The differences between a Power of Attorney and Court-appointed Conservators and Guardians are quite substantial. One can be done prior to its need arising, while the others are usually done after a traumatic incident has occurred and decisions for the person must be made by another party. The differences will be discussed in part as they pertain to Long Term Care Medicaid.
A Power of Attorney, or POA, for medical decisions and financial transactions is a set of documents that will allow someone of your choosing to make decisions for you if you should become incapacitated and are not able to make decisions on your own. The POA's may be done years in advance of being needed and can be done thru an attorney or with forms available at office supply stores or online.
With these documents, you may appoint someone with whom you're confident, who will make choices on your behalf. For instance, if you discuss your preferences ahead of time with your POA, the appointee would know if you want life support if needed, or if you do not want to be put onto life support. Likewise, a financial Durable POA can pay bills out of your bank account for you, sell a vehicle, or even your home if required for long term assisted housing.
For Colorado Medicaid, it is advisable in the financial Power of Attorney to include an additional paragraph that pertains to setting up trusts. Most documents have a general reference to trusts. However, Colorado Medicaid requires special verbiage in the document to work with the State. The verbiage required includes "create, amend, revoke or terminate an inter-vivos trust." The State of Colorado requires this be included in a financial POA so the POA can set up a Medicaid income trust for the person-in-need, if required. (Please refer to previous articles where I've discussed income limits for the Long-Term Care Medicaid program.)
Many older POA's do not have this additional wording. Because it's only been recently that the State made this change, it would be advisable to review your current Powers of Attorney to see if this is included. Updating POA's every 5-10 years or so would be advisable anyway, as situations change with time.
Did you know that a Power of Attorney appointment ends with the death of the person for whom the POA was established? Should the person pass away, the person's POA, and their rights, end. It's at this point that an executor of a Will begins.
If a person does not have Powers of Attorney set up and there's a life-altering incident, such as a stroke, a court appointment for the person would be required. Conservators cover financial transactions and Guardianships take care of medical decisions. Generally speaking, a lawyer would be well-utilized in helping with the documents required for the courts. The Conservatorship/ Guardianship process can be cumbersome, so having an attorney who is familiar with the procedures is very helpful. Unfortunately, it's also costly.
Overall, the best advice would be to have Powers of Attorney set up while you're healthy and able to make your own choices. Including the inter-vivo’s wording ensures the POA will cover transactions that may be required.
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Editor’s Note: This article was submitted by Joell Gray, owner of JG Medicaid Consulting LLC. She can be reached at 970-216-4999 or by email at jg.ltc.med@gmail.com.
When supporting patients who wish to age comfortably at home, distinguishing between home health and in-home care can be key to effective patient support. These terms are sometimes used interchangeably, but each service addresses different needs in patient care. Lets clarify the distinction, as understanding these differences can help guide patients and families to the right kind of support for their circumstances.Home Health: Skilled Medical Care at HomeHome health involves medical care provided in the patient's home by licensed professionals, such as nurses, physical therapists, or occupational therapists. It is typically prescribed by a physician and can include wound care, medication management, chronic illness monitoring, and rehabilitation therapies. Examples of home health services include: Wound care for pressure sores or a surgical wound Patient and caregiver education Intravenous or nutrition therapy Injections Monitoring serious illness and unstable health status Home health focuses on supporting patients in recovering from illness or surgery, managing medical conditions, and preventing hospital readmissionsall in the comfort of their homes.In-Home Care: Assistance for Daily LivingIn-home care, on the other hand, is non-medical support provided by trained caregivers to assist individuals with daily living activities. This type of care can be short-termsuch as during recovery from surgeryor long-term for older adults who need continued assistance. Examples of in-home care services include: Assistance with bathing, dressing, and grooming Meal preparation Light housekeeping Companionship In-home care is especially beneficial for individuals who need support with daily activities but do not require medical intervention. The goal is to enhance quality of life by addressing personal and emotional needs while promoting independence.Choosing the Right Care for Your PatientsResearch suggests that some medical professionals may not always draw a clear line between home health and in-home care, yet understanding these distinctions can help patients receive the right type of support. Home health is ideal for those needing medical care at home, whereas in-home care focuses on enhancing day-to-day living for those who value independence but need extra help.Aging in Place with ComfortFor many seniors and individuals with chronic health conditions, aging at home is an important aspect of maintaining their quality of life. Advances in telemedicine and remote health monitoring have made it easier to integrate a mix of home health and in-home care services. This personalized approach not only offers a convenient care experience but also helps patients stay in control of their health journey.Comfort Keepers Can HelpComfort Keepers provides uplifting in-home care that helps seniors thrive. Our specially trained caregivers focus on developing genuine relationships with clients, keeping them physically and mentally engaged while ensuring they experience joy in their daily activities.If you know a patient or family that could benefit from Comfort Keepers services, they can reach out for a free consultation. Lets work together to help individuals age comfortably and confidently at home.
As we age, having all our legal ducks in a row becomes increasingly important before anything happens; for example, having a written will. But what is the best way to ensure others can safeguard your loved ones affairs if they cannot? Two common solutions are guardianship and power of attorney. A guardianship involves court-appointed authority over an incapacitated persons affairs, with broader and ongoing responsibilities and oversight. The power of attorney allows a competent person to give another person broad authority over their senior care options and other affairs without court involvement. When weighing guardianship vs power of attorney, it is essential to understand the differences and similarities between them. This article provides a broad overview; please consult an elder law attorney for your specific scenario. What is Guardianship? A guardianship is a legal arrangement in which a court appoints someone to make decisions for another person. This occurs only when a person becomes incapacitated due to disability, age, or another form of incapacity. The purpose of guardianship is to protect the best interests of the person, who then is considered a ward. Guardianship proceedings are held in court, and the guardian is appointed to serve the wards needs. Not all guardianships are the same. Like powers of attorney, there are several types, including: Guardian of the person: This person makes all decisions on behalf of the ward, including living arrangements, health decisions, and financial decisions. Guardian of the estate: Also known as a conservator, this person handles all financial decisions on behalf of the ward, including property, income, and expenses. Plenary guardian: The appointee handles daily and financial business for the ward. Limited guardianship: This person handles a specific area of responsibility for the ward. Guardianship is often a last resort when other less restrictive options are insufficient to protect an individuals interests. It is a significant legal responsibility, with the guardian expected to act with the highest level of integrity and care.What is a Power of Attorney? A power of attorney, or POA, allows a person to act in another persons stead. Depending on the scope of a power of attorney, the person named may be able to make health, financial, and any other decisions as per the termsThere are several types of powers of attorney, includingGeneral power of attorney: Allows the appointee numerous powers depending on the terms of the POA. Special or limited power of attorney: Has a specific purpose and is often used for property transfers or sales. Durable power of attorney: Designed to extend automatically should the maker become incapacitated. The terms of these POAs are generally broad. Nondurable power of attorney: Expires immediately if the maker becomes incapacitated. Springing power of attorney: Takes effect upon a specific event, such as when the maker of the POA becomes incapacitated. It is important to remember that the maker may revoke any power of attorney at any time, although some may have a time limit. Additionally, all POAs expire when the maker of the agreement dies. What is Incapacity for Guardianship Purposes? A guardian may be appointed when a person cannot manage their activities of daily living, such as personal care, property, or finances. A guardianship may occur when the subject of the guardianship petition is a minor or is suffering from a mental illness, physical incapacitation, or a senior with declining cognitive abilitiesSomeone who wants to seek guardianship must file a petition with the court. If approved, the guardian must agree to court oversight throughout the guardianship. The guardian must also demonstrate that the allegedly incapacitated person cannot manage his or her own financial matters, legal affairs, or personal careDoes a Durable Power of Attorney Help Prevent Guardianship? A durable power of attorney is a legal document you can use as a proactive measure. It can prevent the need for guardianship, assuming the person could execute the power of attorney before becoming incapacitated. In some cases, a power of attorney may only cover the principals financial affairs, while in other cases, it can help avoid guardianship proceedingsKeep in mind that the person executing a durable power of attorney can designate a trusted individual to make decisions on his or her behalf should the person become incapacitated. Powers of attorney may allow the person appointed to make health, legal, and financial decisions on behalf of the principal.Advantages and Disadvantages of Guardianship One of the most significant disadvantages of guardianship is a loss of autonomy. Wards may lose the right to make many personal decisions, including where to live. You must weigh the advantages and disadvantages of guardianship carefully to ensure the ward retains dignityAnother disadvantage is loss of privacy since guardianship proceedings are often a matter of public record. While there can be potential for abuse of authority, guardianships are complicated. There are reporting requirements and numerous legal steps that one must completeSome of the advantages of guardianship include ensuring the well-being and safety of the ward. Additionally, this step can help prevent financial exploitation because a trusted person manages finances on behalf of the ward rather than another entity or the state assuming control.Guardians also serve as advocates for their wards, ensuring they receive proper medical care, educational opportunities, and other essential services. The guardian is also regularly present in the wards life, providing stability and more predictable outcomes.Deciding Between Guardianship and Power of Attorney A guardianship proceeding can be complex and difficult under the best of circumstances and should only be implemented when there is no better alternative. You can often avoid seeking guardianship through the courts by creating a power of attorney as a piece of an overall estate plan. Every family is different but ensuring your family members physical and emotional well-being is essential to us all. How CarePatrol Can Help If your loved one needs senior care solutions, whether assisted living, nursing home, or another type of senior living environment, CarePatrol is here to help. Our local senior care advisors will meet with you to help you navigate the best senior care options for your loved one and even take you on personalized tours of the top three communities. The best part is that our service is provided at no cost to you. Contact a local senior living care near you to get started.
More than 16 million Americans provide unpaid care for people with Alzheimers or other dementias.Caring for a loved one can be a rewarding experience, but its not without challenges. These challenges can be significantly more impactful for those caring for a senior with Alzheimers disease or other form of dementia. Changes in behaviors can occur for a variety of reasons, including over-stimulation, physical discomfort, confusion, exhaustion caused by sleep problems, medication, or changes in routine.Understanding the cause of behavioral changes is critical for caregivers, families and friends. And its helpful for caregivers to know how to manage behaviors that will allow them to provide safe and effect support and diffuse tense situations.These behaviors can include: Depression Anxiety Confusion Aggression or anger Suspicion Hallucinations Pacing or wandering The most important thing that caregivers need to remember is that challenging behaviors may not be entirely avoidable. Its also not the fault of the person with Alzheimers or dementia. These behaviors are sometimes a common product of the disease. And, there is specialized support a caregiver can use to help keep a challenging behavior from escalating.While there is no guaranteed approach that will work with every person or situation, there are some methods that can help caregivers manage trying times:Staying calm Its not uncommon for caregivers to feel attacked or helpless when they are caring for someone exhibiting difficult behaviors. Remembering that it isnt personal and that its a symptom of the disease, can help caregivers manage their emotions and avoid contributing to tense or difficult situations. Arguing or reasoning can often escalate an outburst, so its necessary for caregivers to stay calm and supportiveKeeping a schedule Seniors that suffer from Alzheimers disease and other dementias often find it reassuring to have a set schedule for meals, activities and daily tasks. Creating a schedule, and sticking to it as much as possible, can help prevent anxiety, confusion and anger.Exercise Exercise, with approval from a physician, is a great stress reliever for both seniors and caregivers. And participating in activities together helps foster important emotional connections.Participating in activities Whether its an enjoyable hobby, household chore or physician-approved exercise, participating in joyful activities has shown to help manage challenging behaviors. These can be pre-scheduled or introduced when difficult behaviors are recognized. For example, caregivers can ask for help folding laundry to ease anxiety or can play music or sing to calm someone feeling confused, angry or depressed. Mindful communication Caregivers shouldnt underestimate the power of communication. Caregivers can use soothing tones, speak in a friendly way and make eye contact to convey normalcy, understanding and compassion. This can help seniors experiencing anxiety or frustration to calm themselves.Comfort KeepersCan HelpAt Comfort Keepers, we provide specific training for our caregivers and individualized care plans to provide care and support to seniors with Alzheimers disease and to their families. Our specially trained Comfort Keepers engage clients in intellectual, physical and emotional interactions that complement medical treatment and improve the quality of life for everyone involved. And they can facilitate stress management activities, support for physician-approved diet and exercise plans, provide transportation to appointments and will evaluate a home for safety as part of an in-home assessment. For more information on how in-home caregiving can help those with Alzheimers disease or dementia, contact your nearest Comfort Keepers office today. References National Institute on Aging. Managing Personality and Behavior Changes in Alzheimers. Web. 2017. Verywell Health. Complete Guide to Challenging Behaviors in Dementia. Web. 2019. Alzheimers Association. Stages and Behaviors. Web.