Among Elder Law attorneys, Care Consultants and Geriatric Care Managers that I know, it is not unusual to hear about elders who have become so isolated that they may choose a friendly bank teller, waitress or grocery cashier that they see once a week to become their Durable Power of Attorney and their Health Care Power of Attorney. This may sound absurd, but it is not unusual. The elder may not have a church or community of friends to interact with. Perhaps, most of their friends have died or are experiencing their own health challenges. Perhaps, their children have become estranged from them or are untrustworthy. The trouble with the friendly waitress is that she may have a tendency to “borrow” money she needs for their husband’s business, child’s school, etc…
There are horror stories I have witnessed with POA’s, such as, the loving son/ Power of Attorney with a gambling addiction with securities trading that depletes the estate in short order. There are the family member POA’s who go power-mad and isolate the elder in a skilled nursing facility from their family members and friends. There are the family member POA’s who are very nice people, however, they are quite simply not up to the task of making the hard decisions on your behalf.
These scenarios can be fairly easily avoided by selecting a third party Power of Attorney for hire. It may feel disloyal to your family or even a bit unnerving to have to rely on a professional to help you with End of Life decisions and care. With some discussions and well prepared interviews that you must have with these POA agents, you can build some rapport to the extent that you will feel more confident in their care. You can buy peace of mind, in this instance, provided you have vetted your POA agent and communicated your health care decisions in a Letter of Intent.
A good Elder Law attorney will have connections with agencies and individuals who will serve as Power of Attorney or Trustee for hire. One organization I like is PACT, Inc. in Lisle, Illinois. They do this work on an hourly fee basis and it can be very good for small to modest estates. Larger estates may want a professional fiduciary to serve as their Successor Trustee. Community banks, such as First Bank & Trust in Evanston will serve as Trustee for estates that are more modest. In selecting your advocate to be your POA for Property or Health Care, you will want to talk with them first and if there are already disagreements brewing in your family, they may not want to step into it. In any case, you will want to talk with your children and spouse about your decision. You will need to let them know that it is your life and your decision and that you want them to accept it and support your decision. It is your life and a failure of trust is very expensive and painful to you and your estate. The loving and caring thing to do is to take good care of your self and plan for a time when you won’t be able to make your own decisions. Leaving these powers to able agents to act on your behalf should provide you with a degree of comfort to carry on with the rest of your life.Read More...
My wife, Amy, and I became enamored with the wonderful pie at Lulu’s Café in Milwaukee after riding our bicycles around the lovely Wisconsin farm country all day. Every chance we get to try a new pie place, we seize it. We now include our pie loving son, Gabriel who enjoys ordering his own slice and doesn’t mind trading a bite here and there. We first encountered the First Slice Pie Café while driving up Ravenswood and stopped into their café tucked into an art gallery for a slice of their signature sour cherry pie. It was outstanding and we couldn’t help but notice people lining up for their weekly subscriptions to First Pie’s meals to go. It turns out, First Slice Pie Café is a non-profit organization founded by woman named, Mary Ellen Diaz, a first rate chef, trained at l’Ecole des Arts Culinaires in Lyon, France. Ms. Diaz has built her organization as a job training program after she volunteered in a soup kitchen and stunned the people there with her delicious soups. She has a program she calls “The Shareholders Program” with over 100 families subscribing and receiving home-cooked meals on a weekly basis. First Slice Pie Café recently placed in the top 10 of all apple pies in the country in Food and Wine Magazine. It is heavenly to a pie fancier.
So, what has this got to do with Elder Law? Well, there is a component of Elder Law dedicated to helping elders find housing. One interesting option for housing is the growing movement of elders who are choosing to age in place by supporting one another to that end. There is such an organization located in Evanston, called North Shore Village that is a part of this admirable trend. Key indicators for a livable community that can influence aging in place are:
* A living community offers a variety of accessible, affordable, and visitable housing options so that older adults have a place to live.
* A Livable community has features that promote access to the community, including:
– Safe and walkable neighborhoods
– Transportation options
– Safe driving conditions
– Emergency preparedness
* A livable community provides a wide range of supports and services, and opportunities to participate in community life:
– Health care
– Supportive services
– General retail and services
– Healthy food
– Social integration
Evanston is one community that seems to satisfy most of these indicators quite well. See my Resources tab on my webpage for a fraction of the terrific service providers and non-profit organizations located in the Evanston area servicing elders.
Though First Slice Pie Café does not deliver their weekly allotments to subscribers, Elders who do not wish to or cannot continue to do their own food shopping and cooking can rely upon top quality cuisine instead of microwave and frozen foods by picking up their subscriptions or asking for some help doing so. Delivery of the food for the week could be a service traded by the elder or it could be carried out by a volunteer, friend or family member. In any case, it is a comfort to know that such an option exists for healthy and delicious food.
This trend of elders choosing to age in place is also supported by studies conducted by a John Hopkins Medicine study, titled, Hospital at Home. In this study experts predict Medicare, through the Affordable Care Act, will provide this option to patients due to saving overall cost, less patient complications and stress upon them. In the study, elders are able to receive treatment remotely in their homes instead of entering hospitals, employing high tech communication and monitoring devices to allow elders to talk with nurses and caregivers.
Speaking as a former chef (I apprenticed in Seattle, Washington with a French and a Swiss Chef and graduated to become a member of the American Culinary Federation), one of my dreams was to help a hospital design a menu that would truly please its patients and make them want to get well. With the right ingredients and techniques institutional cooking could be transformed to a competitive advantage for hospitals. There is some evidence that sourcing local, organic food could result in lower cost for hospitals. I will have to leave that to the next generation of chefs. For now, chefs such as Ms. Diaz and her staff are enabling elders to eat well and savor their golden years in the sanctuary of their homes. Picking up the food is an opportunity to get to know some other wonderful organizations with inter-generational volunteers, such as Caring Connections.