The spot where George Washington entered Wellesley in 1789/Photo by Douglas Flynn

Caregivers must deal with a host of complex issues in their efforts to assist their loved ones. But the one area that may be the most complex and intimidating of them all is the variety of legal issues to consider.

It’s usually best to leave such complex issues in the hands of the professionals, and working with an elder law attorney is recommended. Our local resource section provides a list of elder law attorneys in the area, as well as some other legal resources if you cannot afford to hire an attorney of your own.

Among the legal issues for caregivers to navigate are financial concerns dealing with long-term care planning, government benefits, other retirement benefits and income, reverse mortgages, long-term care insurance and estate planning.

Caregivers will also have to consider helping their loved one set up a durable power of attorney for finances, a document that allows another person to make financial decisions on their behalf if they become unable to make those decisions themselves.

Wills and living trusts that direct how a person’s property will transfer after their death should also be discussed and finalized.

Many legal issues also surround the health care needs and preferences of the care recipient. These include decisions about setting up a health care proxy, living will or do not resuscitate order. Each of those are legal documents designed to protect a person’s wishes for their medical care and treatment if they become incapacitated.

A health care proxy designates another person to act with the authority to make health care decisions for the grantor if that person becomes unable to make or communicate their wishes. A living will outlines those wishes about medical care intended to sustain life, while a do not resuscitate order is a more limited advance directive informing medical personnel of their desire not to have cardiopulmonary resuscitation (CPR) performed if their heart or breathing stops.

The Caregiving Chronicles blog conducted a more in-depth discussion about what caregivers should know about advance directives in a Q&A with Century Health Systems CEO Judith Boyko, MBA, MS, RN.


Medical Orders for Life-Sustaining Treatment (MOLST)

Another form of an advance directive that can be used in Massachusetts is the Medical Orders for Life-Sustaining Treatment (MOLST). Use of this form is strictly voluntary, but patients with advanced illness can, after discussion with a clinician (physician, nurse practitioner, physician assistant) and trusted family members or advisors, use the form to make decisions about medical treatments.

Five Wishes

Another option available to Massachusetts residents is the Five Wishes form. The five wishes in question dictate who the person wants to make medical decisions for them if they cannot make them for themselves, the kinds of medical treatments they want or don’t want, how comfortable they want to be, how they want people to treat them and what they want their loved ones to know.

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