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The following is a podcast from a qualified senior care provider, hurt, on the answers for elders radio show. And Welcome back to answers for elders radio everyone. I am here with a first time very special guest by the name of car and Typho, and carn is with aging care consultation services. CARN, welcome to the program thank you. I you know, I love this pronunciation of your name because I’m Swedish, Sah. So obviously I don’t know what your nationality is, but I’m Swedish as well. Well, it’s that my family back I have two cousins. My one cousin, her name is on a Carn, and I always love that. That’s just, you know, definite a connection for me. So let’s say we have something in common. Yeah, so carn is here everyone and and I think it’s a really important thing. We have not done enough on this topic, and that is talking about advance directives. And you know it’s kind of a blanket legal term that we don’t necessarily know what those are. And so obviously, first of all, before we begin, what does that mean? That blanket termed car and the advance directives were generally talking about legal documents where you’ve set out your wishes from what you want to happen in your later life. We’re at the end of life if you’re not able to communicate those decisions yourself right, right, and and you know there’s people just think it’s just the standard form, that you really don’t have a choice, and I think this is one thing that, when you have the right type of planning, you can make all kinds of determinations. Can’t you write as far as what happens when you can’t speak for yourself? Yes, so tell me a little bit about what’s most important in this process. Yeah, I think the most important thing is the conversation to have, whether it’s for yourself to sit down and talk with your doctor about it, or sit down with your family and talk about it, if you’re a family member with an older loved one that you’re trying to help, to really sit down and have the conversation and it’s not you know you’re going to die soon, but it’s I want to make sure that I’m giving the right kind of support that you want me to do. Have for you issue age and and so the conversation is really the first part there’s a great resource for folks called end of life Washington that has packages and all kinds of information on their website that people can download as far as conversation starter kits and ways that you can ask questions about different kinds of issues that need to be talked about, and it’s very helpful because when these things aren’t talked about, it can be very uncomfortable to try to start talking about it right and it. You know that that’s the uncomfortable piece. Nobody wants to talk about end of life, right, you know. And yet that is such a huge piece of elder care and, in a then the whole, because that’s really what you’re doing, is yours. You’re you know you’re in the twilight of your life. You know you’re in the sunset of your life, and and understanding that there is and responsibility there to your loved ones, because I think as the family caregivers and the adult children not there, they all want to do right by you. Yes, they just don’t know how unless you communicated. And how would they know how exactly? And it’s like we’ve had, you know, Dan White here from Wash Shelley, and he’s talked a lot about you know these things need to be taken care of an advance, and one of the things we talked about, and is that you know, if there’s no preplanning done in advance, for you know even your final wishes, your family members will tend to spend eighty percent more than what you really would, typical person, actually would want right. So the idea is, obviously, is that you know having these conversations, as difficult as they are, really is a service to your loved ones, and I think that’s really the key here, is to make sure that they know and that you appoint the right individuals that or one person or more than one, that have you know that you trust to make those decisions on your behalf. Is To is important and that’s again where that conversation comes in. Even if you feel really comfortable with the person that you’re choosing to list as your power of attorney, for example, you still want to talk with them about what your wishes are, because you know the documents one thing, but the person that you name is your agent, which is what it’s called in the power of a train document. You’re not an agent to be your agent to speak for you. And if they don’t know what you meant when you set that document out, they’re going to have a hard time acting as you would like them to act. But again, it’s also important, as you said, to know designate more than one person, because if that first agent is out of the country, out of town, none available, sick, it could be any number of things, then you have to have another backup person and in these documents you can name as many backup people as you want. Right. What people don’t realize is that under state law there is, you know, if you don’t designate anyone, there’s a default. And if you’re married, that’s your spouse. If you’re not married, it could be your adult children, who all have to agree, and not to mention and if you’re at in adversity or you know your you don’t have that connection, you’ll be a ward of the state, correct and the state will make the decisions for you. Right. Even crazier? Yes, and I was just talking with the Guardian who’s been working with cases where people have been in the hospital for months because they can’t find a guardian to help make that decision of what their long term care should be. So and in that case that person doesn’t have any voice. Know and like you said about families spend more when they don’t know what their loved one wishes are for like funeral arrangements. I’d argue it’s even, you know, by a factor greater than that, for medical care, because someone might not want any and, you know, any prolongation of their life exactly. But the family is thinking we have to do everything for them right and think about the medical will alive forever. Right in the medical community. That’s their job, is to keep people alive and well. So that’s what they that’s all to as well. Take absolutely. So what kind of documents car and do we need to make sure that these need be in place? What kind of I think the key ones are a durable power of attorney for healthcare. Durable means that it endures even if the person that signed the document has a lost capacity, meaning there maybe it’s a diagnosis of dementia or some other means by which they can’t make their own decisions anymore. That means that power of attorney document will endure. Got It. And then there’s usually two powers of attorney, one for medical or healthcare and one for financial or something. It’s called first state right or attorney. In fact, it’s also called, well, the attorney, and fat atry in fact just refers to the agent that’s named on the document. Okay, everybody thinks it’s an attorney. It’s not a lawyer, but it’s your agent. Yes, and so they could be the same person, it could be different people. My sister and I, for example, are named. One is primary and one one is primary on the other and the other secondary. So we can we can both do share anything that my parents would want us to do. But then the the third one, I think that’s that’s crucial, is an advanced directive for medical care. Absolutely, and that’s where you lay out what kind of medical care would you want and what kind of situation like. If you’re for example, you have a heart attack, do you want to be resuscitated? And lots of people think, well, of course I do. Well, if you have osteo process, having CPR is going to fracture all those ribs correct just you could cuncture along, you could puncture other organs. If you have and stage cancer, maybe you don’t want to be resuscitated by all means. And there’s all kinds of decisions that you can make about different kinds of treatments. Or not. That’s great. We are talking here again to car and type for and car and you are from aging care consultation services. Tell me a little bit about your role and all this. Well, I kind of work as a a consultant in that I can help people work through, look at what problems they might be having or challenges they might be facing and figuring out what their options for action or solutions are, as well as you look at the positives or negatives of different actions and what might be most helpful. I also do comprehensive evaluations or assessments of people at home see how they’re functioning in their home environment. I can do everything from cognitive testing and looking at someone’s decision making capacity all the way to the home safety environment, you know, trying to reduce those risks of whether it’s, you know, things that could contribute to falls or safety issues. And then if families are looking for an alternative living situation, I don’t help people find that place, but I help them figure out what to the what kinds of things are important to them. Sure and for example, if someone has dementia or has some memory problems and may develop dementia, I might suggest that they consider looking at places where they do provide memory care so they wouldn’t have to move again down the road. Yeah, but I refer on to other professionals who can help find the perfect place for them, ideal. Yeah, and you know, I mean we cannot say enough about having these conversations and, you know, dotting your eyes and crossing your teeth. And the other thing is, even if mom, you think mom are dad already have those documents in place, how long ago? Was that right? That there has been all kinds of league laws that have changed since if these documents are more than like three to four years old, from what I understand, they still should be reviewed. Yes, and make sure that there’s not any additional factors. I mean with our healthcare laws have changed, are legal laws are changed, the tax laws have changed, all different types of laws have changed, and so it’s always, you know, really important that these documents are reviewed at the very least every three years, right, and I would say even more often if you have circumstances change. Well, if circumstances change, absolutely, you know. The other thing is you may decide to change your agents, right, you know, you never know. What what happened in my mother’s case. Huh. She had appointed my sister in law, will my mother. My brother and sister in law got a divorce and so here was her former daughterinlaw. That was on her paperwork, and so obviously she had to transfer those documents over and it was almost too late. Luckily she still had enough caught, you know, cognitive abilities to do that. But it was also kind of hard to write because she’s going like, where are you taking it away from me? Well, because it’s really different now. But yeah, so all of those things obviously need to be reviewed and and really it’s okay to trade those things over. It right is, as you see, circumstances change from loved ones. So the final thing I want to talk about before we close and is talking about Alzheimer’s Dementia. All right, that’s a whole other story. Yes, so fill me in about how that affects the advance directive. Well, I think, like you said, with someone with dementia, you know, making any change to their documents, the level of cognitive ability that you have to have to be able to make curious legal decisions is, you know, it’s not that you have capacity or you don’t have capacity. Someone could have dementia even moderate dementia, but still have the wherewithal to understand this is my daughter or you know, this is the person that I want to make my decisions for me right and still sign those documents, even if they have a diagnosis of dementia. That’s where that capacity assessment is home. Right, right. And the other thing is there is an advanced direction, advanced directive for Alzheimer’s, dementia and mental health. Wow, wow, that’s amazing. And so obviously you can go in and determine what kind of things need to happen, happen and what documents need to be put in place. Right, assuming. So, carn, how do we reach you? I have a website that’s aging care consoltcom and on my website there’s a form you can email me you have any questions. That’s going I welcome people to call me, your email me anytime. I’m soolutely happy to answer any questions. And what area is just do you serve like what what use your main radio? So I live in northeast Seattle, so I cover all of Ken County. I go up into Snow Mush County and even to pierce or scatget. My parents are in Olympia, so I’ll even go down there. Oh, that’s wonderful. Well, Karen, thank you so much for being on the program we’ll look forward to having you on again. Thank you. Answers for elders radio show with Susan Newman. Hopes you found this podcast useful in your journey of navigating senior care. Check out more podcasts like this to help you find qualified senior care experts and areas of financial, legal, health and wellness and living options. Learn about our radio show, receive our monthly newsletter, receive promotional discounts and meet our experts by clicking on the banner to join the Senior Advocate Network at answers for elders RADIOCOM. Now there is one place to find the answers for elders.
Originally published August 25, 2018