio program coming to you live from the BBM Global Network Channel 100 in TuneIn Radio. The Caring Generation focuses on conversations about health, well-being, caring for ourselves, and loved ones all tied together with humor and laughter, that are essential to being a caregiver. Helpful information for caregivers and aging adults are on my website at PamelaDWilson.com, where you’ll find articles in my caregiving blog called Caring for Aging Parents. Our topic for this radio show is “10 Things That Families Should Know About how to Get Power of Attorney for Elderly Parents,” and helping elderly parents make decisions.” This is a subject that caregivers ask me about when they become frustrated with how to deal with aging parents.
Power of Attorney: What You Need to Know About Making Life-Changing Decisions
01:40 Pamela D. Wilson: You might wonder why I can talk about the subject of how to get power of attorney for elderly parents. I served as a power-of-attorney-in-fact, that is the technical wording, but we’ll use power of attorney to make this very simple, and as a court-appointed guardian for my clients who were elderly parents, single adults, and disabled children, and I did this for over 10 years. I’m the person, like you, if you’re the person who is appointed, who made medical and financial decisions based on the wishes expressed in my client’s power of attorney documents. Let me be clear. I am not an attorney. I’m not a lawyer. I am a professional fiduciary and a caregiving expert. Spouses, adult children caregivers, anyone who is helping elderly parents make decisions by serving as a power of attorney has a fiduciary responsibility. In simple terms, this means that you have an ethical responsibility to act in the best interest of an aging parent when making decisions about health, well-being, and money. So we’ll talk about 10 things that you should know about how to get power of attorney for elderly parents, and helping elderly parents make decisions.
02:54 Pamela D. Wilson: On this subject of how to deal with elderly parents, some children tell me this gives them headaches. We will be talking about headaches and the relationship between the stress of caring for aging parents, and migraine headaches, or really any stress like work that gives you a migraine. Our guest tonight is Dr. Dawn Buse. She is a licensed psychologist, a clinical professor in the Department of Neurology, at the Albert Einstein College of Medicine, in New York, and a member of the board of directors of the American Headache Society. Dr. Buse has won seven national and international awards for her research on migraines. She really knows what she’s talking about, and it’s going to be a great interview. Let’s get back to number one of the 10 things that you should know about how to get power of attorney for elderly parents, and helping elderly parents make decisions.
03:49 Pamela D. Wilson: Power of attorney does not give you—this may shock you—legal permission to take over the life of an elderly parent. The idea of wanting to take over is very attractive for some adult children caregivers who feel that their aging parents are not making good decisions. Surprise, we all have the right to self-determination and making bad decisions without asking anyone’s opinion or approval. If we’re honest with ourselves, we’ve all made a wrong decision every now and then, and that doesn’t mean that somebody else can or should take over making decisions for us unless. The unless is number two of the 10 things that you should know about how to get power of attorney for elderly parents and helping elderly parents make decisions. There’s a term you might hear called capacity. Do elderly parents have the capacity to make decisions? What does capacity mean, and how do you know?
04:48 Pamela D. Wilson: Let’s look at the opposite term that relates to helping elderly parents make decisions. It is incapacity. Incapacity is a legal term that anyone who is deemed to be incapable of making decisions might find derogatory or unpleasant depending on whether your aging parents, in this case, agree that it’s time to talk to adult children about how to get power of attorney for elderly parents. The other instance related to incapacity is when mom or dad has a brain disease like dementia or Alzheimer’s and they don’t realize that their brains are faulty and making bad decisions. Incapacity is a legal term. Legal terms are not emotionally sensitive. You can find the legal definition of incapacity by Googling your state’s probate code for the definition. I’ll give the meaning, and I’ll also put a link in the show transcript that will be on my website at PamelaDWilson.com in about a week from this show so that you know how to search for this information in your state.
05:50 Pamela D. Wilson: In Colorado, the state statute that defines persons under disability is 15-14-102. In Colorado, an incapacitated person means, an individual not a minor, who is unable to effectively receive or evaluate information—or both—or make or communicate decisions to such an extent that the individual does not have the ability to satisfy requirements for physical health, safety, well-being, or self-care, even with technological assistance. So you might wonder, who makes this decision about capacity or incapacity and helping elderly parents make decisions, and why is this important? How to get power of attorney for elderly parents happens when aging parents or anyone has capacity, has a clear mind, and makes good decisions, although the decision about who to appoint can definitely be the wrong decision. If, as an elderly parent, you appoint a child who takes advantage of you.
06:52 Pamela D. Wilson: We’ll talk about who to appoint later in the show. Capacity allows estate planning documents that include a medical and a financial power of attorney and a living will. In the documents, there is usually a statement that says, if one or two doctors confirm that I cannot make good decisions because of a health diagnosis, I agree that the person in this document can make decisions for me. Up until this point, it’s evident that an elderly parent agrees on the process of how to get power of attorney for elderly parents. Even without a doctor confirming incapacity, an elderly parent can voluntarily allow the power of attorney to help with decision-making. We’ll talk about two unexpected situations that take this plan off-track. Your elderly parent has completed POA documents. The physician agrees that mom or dad isn’t making good decisions and that you should make decisions. Mom or dad disagrees, or even worse, mom or dad didn’t complete documents. They’re making bad decisions about money and health. The physician agrees. Now you want to have power of attorney documents completed so that you can make decisions. It’s too late if your parent is incapacitated. They can’t sign POA documents. What now? Instead of how to get power of attorney for elderly parents, you are looking at guardianship and conservatorship through a legal court process.
08:12 Pamela D. Wilson: More of the 10 things you should know about how to get power of attorney for elderly parents in the second half of the show. Up next, Dr. Dawn Buse talks about stress and migraine headaches. This is Pamela D. Wilson on The Caring Generation. Visit my website, PamelaDWilson.com, for more information for caregivers and aging adults. You can check out all of the past podcasts of this radio show under my media page. You click down four, and all the podcasts and the transcripts are there if you’d like to read. My caregiving blog, it’s called Caring For Aging Parents, is also on that website. There is so much helpful information for caregivers and aging adults. Please do share this information, one in four people that you know are caregivers looking for hope, help, and support. This is Pamela D. Wilson on The Caring Generation live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with me, we’ll be right back.
11:21 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. With us is Dr. Dawn Buse to talk about the relationship between stress and migraine. Dr. Buse, welcome.
11:37 Dr. Dawn Buse: Hi, Pamela, thanks for having me.
11:41 Pamela D. Wilson: My pleasure. So talk to me, what is a migraine, and how does somebody know if they have a migraine versus a normal everyday headache?
11:51 Dr. Dawn Buse: That’s a great question. So migraine is most often a moderate or severe headache. But it’s got some cardinal features that make you think this is migraine. Those are going to be extreme sensitivity to light, to sound, to smell, nausea or impairment, like you really need to go to a dark, quiet room and lay down. And those are features that are fairly unique to migraine. So if you’ve got any of those associated with your severe headache, it’s worth talking to your doctor about.
12:25 Pamela D. Wilson: And when I was younger, I used to get migraines. But it was more because I ate MSG or I was drinking wine at the time, red wine. So what’s the relationship between stress and migraine, and does food come into that in any place?
12:39 Dr. Dawn Buse: Well, absolutely Pamela, you just described triggers. We say that someone has migraine, the same way that someone might have dementia or epilepsy, or we like to say living with migraine. And then a migraine attack is when the headache and those other symptoms happen. What might cause a migraine attack for someone who’s living with migraine is a trigger. That may be changes in hormones. That may be changes in stress. That may be changes in diet. And Pamela, you shared with me actually before the show that there are certain foods that you knew were pretty predictable for you as triggers for migraine, and I think you’ve been avoiding them most of your life ever since, is that right?
13:18 Pamela D. Wilson: Yeah, that is correct. I don’t want to have those. Oh, those migraines are horrible.
13:23 Dr. Dawn Buse: Yes. And I think a lot of people living with migraine. There’s actually 40 million Americans and one billion with a B, people around the earth who are living with migraines. I think a lot of people probably already know their triggers. Now, some like a certain food you can avoid. Some you can’t really avoid. And unfortunately, for all of us, stress is one of those that we can’t really avoid.
13:47 Pamela D. Wilson: So, as we continue to have these migraines throughout life, does our age or anything else make us more likely to have a migraine?
13:58 Dr. Dawn Buse: Oh, migraine is very, very age-related. In children, we’d see about 6%, 7%, 8% of the population having migraine. And then when girls hit puberty, it skyrockets for young women, up to as much as 18% of young women, and even higher having migraine. And men, adult men are more in the 6% range. It peaks during mid-life, which is, of course, when people are the busiest. Probably possibly caring for their own children, caring for aging parents, holding down jobs, caring for their households. And then for the majority of people with migraine, it quiets down after the mid-50s, which is after menopause is complete for women or about a corresponding time for men. So most people who’ve lived with migraine most of their life, tend to get some relief during the 60s, the 70s, and onward. If someone has a first migraine attack after age 50, that’s a red flag, and you should call a doctor immediately, and the doctor should go into your history and see what’s going on because the overwhelming majority of people will start at a young age.
15:11 Pamela D. Wilson: You know, you mentioned that I actually had two friends who are over age 50, who had severe headaches, and went to the emergency room and they weren’t really diagnosed with anything. What could that mean? Is that a migraine, or might it be something else?
15:26 Dr. Dawn Buse: Even if it is a migraine, a physician is going to want to check out all the cardiovascular factors around it, and make sure that everything is okay in the brain and the nervous system and that nothing is going on that’s concerning. We call that a secondary headache. When it’s secondary to some other condition, like a stroke or something structural in the brain. So, I don’t want to scare listeners. Because most of the time it’s a good old fashioned migraine. But that’s one of our advices, after 50 if you have your first onset of migraine, talk to your doctor about it. If you’ve been having migraines your whole life and you’re used to it, and you continue after 50 or 60 or any age, that’s not necessarily anything to worry about. Although with age, your healthcare professional may change your treatment. The mainstay of acute pharmacologic or medication therapy for migraine is a triptan, and triptans are contraindicated or not advised for people who’ve had a heart attack or other serious cardiovascular events. So, some people may have started their medication decades ago in their teens, their 20s, their 30s, taking the same medication for decades, and it’s good to re-check in with your physician about your age. About what’s going on with comorbidities and say, “hey doc, is this still the right medication for me because it might have changed?”
16:53 Pamela D. Wilson: So, I’m a parent, and I have a child or a teenager who’s starting to have headaches, do I go see a primary care doctor or do I want a specialist?
17:03 Dr. Dawn Buse: Right. Okay, first off, I’m not surprised, and I would expect that you might have had parents and grandparents who had migraine and that you might have a child who has migraine or two. As someone with migraine, if you have one parent with migraine, you have a 50% chance of also having it. Two parents with migraine give you about a 75% chance. So, it really strongly runs in families. So, for a younger person starting out experiencing migraine, absolutely, start with the pediatrician or primary care doctor. For the majority of people in the world with migraine, a primary care professional can do wonders and take care of what needs to be taken care of. If that doesn’t seem to be enough for some complicated reason, you and your primary care professional might decide that she should see a neurologist or even a headache specialist. But it’s great to start with a primary care professional.
17:58 Pamela D. Wilson: And are headache specialists, how do you find them? That’s a silly question, but I mean, how would I find—do I Google headache specialist? [chuckle]
18:04 Dr. Dawn Buse: Nope, it’s really easy. They’re listed. Because they are specifically certified. You can go to the American Headache Society webpage, the American Migraine Foundation webpage, the National Headache Foundation webpage, or my website. And all four sites will give you a link to people in the US who are headache experts. Because again, there’s about 600 or 700 of them. So depending on where you live, you might or might not be close to someone. They are more in the bigger cities. Nonetheless, most states have at least one nowadays, and we’re getting more and more headache specialists all the time, so you can find them on any of our national organizations’ websites.
18:52 Pamela D. Wilson: Perfect. We will continue our conversation with Dr. Dawn Buse after this break about stress and migraines. Helpful information for caregivers and aging adults is on my website. This podcast will be there in about a week, where you can download the podcast, or read the radio show transcript. Go to PamelaDWilson.com, click on the media button, and click on The Caring Generation radio show. This is Pamela D. Wilson, your host, you’re listening live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with me. We’ll be right back after this break.
21:36 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host, you’re listening to The Caring Generation radio program for caregivers and aging adults coming to you live from the BBM Global Network Channel 100 and TuneIn radio. Let’s continue our conversation with Dr. Dawn Buse. Dr. Buse, so, do feeling anxious, worrying, and just being over-excited relate to having a migraine?
22:03 Dr. Dawn Buse: Well, yes, remember we talked about triggers. So, it would not be what causes you to have the disease migraine, that’s really a genetic predisposition. But what triggers migraines can be changes in stress. Both increasing levels of stress and decreasing levels of stress. So, it’s kind of a sad state of affairs that sometimes someone will get through a stressful period, and then have a migraine attack at the end of it. So the first day, once they get on vacation or after finals week, the first day of spring break, we call that a letdown headache. So, it changes. So, the migraine brain or the nervous system assigned with migraine does its best with very regular routines, and we use the mnemonic SEEDSS, S-E-E-D-S-S, so regular sleep, regular exercise, regular eating and drinking, social support, and stress management. And those seven things can make a world of difference in managing not only migraine attacks, how often they happen, but how frequent or how severe they are, how intense they are, and how quickly they resolve.
23:14 Dr. Dawn Buse: That’s not to say that someone may not want to also use a medication after talking with their doctor, and in fact, 97% of people with migraine do use a medication at the time of the migraine. But you don’t have to. And keeping those regular routines is very, very important. However, we do know that about 30% of people with migraines have anxiety, and about 30% have depression, and it’s a little bit of a chicken and the egg. If someone has anxiety first, we also see migraine more commonly later. Same thing with depression. Or if they have migraines first, we see depression and anxiety later. So, it may not be that one causes the other. It may be some underlying neurotransmitters that act on all three of the conditions. And I want to say that because I don’t want people to blame themselves. It’s not that they’re not coping well enough, or they’re not strong enough. Migraine depression and anxiety all travel with the same neurotransmitters, and they just travel together.
24:22 Pamela D. Wilson: And when you say they’re hereditary—there’s just, it’s something in us that—like you say, I’m not blaming myself, but I was born with whatever this is, and I happen to have it, and that’s why I get the headache.
24:33 Dr. Dawn Buse: You are born with it, as you told me, Pamela.[chuckle]
24:37 Pamela D. Wilson: Yes.
24:39 Dr. Dawn Buse: And it has been with us as humans as far back as pre-language. So, there’s pictures of it in Egyptian hieroglyphs. And so, that means it’s not going away. So, there may even be as much as this is terrible, painful, debilitating, unpredictable disease to live with; it may have had some functional survival benefits. So, when the light became too bright, and there were strange smells, and the storm was coming, and things were dangerous, maybe the person with migraine ran into the safety of the cave, and someone without stayed outside. But whatever it is, it’s been with us for human history. And so, it seems like it might be here to stay. But there are things we can do, medication and non-medication that can make living with migraine much more bearable.
25:32 Pamela D. Wilson: And on the medication forefront, so people who take medications, do they take them all the time or just when you have the headache or before you think you’re having the headache?
25:41 Dr. Dawn Buse: There’s two types. There’s the therapies that you take when the headache happens, or the migraine happens, and then there’s prevention. Which you do on a regular basis, which comes in just a couple of different forms. There’s a pill you take every day. There are actually botox injections that you get every 12 weeks or some new therapies which are called monoclonal antibodies. Which you give yourself a shot once a month, and behavioral, like cognitive behavioral therapy and relaxation therapies and biofeedback. Those are all considered preventive. Things you do to avoid having attacks altogether. So there’s those types of therapies. And for someone who experiences frequent and debilitating migraine, if they’re working with a healthcare professional, they may be doing both approaches.
26:36 Pamela D. Wilson: And how are sleep and migraine-related?
26:39 Dr. Dawn Buse: They’re very closely related. We know that people with migraines have higher rates of several sleep disorders, sleep apnea, restless leg, insomnia, as well as migraine, of course, exacerbating those. When you’re in pain. It’s not easy to sleep. So migraine affects sleep quality and affects insomnia. However, as I mentioned, it’s one of those cardinal seven things that we really want to keep it regulated, and by regulate, I mean boring. Go to sleep at the same time every night. Wake up at the same time every day as much as possible, seven days a week, and get enough sleep. And the nervous system just thrives with that routine. It does really, really well on the regular routine. So sleep is something that we do have more control over, as well as stress management. I love the quote by Jon Kabat-Zinn that says, “We can’t stop the waves from coming, but we can learn how to surf.” So, whether it’s living with migraine or living with other challenges and stressors in our lives, there are things that we can do to cope the best that we can and to control the disease the best that we can.
27:48 Pamela D. Wilson: And if I don’t want to take medication and I want to learn how to manage my stress, and I’m not doing it well, do I see you? Who would I see to get help with that?
28:01 Dr. Dawn Buse: Yes. So you could see a psychologist. And there’s a couple of things that have excellent data. That’s going to be biofeedback, which is really an interesting thing to do. Where you’re hooked up to some leads, and you see the effect of stress on your body, cognitive behavioral therapy, and relaxation training. And more and more, some of these therapies, do no longer do you need to go to a psychologist. Some of them are coming to the convenience of your own home. I personally am involved in working on bringing biofeedback to the smartphone, and that’s something that will be in the App Store this year, as well as other companies who have other biofeedbacks that you can do right in your own home. There are relaxation exercises. I offer several for free on my website. But you can find them all over iTunes and YouTube. And cognitive behavioral therapy, you can see a psychologist, or you can try to do a kind of at-home or online approach. But all three of those have great evidence for both helping migraines, as well as helping stress.
29:11 Pamela D. Wilson: That sounds wonderful. I think I would do that even if I wasn’t having a migraine headache. [chuckle]
29:16 Dr. Dawn Buse: Yeah.
29:17 Pamela D. Wilson: Dr. Buse, I thank you so much for joining us. Up next, we will continue our conversation of the 10 things that you should know about how to get power of attorney for elderly parents. Again, this show, this podcast will be available in about a week on my website at PamelaDWilson.com. This is Pamela D. Wilson, your host. You’re listening to The Caring Generation live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with me, we’ll be right back.
32:03 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. This is The Caring Generation radio program for caregivers and aging adults, live on the BBM Global Network Channel 100 and TuneIn Radio. Follow me on social media on Facebook. My Facebook page is PamelaDWilson.page. On Twitter, I am CaregivingSpeak, on Instagram, wilsonpamelad, and LinkedIn, pameladwilsoncaregiverexpert.
32:27 Pamela D. Wilson: Number three of the 10 things you should know about how to get power of attorney for elderly parents and helping elderly parents make decisions is; do not wait to complete these documents. I had some clients who waited until they were in the hospital emergency room. Me and an attorney and a notary had to show up to complete these documents. Also, don’t wait if your parent has a diagnosis of dementia or Alzheimer’s. It can progress, and they may not then have the mental capacity to complete the appointment and the documents. Not a situation that you want to be in. How do you know for sure if your parent has capacity? A neuropsychological evaluation by a neuropsychologist who works with the probate court system is the best way to confirm that an aging parent is able or not able to move forward with the process to appoint a power of attorney. If you have that evaluation, it supports the ability to get power of attorney for elderly parents who have capacity and avoids being questioned later. If you do have to petition for guardianship or conservatorship, that neuropsychological evaluation goes to the judge, along with some court paperwork. Then it’s up to the judge to confirm if that medical and other information meets the statutes that we talked about for guidelines for incapacity.
33:46 Pamela D. Wilson: Number four of the 10 things you should know about how to get power attorney for elderly parents, this assumes an aging parent has capacity, is who to appoint. For a married couple, the obvious person is the spouse as the first power of attorney. After a spouse, it usually is a child or another family member. When elderly parents make these decisions, they want to look at the family situation. Are there children? How many? Do the children live in the same city as the parent? Are they responsible? Are they capable? Are they willing to make medical decisions and manage money? If you’re the parent, do you think your child is an excellent fit to manage your money and make healthcare decisions for you? Do you trust them to follow your wishes?
34:27 Pamela D. Wilson: Looking at how to get power of attorney for elderly parents is as significant as picking the person that you marry. You have to trust this person with your money and your life. And if any of your children are likely to need or want your money, probably not a good idea to appoint them. Would they make medical decisions to hasten your death? These questions may sound crazy, but they’re not. I’ve seen these things happen in families. Helping elderly parents make decisions can go wrong when you choose an irresponsible child, a friend, or somebody else. This is why how to get power of attorney for elderly parents can involve choosing a professional fiduciary instead of a family member. This was what I did. Making money and financial decisions for aging parents can put adult children in emotionally challenging situations, especially if siblings disagree with the decisions that are being made.
35:18 Pamela D. Wilson: Number five of the 10 things that you should know is to understand the decisions that you have to make, and be sure that you’re willing to make them. If you’re the person who’s appointed, you want to know all the responsibilities. Being a power of attorney—in addition to helping elderly parents make decisions—means that you’re usually the primary caregiver. Are you ready for that? Being a power of attorney can be time-consuming. It’s like having a second job in addition to that full-time job that you go to every day. You make medical decisions, including life or death decisions. You decide how money is spent. Do you have brothers and sisters who are supportive, or have their own financial self-interest? Meaning, they might battle with you over every single decision, over every penny that is spent? Families who don’t get along are one of the main reasons that adult children caregivers decline to be the power of attorney. Adult children who don’t get along or who are irresponsible are one of the reasons that aging parents choose professional fiduciaries when thinking about how to get power of attorney for elderly parents. For adult children caregivers who become the power of attorney, helping elderly parents make decisions involves learning how to deal with aging parents and how to work together as a team.
36:34 Pamela D. Wilson: As the power of attorney helping elderly parents make decisions, you have to follow the wishes and direction of your aging parents, even if you disagree. This is part of being in that fiduciary role. While you can talk about the decisions, you have to follow your parents’ directions if they have capacity. Can you see yourself in a position of doing what your parents tell you even if you disagree? As long as they have mental capacity, that’s your responsibility. Then, what happens if you follow your parents’ directions and your brothers and sisters are disagreeing? Who will you side with? The answer should be that you support the decisions of elderly parents, and you are helping parents follow through with their decisions.
37:16 Pamela D. Wilson: That gives us number six of the 10 things you should know about how to get power of attorney for elderly parents. In some situations, you may have to hire professionals to support the decisions of your parents and your decision to follow through, so that you can reduce family friction when your brothers and sisters disagree. Consulting experts to verify the reasonableness of decisions can avoid nasty family court battles. If you want to learn more about that, listen to The Caring Generation podcast called “When Families Don’t Get Along.” My interview on that show with elder law attorney Spencer Crona shares stories of caregiving situations gone wrong that you definitely want to avoid.
37:55 Pamela D. Wilson: Consulting a care manager or a financial planner is also helpful if you want to learn how to manage money. If you have questions or doubts about making healthcare decisions, if you have to take money out of financial plans, and you want to make sure you’re doing it right. This helps you gain confidence in the decisions that you want to make. Being power of attorney is a very serious role. Many parents complete the documents, and they throw them in a filing cabinet or a safety deposit box. They hope that they will never have to use these documents. Sometimes they don’t even tell their children that they’re appointed or tell professionals. I used to get calls from people all the time saying, “Well, you’re my power of attorney, I need your help now,” and I had no idea I was even appointed. The process of appointing and working with a power of attorney, it really is more than that piece of paper that you hope that you never have to use. We’ll talk more about how to get power of attorney for elderly parents, coming up after this break.
38:56 Pamela D. Wilson: You can follow and like The Caring Generation on your favorite podcast apps. You can add those apps to the cell phone of your aging parent and have them listen to all of these podcasts. The more we know about caregiving, and all of the unexpected situations that continue to arise, the more prepared we can be to have caregiving discussions. The Caring Generation is on apps like Apple Podcast, Google Podcast, Spotify, Spreaker, Stitcher, Pandora, iHeartRadio, Castbox, SoundCloud, and even Amazon Alexa. This is Pamela D. Wilson, caregiving expert, visit my website PamelaDWilson.com for helpful information for caregivers and aging adults. I am your host. You’re with me on The Caring Generation live from the BBM Global Network Channel 100 and TuneIn Radio. Stay with me. We’ll be right back after this break.
42:14 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, this is The Caring Generation, coming to you live from the BBM Global Network Channel 100 and TuneIn Radio. What does a caregiver do? Answers to this and other caring questions are on my website, PamelaDWilson.com, in my caregiving library called The Caring Generation. Articles, tips, and caregiver support are in this library for family caregivers and for professional caregivers. You can subscribe for free to gain access to more articles in my caregiving membership library.
42:45 Pamela D. Wilson: Number seven of the 10 things that you should know about how to get power of attorney for elderly parents and helping elderly parents make decisions. Is that as power of attorney, you are in the role, and you have the responsibility of initiating conversations with elderly parents about care. If you’re the primary caregiver, you know how difficult having any conversation about care with elderly parents can be. Conversations about how to get power of attorney for elderly parents can be equally difficult. Talking about planning for healthcare needs and money, also a tough subject. Being in the caregiving role of helping elderly parents make decisions without being controlling, bossy, impatient, or condescending, that takes some caregiving skills. As the adult child caregiver who is the power of attorney, you will benefit from learning to see situations from the perspective of your elderly parent, which may be very different from the way that you see the situations today. This aspect of how to deal with aging parents is a skill that we learn. Successful conversations with elderly parents happen when we can think about our responses instead of reacting immediately.
44:00 Pamela D. Wilson: When I had my care management business, I taught my care managers the idea of reflect before responding so that we don’t do the idea of foot-in-mouth or saying something that you can’t take back. Especially when you’re trying to help elderly parents make decisions. How to get power of attorney for elderly parents means that we’re having conversations with elderly parents about what they want for care, and about what they are willing to spend on care, as far as money. Elderly parents will have to tell you how much money they have. That’s another tricky, uncomfortable conversation. In having all of these conversations with elderly parents as that medical power of attorney, you want to know about their health diagnosis, the prescriptions they take, and you want to attend medical appointments with them.
44:44 Pamela D. Wilson: Why? Because it’s you who has to help them make healthcare decisions and decisions about how to spend money on care. If you don’t know about this information, how can you be a responsible power of attorney? How to get power of attorney for elderly parents, it’s like being married to your parents. To be effective, you need to know everything. Well, almost everything. Sometimes too much information is too much information. A lot of my clients, because of knowing that our conversations were confidential, they told me things that they would never have dreamt of telling their adult children. And of course, I couldn’t tell their children either. In the power of attorney role of how to deal with aging parents, you might become a confidant for your parents. You have to realize that confidential information they tell you, they may not want you to tell your brothers and sisters. Can you be that confidant? Can you zip up your lips? [chuckle]
45:37 Pamela D. Wilson: Number eight of the 10 things you should know about how to get power of attorney for elderly parents and helping elderly parents make decisions, is that the healthcare system has absolutely no idea of the roles and the responsibilities of a power of attorney. What does this mean? It means that as the power of attorney, you put the documents in the file of your elderly parents at their doctor’s office, every healthcare place. Being that power of attorney gives you access to their medical records. You talk to doctors, and you help make healthcare decisions. There will likely be a point, whether at a hospital or a nursing home, that your request or decision is questioned. It’s as if the healthcare system says, “Who are you?” The healthcare system doesn’t realize the powers or responsibilities of a power of attorney. Here’s a couple of examples: When I was a medical power of attorney for my clients, I would ask the physicians to contact me before changing any medications. Why? Because I knew the health conditions of my clients and how they might react to certain medicines. Physicians would change prescriptions without my knowledge, and my clients would suffer bad health consequences. The doctors would prescribe medications to which my clients were allergic, without checking. You will come across these circumstances, I promise you when you start to manage medical care for elderly parents.
46:55 Pamela D. Wilson: Let’s talk about financial institutions and banks. Most financial institutions make it difficult for how to get power of attorney for elderly parents. You may have correctly drafted legal documents. The banks will make you fill out additional forms, more paperwork. Banks who are not familiar with working with a power of attorney will always send your paperwork to their legal department for review. It can be a nightmare. It can be time-consuming. But banks and financial institutions are difficult for good reasons. Many of them allowed a family member who wasn’t a power of attorney to have access to money, and financial abuse was committed. So, all of these extra hoops, it’s a good thing. My advice though is don’t wait to go through the process of having your name if you’re the power of attorney, added to medical records, and put on bank accounts. Because in some cases, especially for the banks, you will have to do extra paperwork. Your parents will have to sign extra forms, and it can take a little bit of time. Especially if there are investment accounts and things like that.
48:00 Pamela D. Wilson: In all power of attorney situations, you want to be on a first-name basis with the doctors and the medical care staff, including care agencies and any person that you hire to care for your elderly parents. Your relationships with these contacts is very important. It’s very essential for you to have success in getting the care that you want for elderly parents. It’s like the idea of gathering flies with honey. You want them to work with you. If you don’t, trust me, they cause all sorts of problems. I’ve had this when providers didn’t agree with my decisions. When they questioned if I really understood what my clients wanted. When they didn’t want to provide medical care for my clients. And I had to argue and say, “Yes, this is what my clients would want. This is what you will do.” You might wonder how this will happen. Healthcare providers disagreeing with you as power of attorney. We could talk about that in an entire another show. I’ve had providers report me to the police, to adult protective services, the ombudsman, and advocates when I disagree with them.
49:07 Pamela D. Wilson: As a power of attorney, you advocate for your parents, and this advocacy does involve disagreeing with providers. You can fire doctors. Doctors can fire you. It’s all part of how to get power of attorney for elderly parents and going through the decision-making process for elderly parents. More information about power of attorney is on my website. You can go to the search button and type in “power of attorney.” Many articles will come up. A lot of information will come up in addition to the show in about a week. Go to my website, PamelaDWilson.com, and type information into the search bar. This is Pamela D. Wilson, your host. This is The Caring Generation live from the BBM Global Network Channel 100 and TuneIn Radio. Next week, we’re going to be talking more about caregivers and help for caregivers who are trying to keep elderly parents in the home. This can also involve your responsibilities as being the power of attorney for elderly parents. So, if you haven’t had the power of attorney conversation yet with your parents, it is time. This is Pamela D. Wilson, your host. This is The Caring Generation live from the BBM Global Network Channel 100 and TuneIn Radio. Stay with me. We’ll be right back.
51:39 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host. You’re listening to The Caring Generation, coming to you live on the BBM Global Network Channel 100 and TuneIn Radio. The number nine of 10 in how to get power of attorney for elderly parents and helping your elderly parents make decisions is to make sure that when the documents are created, that there is a backup plan for you. Caregiving is stressful. Statistics confirm that 30% of caregivers die before the person for whom they provide care. That means your healthy parent, and possibly you. You or an elderly parent don’t want to be in a situation where your sick, elderly parent dies, and there was no successor power of attorney for helping elderly parents make decisions, or the same happens with you, and there’s no successor. What is a successor? It’s a backup person. I recommend having two or three successors listed in the documents for helping elderly parents make decisions. So the healthy spouse, child number one, child number two, another person. Because the people who are appointed may die before it’s time for them to act, and you don’t want to have to try to create new documents or go to court to create new documents to appoint a successor. You can avoid those financial costs.
52:57 Pamela D. Wilson: I know that this happens because in many cases, I was a successor where no one else was named. It’s not a good situation. It can place that person, your elderly parent, in limbo for their care and financial assistance while all of these plans have to be redone. And number 10 of 10 in how to get power of attorney for elderly parents is for you. If your elderly parent needs help making decisions, one day, you will too. Create your estate plan at the same time that you are working through how to get power of attorney for your elderly parents. Most important of all, use a qualified attorney for helping your parents make decisions and get these documents. A qualified attorney is an elder law, an estate planning, or a probate attorney. Don’t use a family law attorney who is your friend or who might be willing to do you a low-cost favor. Not using an expert, it has the potential of creating costly nightmare situations later when those documents are not correctly drafted.
54:00 Pamela D. Wilson: Not all attorneys, and this includes attorneys who sometimes specialize in elder law, probate or estate planning—unless they litigate, unless they go to court for contested hearings—many of them don’t know what can and what does happen when helping elderly parents make decisions and family members disagree—your brothers and sisters, other people in the family. The goal is to have well-drafted documents. It’s to make the work very smooth for you as the power of attorney, avoid family disagreements, avoid expensive court hearings, and other situations like disagreeing with healthcare providers. These things happen in families when people don’t get along. When the wrong person is appointed. When the person doesn’t know how to manage care or make good decisions. During my years as a power of attorney and a guardian for clients, I testified at so many contested family hearings that honestly destroyed family relationships, because adult children disagreed or hated each other.
55:01 Pamela D. Wilson: I was appointed by married couples over their adult children caregivers who were unqualified. Don’t put yourself in this situation. If you have ideas for The Caring Generation Show, you can post suggestions on my social media channels or send me an email through my website. There is a contact page there. PamelaDWilson.com, go to “contact me.” All of these show ideas that I talk about; they come from you. Thank you for being proactive and interested in caregiving, aging, health, and well-being, and for being dedicated and amazing caregivers. Share The Caring Generation radio program and The Caregiving podcast with everybody, you know. Thank you for joining me live on the BBM Global Network Channel 100 and TuneIn Radio. I am Pamela D. Wilson, caregiving expert, advocate, and speaker. Join me on The Caring Generation next Wednesday evening. Invite your friends and family to join us. God bless you all, sleep well tonight. Have a fabulous day tomorrow and a great week until we are together again.
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