Caregiving Support: Initial steps after you or your loved one has received a troubling diagnosis

First Things First: Getting your affairs in order

It is hard to know where to begin once you have received a troubling diagnosis. First, take a deep breath and remember, right now you only have to face today, tomorrow will take care of itself. 

There will be many scenarios that you will need to plan for, and you will need to consider a variety of legal documents. Some of these fall under the category of Advance Directives, which include Durable Power of Attorney for Health Care, also known as a Health Care Proxy, and a Living Will. These can easily be completed with two witnesses or a Notary. 

Another important document to consider is a Financial Power of Attorney (POA), which addresses financial matters, and requires the assistance of an attorney. It is highly recommended that you consult an Elder Law Attorney for this, and not a general practice lawyer, as the Elder Law Attorney is an expert in retirement/estate planning, paying for health care and the laws regarding Medicaid. The Living Will and Durable Power of Attorney forms are often completed as part of a package if you engage an Elder Law Attorney for assistance with your estate planning. 

A Living Will is a document that every adult should complete, and review every few years, especially as they get older, as opinions can change over time. A Living Will is a form that an individual fills out which instructs their loved ones and medical professionals on what treatments they would or would not want should they become incapacitated and unable to make decisions for themselves. It is meant to be a guide, and is not definitive, as it cannot anticipate every possible scenario. Living Wills are very beneficial for families because it helps to relieve feelings of confusion and guilt if a loved one needs to make a tough decision, as they know they are following the ill person’s wishes. This form can be filled out on your own and have two witnesses sign it. The witnesses should not be designated as a health care proxy. 

A Health Care Proxy form is used to designate one or more people to make decisions for you, should you no longer be able to make decisions for yourself. You can name anyone whom you believe will be willing and able to carry out your wishes, it does not have to be a family member. 

In the absence of this form, there is a hierarchy for decision makers designated by the State. First, a State Appointed Guardian, then spouse, then Adult Child, then parents, then siblings, then other potential extended family members. You can name one person as your proxy, and an alternate. It is important to tell your designated proxy what your wishes are. As with a Living Will, no attorney is required. This form can be signed by you in front of a Notary, or with two witnesses who are not designated as decision makers. 

You can access these forms and see frequently asked questions at The State of New Jersey Department of Health website: 

https://www.nj.gov/health/advancedirective/ad/forums-faqs/  

Putting a Financial Power of Attorney (POA) in place is extremely important as well. The person you designate does not have to be family, but should be someone you can TRUST, and is up for the task. Designating a POA will allow someone else to have access to all of your finances. They will be able to write checks on your behalf, access all financial records, pay your bills, sell property, pay taxes, manage investments, etc. Designating a Financial Power of Attorney requires a lawyer. If the individual in question has a dementia diagnosis, putting the POA in place must be a priority, as only someone who is deemed competent can legally designate a POA. 

It is a lot to take in, but you do not have to go through this alone. Reach out to family and friends, your faith community, your doctor, or to respected community resources for assistance, such as the Department on Aging, or the staff at NeuroCog Solutions.

If you have questions about life planning, NeuroCog Solutions offers caregiver counseling and life planning guidance to support you through this journey.

Michelle Rutigliano, LCSW

Michelle Rutigliano is a Licensed Clinical Social Worker who earned her Master of Social Work degree from Hunter College School of Social Work in 1995.  She majored in Gerontology and Group Work.  Her social work career has spanned over 25 years and has been exclusively focused on assisting families coping with memory loss and physical illness.  Michelle is certified through NASW to engage in Advanced Care Planning conversations in New Jersey.  Michelle has a strong desire to help clients and families prepare emotionally and practically for their future.  She has a clinical interest in Cognitive Behavioral Therapy, Acceptance and Commitment Therapy and Motivational Interviewing techniques.

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