Six Tips for Health Care Decision-Makers

Medical ConsultationIf you've perused much on our website, you are aware that there are two distinct Power of Attorney roles: a General Power of Attorney, which gives an agent authority to conduct business for an individual, and a Health Care Power of Attorney, in which the agent is granted health care decision-making powers. Some people believe that managing financial or business matters is the more difficult job. Not necessarily so. Making important health care decisions on behalf of another person can be a mentally and emotionally exhausting responsibility. If you are named as an agent in someone's Durable Health Care Power of Attorney or you are appointed by a court as conservator for another individual you could easily find yourself in the position of having to make critical health care decisions, literally life-or-death decisions, for another person.A few years ago I served as a conservator for a gentleman whose health took a very sudden downward turn. He went from being in relatively good physical health to being on life support in a matter of days. Managing his medical care from the moment he entered the emergency room through the end of his life was full of challenges that stretched out over several weeks. I want to share some tips with you that may help you if you are serving as a health care decision-maker.• Be sure you've had a conversation with the person who has named you as their agent so that you thoroughly understand their beliefs and desires about how they want to be medically treated or not in the future. There are many tools you can use to help guide the conversation. At Elder Law of East Tennessee we keep a supply of My Way booklets on hand for the benefit our clients and their agents.• Educate yourself about the history and current treatment for any known health or mental health issues, prescribed medications, or special dietary restrictions. You may be the one called upon to give a complete medical picture if the individual cannot speak for themselves.• Keep a copy of the Health Care Power of Attorney document handy for those unexpected trips to the emergency room, etc. Don't assume the doctors or hospital will have record of the POA from a previous visit or hospitalization. These providers need to feel confident that the document is current and still in effect.• Avoid leaving a vulnerable hospitalized person alone. If a person is sick enough to be hospitalized, chances are they are not well enough to adequately take in information or to ask and retain the answers to important questions. Be mindful that many of our older adults who suffer from any level of cognitive impairment, hearing loss, or vision impairment may need an on-site advocate. As Elder Care Coordinator I try to encourage my clients' families to visit and stay with a hospitalized loved one in shifts. If necessary, consider hiring caregivers.• Keep a legal pad or spiral binder in the room to record details such as what medications are being given and when, dietary restrictions, and names and contact information for physicians or specialists providing treatment. Elder Law of East Tennessee can provide guidance to help clients and their families communicate effectively with their doctors or other health care professionals.• Take the time you need to make decisions about treatment options. In most cases the need for a decision is not urgent. If you don't have the expertise to know what is best, ask for time to consult with another professional who can help you. Despite my previous experience in geriatric health care management, I supplemented my own knowledge by asking for assistance from the hospital's Ethics Committee when I had to make a critical decision for my ward.Elder law firms that do Life Care Planning have elder care coordinators like me on staff. If you don't have access to a care advocate through a your elder law attorney, Elder Law of East Tennessee will be happy to talk to you about how to find a care manager or medical advocate in your area.

Amelia Crotwell, JD

Amelia Crotwell, founder and managing partner at Elder Law of East Tennessee, has guided families through long-term care and special needs challenges for nearly two decades. Specializing in Life Care Planning and special needs trusts, Amelia also collaborates across all areas of elder law, including wills, trusts, Medicare, Medicaid, probate, and veterans benefits planning. Certified as an Elder Law Attorney since 2011, she is president-elect of the Life Care Planning Law Firms Association and co-chair of their strategic planning committee. Amelia is deeply involved in the Special Needs Alliance and a prominent member of the National Academy of Elder Law Attorneys. She played a key role in founding the Tennessee chapter of NAELA, serving as its first president. A member of the Tennessee Bar Association and past chair of its Elder Law Section Executive Council, Amelia also dedicates time to pro bono work and community education. She earned her J.D., summa cum laude, from the University of Tennessee College of Law and teaches Elder Law there as an adjunct professor since 2018.

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Understanding the Importance and Implications of Conservatorships