Caring Committee: A Planning Tool for Clients Without Families
Anyone who has ever sat alone in a doctor’s office and attempted to listen to the physician’s diagnosis and suggested treatment, while simultaneously trying to remember which questions to ask, understands the challenge of coordinating ones’ own care. Never mind trying to do so while ill or suffering from cognitive impairments. Older individuals are particularly vulnerable in the health care arena. They often need assistance both with the big questions (Which treatment should I pursue?) as well as the more mundane ones (How will I get to my doctor’s office?).
Family members at first glance are the most logical choice to assist elders with healthcare-related tasks, to advocate on their behalf, and to serve as surrogate decision makers in the event the individuals become incapacitated and can no longer make decisions for themselves. However, many elders are aging alone. Today, almost one third (28%) of all elderly individuals live alone, according to the Administration on Aging, a percentage that increases with advanced age. The combination of our increasingly mobile society, declining marriage rates and the often- referenced aging baby boomer generation ensures that the next 25 years will see an even greater number of elders living alone. These clients do not have the network of family, friends or personal connections that many of us take for granted. This begs the question, who will make decisions on their behalf?
There are many discrete tasks involved in ensuring that we receive quality care; monitoring health, identifying care providers and medical personnel, scheduling appointments and arranging transportation, gathering medical advice, weighing information and making decisions regarding care, paying for care and ensuring proper insurance reimbursement, identifying the best setting for care, making end of life decisions – the list goes on and on.
Even if a surrogate decision maker can be identified, he/she may decline the responsibility in the face of shouldering this burden alone. Professionals (social workers and attorneys) are often reluctant to serve as a healthcare agent for a variety of reasons. Creating a “Caring Committee”- a team of friends, family and professionals to assist the client and her proxy with the spectrum of health issues- is an attractive alternative to traditional models for healthcare assistance.
Many clients already have an informal Caring Committee. Consider a client who lives in New York City. She has a daughter in California and a niece in Connecticut. The daughter hires an Aging Lifecare Manager to oversee the mother’s care and the niece comes in to check on her aunt on weekends. Although it’s not named such, the Caring Committee already exists for this client. Is there an advantage for formalizing this arrangement? The team at Pabian & Russell and LifeCare Advocates believes so. Although the Caring Committee document is not legally binding, it provides the members, and all those involved a “road map”, developed when the individual is well and able to articulate and inform their decisions. Through a thoughtful and holistic process, led by a Lifecare Manager, scenarios and desires are determined, which eliminates the guessing that is often inflicted on representatives during a crisis. All clients need a network of connections to help them as they age. By naming the network as the Caring Committee, everyone is better able to recognize its importance and how it should function on behalf of the client. The Committee is intended to share the responsibilities typically shouldered alone by the client or by her appointed agent. In addition to sharing the tasks, the Caring Committee should also advise the agent in making decisions, monitor the agent’s actions and, finally, hold the agent accountable.
As advocates for our clients, part of our job is to make our clients aware of the planning tools available to assist them in achieving their stated goals. From our past experience, we may be able to anticipate that, for some of our clients, their healthcare proxy alone may not be enough to meet their needs. For these clients, the Caring Committee can be an effective addition to their estate plan. The Caring Committee’s success can be measured in part by the quality of care the client receives and in how care is experienced for the various members. Many Committee members find the experience to be enriching. Keeping this in mind, we may find that in recommending the Caring Committee we are not only helping our clients, but also helping ourselves.
If you are interested in talking further about the Caring Committee, please contact any of the attorneys in Pabian & Russell, LLC’s Elder Law practice group at 617-951-3100 or an Aging Lifecare Manager at LifeCare Advocates at 617-928-0200.