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Stage Four, section 2: End-Of-Life-Decisions

Make sure plans are in place for end-of-life decisions.

  • Personal information
  • Emergency contacts and informal support network
  • Formal service providers and utility companies
  • Insurance information
  • Financial information
  • Legal information
  • Medical information
  • Funeral arrangements
  • Plans for care of pets

To the information collected earlier, add payment arrangements. You will probably be the person who will notify providers of care that services are no longer needed. You may also be the person who pays final hospital bills, nursing home bills, bills for therapy or durable medical equipment, etc. after your care receiver is deceased. If you are not, you may need to supply information to that person, who may be executor of the estate.

Note: Following the death of your care receiver, you may want to review the final Medicare Summary Notice (MSN). Take a few moments to look at this to make sure that procedures billed to Medicare were performed prior to your care receiver's death. If your care receiver had an HMO, there may not be a copy of the Medicare Summary Notice, but HMO's can furnish a breakdown of charges if requested. Caregivers have sometimes found that Medicare was being billed for months after the patient's death. Sometimes there is actual fraud or deliberate effort to cheat, but often it is accidental over-billing. The Area Agency on Aging of Pasco-Pinellas, Inc. has a Medicare Patrol Project dedicated to reducing errors, waste, and abuse in these programs. If you find errors that are not corrected upon your request, please report these. Call 866-357-6677 and ask for the SMP Project.

Elder law attorneys (see below) can help with end-of-life decisions, advance directives, wills, trusts, and other legal documents. Please be aware that even if your care receiver has had legal documents in place for years, changes may be needed. For example, Florida has a new Pet Trust law that makes it legally enforceable to set up and fund pet care to take place after one's death.

Helpful Resources
  • Select "End-of-Life Choices" on the Florida Department of Elder Affairs web site, www.state.fl.us./doea for Making Choices: Beginning To Plan for End-of-Life Care. This book discusses issues such as Do Not Resuscitate Orders, communicating end-of-life wishes to physicians, hospice care, and the advantages and disadvantages of various decisions regarding advance directives.
  • Project Grace, a Tampa Florida organization that serves Pinellas and Pasco County, offers public education on the subject of advance directives. Visit the Project Grace web site, ((www.p-grace.org|http://www.p-grace.org. This web site includes online forms.
  • What Is An Elder Law Attorney? This article can be found in the Aging Topics section of the Area Agency on Aging of Pasco-Pinellas web site, www.agingcarefl.org/aging/legal, and as one of three legal questions in The HELP Pages at the back of the Senior Resource Directory, available free to Pasco and Pinellas County seniors by calling the Senior Helpline at 727-217-8111 in Pinellas County and 1-800-861-8111 in Florida.
  • Legal Considerations When Facing Incapacity is another article that can be found in the Alzheimer's Disease and Related Disorders section (purple-edged pages) of the Senior Resource Directory and in the Alzheimer's section of the Area Agency on Aging web site, www.agingcarefl.org/caregiver/alzheimers/legal.
  • The National Academy of Elder Law Attorneys (NAELA) web site, www.naela.org, provides a listing of attorneys by area and has tips for choosing a good elder law attorney.
  • A number of elder law attorneys in Florida's Pasco and Pinellas Counties are listed with the Senior Helpline of the Area Agency on Aging of Pasco-Pinellas, Inc. Look up "Legal Counseling/Representation" in the printed Senior Resource Directory or call the Senior Helpline at 727-217-8111 in Pinellas County and 1-800-861-8111 in Florida.
  • Call the Florida Bar Association toll-free at 1-800-343-8060 for a listing of elder law attorneys for any county in Florida.

Next: Hospice Care.