Aretha Frankin Died without a will last week. Most of us have heard this. According to her lawyer, she was aware she needed to take care of this but ” never got around to it”. This leaves her estate liable for potentially millions of dollars of taxes and attorneys fees and a drawn-out timeline for her 4 sons to inherit the proceeds from her estate.
Could a really good care manager have convinced Ms. Frankilin to ” get around to it” . She was, as many have said, ” a force of nature” and a woman who would be hard to sway. But care managers specialize in working with VIP clients and the rich and famous, who are often highly difficult to work with, so she might have convinced that she needed to work with her attorney to this to protect her family and her estate.
But we will never know.
However, care managers can specialize in End of Life care and one of their jobs is to make sure their client has all their legal documents
Once the terminal diagnosis is known with an elderly client, the care manager who has added “end of life services” to their agency, is often the one who will initiate and guide advance care planning discussions. As difficult as these discussions may be, the burden on the family is significantly lessened if decisions about advance care planning are made before the client’s condition worsens.
Hopefully, this has already been done but many people put it off for fear of death. A recent study found that less than 50% of severely or terminally ill patients had an advance directive in their medical record.
Advance directives are legal documents that allow clients to make decisions about their health care and finances in advance of when they are not mentally or physically able to do so. These documents which must be signed, dated and witnessed naming another person to make decisions for you.
Your job as a care manager is the make sure the dying client has these documents:
- A durable power for attorney for healthcare
- A living will
- A do not resuscitate order DNR (efforts to restart the heart after it has stopped
If the client does not have these legal documents and wishes to create them, the Geriatric Care Manager will suggest that the documents be put in place with the oversight and consultation of an elder law attorney
Care Managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care.
The final passage through life can emotionally charged. If the family is following a long labyrinth to the end, the blind alleys may be blocked by cultural, religious, and moral beliefs. Care managers can find an opening through this maze. Money, family dynamics, and fear of dying can all explode a fraught crisis of care in dying. When the important end of life decisions need to be made, like Ms. Franklin’s will, the stress of the responsibility and the seriousness of the situation can break a wave of distress fear and anxiety over the “ whole family system” the dying elder. The geriatric care manager specializes in this whole family system.
Proactive discussions and legal planning can help to reduce some of the potential pitfalls. Good legal guidance can also help clients like Aretha Franklin make better decisions, like making a will or a trust, and saving her family from adding to the burden of her death.
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