Bell, Virginia and David Troxel. - CARING FOR MOM



Caring for MomA Practical Workbook for CaregiversDiane Moore, Ed.D.This book is for informational use and is based on the author’s experience. The information in this book should not be considered as a substitute for the advice of a qualified professional in the appropriate field. The author expressly disclaims responsibility for any adverse effects arising from the use or application of the information contained herein.CARING FOR MOM: A PRACTICAL WORKBOOK FOR CAREGIVERS. Copyright ?2012 by Diane Moore. All rights reserved. This book has been uploaded to , a caregiving website managed by Diane Moore. The book may be downloaded from the website for free and printed and/or customized for the reader’s personal use. Any forwarding of a downloaded version to another person will be considered a violation of the copyright.For information contact Dr. Diane Moore at diane@HARMONY RODRIGUEZ, MLS“This book is a great help for people at a loss as to how to organize their parent’s affairs! This is a thorough guide to remembering all the balls we juggle for ourselves in day-to-day living, and it supports the caregiver trying to apply that knowledge to their parent’s needs – a very practical guide! “ “I think we are all initially overwhelmed when we start down the caregiver road. I would suggest that a person start with the one system [in the book] that seems the most relevant and gradually work from there. “CAROL CHAPMAN, M ED.“Your book is amazing! It is so relaxed and conversational. I think it will be a great comfort to people who need it. I can’t wait to share it with my sister and office assistant. Thank you from hundreds who will read and benefit and thank you from me.”Caring for Mom: A Practical Workbook for CaregiversTable of ContentsIntroduction 2Taking Care of Yourself 7Self Care Inventory and Planner 9 Living “Independently” in the Family Home 11Clothing & Size Information 14Gardener Information 15Grocery List 16House Information 19Media and Communications InformationTravel List 25Leaving the Family Home 27Furnishings for One Bedroom Apartment in Senior Living Facility 29Disposal of Furnishings and Appliances 31Renting the House 33Sale of the House 36Choosing a Senior Facility 37Initial Visit Checklist 40Comparing Care Facilities – Follow-up Visits 45Summary Comparison Chart for Care Facilities 46Address Changes 48Change of Address: Sample letter 50Change of Address to Caregiver’s Address: Sample letter 51Change of Address Master List 52Making Address Labels: Directions for Word 53Living in a Senior Facility 54Visitor List for Resident of a Senior Facility 56Daily Schedule Sample 57Emergency Contact Information 59Notes to Staff (Generic Form) 60Trip Itinerary for Caregiver and Emergency Contact Information 61Doctors and Other Service Providers 62Master Appointment Schedule for Service Providers 65Notes from Doctor’s Visit 67Medical Expenses and Insurance Payments 68Medications and Assistive Devices 69Over the Counter Medicines for Various Symptoms 71 Prescriptions Ordering Tracker 72Request to Doctor for Prescription Renewal 74Over the Counter Medications and Vitamins Tracker 75Assistive Devices Tracker 76 The Attorney and Legal “Stuff” 77Setting up the Finances 80Accessing Accounts – Sample Letter 83Mom’s Sample Budget 84IOU for Reimbursement to Caregiver 86Bill Payment Tracker 87Keeping Track of Important Items and Information 90Location of Important Items and Information 92Income Tax Organizer 98Insurance Policies 100Personal Property Inventory 103Antiques, Artwork, Furnishings, Furs, Jewelry, etc. 103Cars 104Pets 105Summary of Important Information 106 Preparing for the Inevitable 108Making Final Arrangements 110Death Arrangements Notice to Care Facility 111Places to Notify Upon Death 113Things to Gather Upon Death 115 Works Cited 117PrefaceMany thanks to the caregivers who spent precious time reviewing this book and providing helpful suggestions. They include Gloria Chinea, Dottie Edwards, Ruth Hemming, Jennifer Hendricks, Anita Linton, Linda Moore, Harmony Rodriguez, Dorothy Scovil, Karen Staples, Carol Chapman, Amy Utsunomiya and Joy Uyeki. Thank you to Jim Gilden and Louise Kertesz for the encouragement and to Beverley Simmons for headers and page numbers.. Thank you to Dina Pielaet for donating her time and enabling the book to be published by sharing her special talents in photography, publishing, and technology. A very special thanks to my life partner and mentor in caregiving, Lyn Utsunomiya – counselor extraordinaire!!And finally, thank you, Mom! You’ve spent your life teaching me by word and example. IntroductionMy Mom is ninety-three. Eight years ago I got the call that my father had died suddenly. I flew to their home in Oregon and helped Mom make the funeral arrangements and deal with the paperwork required by various agencies and companies. We talked about her living in the family house with winter weather, no supporting relatives and few friends. She agreed that it would be a good idea to move to a senior mobile home park across the street from my home in Southern California.I immediately went to the Area Agency on Aging office and gathered information on senior services, organizing it into a notebook that would be a “welcome to your new home” book for my Mom.That began a journey that I wouldn’t trade for the world. Yes, it entailed many hours of work and worry on top of the pressures of my job and my life – probably much like those you are experiencing in your life right now. It impacted my family. But it also provided many hours of enjoyment as we worked and played together shopping for groceries, going to the movies, eating a special dinner or knitting on a Sunday afternoon. We got to know one another again in a different way and became fast friends.It has been a progressive journey. Since she moved to California Mom has lived in my home, a senior mobile home park, an independent senior living facility, and now she now lives in a senior residential care facility. She has lost weight and lost memory, but, luckily, she has not lost her sense of humor. I take comfort, as may you, in knowing that I am not alone in this venture. Gail Sheehey, in her book Passages in Caregiving: Turning Chaos into Confidence, says nearly 50 million American adults are taking care of their parents, relatives or partners. (10) She goes on to say that “the average family caregiver in the United States is a 48 year-old woman who holds down a paid job. . . One-third of family caregivers are actually on duty forty or more hours a week. One-third also still have children or grandchildren under the age of eighteen living with them and take care of two or more people, usually parents. Not surprisingly, one-half report a high level of burden and nearly one-half say their own health is fair or poor. And this role lasts for an average of five years. (12) The American Association of Retired Persons (AARP) says that the number is expected to double over the next 25 years. “For many Americans, life at 40, 50 or 60 years old will include care for an aging parent or relative. As the nation grows older, the need for care giving will be as common as the need for child care.” (AARP Hew Hampshire Web site) This book is designed to help you as you take on the role of caregiver. Being an organized person who is juggling many balls, I created a number of systems and check lists to simplify taking care of my mom. I’m sharing them with you in the hope that they will save you many hours of work and frustration. Although I have grouped the systems under headings, you need not read the book in any order, but simply look in the index for the area that will be of help. I know implementing the systems looks overwhelming as a whole, but I’ve included all I can think of in order to meet the various needs of different families. Start by choosing just one system that will help you get organized. If you’re the sole caregiver, keep it simple. Then each week choose another system to implement, and before long, you will be saving time, minimizing your frustration, and feeling less stress as you go about the tasks of caregiving.You might be lucky enough to have an extended family to share the care. If you decide to involve your family, Hugh Delehanty and Elinor Ginzler’s book Caring for your Parents: The Complete AARP Guide has a good chapter on how to hold family discussions and share the work. You can find a system for care sharing in the book by Cappy Capossela and Sheila Warnock called Sharing the Care: How to Organize a Group to Care for Someone Who is Seriously Ill. Also, a private, free family scheduling calendar service is available at . Hoping that various members of your family may take on specific responsibilities, I have duplicated information in some areas so that everyone would have what they need to do their job.I created the check lists found in this book in Microsoft Office Word 2007. They can be used in several ways. You can photocopy them and fill them in by hand, keeping paper copies in your filing system. Or, if you like using the computer, you can copy them to your computer, customize them to your situation, and fill them in, updating them in your computer. (Many of the checklists are in table format. The “Help” section of Word provides instructions on how to add or delete rows and columns to customize your table.)At the back of the book, you will find a list of sources that I mention in this book. I did not include an extensive bibliography of resources on caregiving since such lists become obsolete quickly so feel free to use your friendly internet search engine to find up-to-date sources. I can’t resist, however, sharing five books that I think are exceptionally useful. I wish I had read them at the beginning of my caregiving journey. They are the following: Delehanty’s Caring for Your Parents: The Complete AARP Guide which is filled with many anecdotes and practical tips. Johnson’s “Navigating the Health Care System” which is a detailed description of what to expect from a hospital, hospice and nursing home based on personal experience.Loverde’s The Complete Eldercare Planner which helps you to set and prioritize goals, create action plans for each step in the caregiving process. It also lists many resources with an extensive list of web sites at the back.McCullough’s My Mother, Your Mother: Embracing “Slow Medicine,” The Compassionate Approach to Caring for Your Aging Loved Ones which, being written from a doctor’s and caregiver’s perspective, provides much useful information about interacting with the medical community as a caregiver. It focuses on how to provide “slow medicine” care (palliative compassionate care vs. crisis driven medical intervention care) and has a list of “slow medicine” websites in the appendix.Sheehy’s Passages in Caregiving: Turning Chaos into Confidence which focuses on the psychological aspects of the various stages in caregiving. Zukerman’s Eldercare for Dummies which, although now somewhat dated, provides hundreds of resources for various aspects of caregiving. It is easy to thumb through and find basic information right when you need it.Finally, I would like to recommend an article by Louise Kertesz entitled “Resources for Caregivers, or, ‘Who has time to read when you’re going through all that stuff?’” which can be found at . It is a current select list of websites, US government sites and books on caregiving, having just been written a few months ago. As I provided drafts of this book to caregivers to read and give me feedback, I was surprised that those who were single or in recent relationships said that they would be filling out some of the checklists with information about themselves that friends, new partners or family members could use in the event of their sudden illness or death. So, when you catch your breath, you might think about doing the same for yourself.I struggled with the conventions of naming your parent and yourself throughout the book. I settled on the scenario most familiar to me, a daughter taking care of a mother. Please do not be offended if this does not fit your situation.You have my best wishes as you and your parent go on this journey together. . . . . and don’t forget to laugh along the way.Taking Care of YourselfI’m such a typical caregiver – I never thought of starting this book with a chapter on taking care of myself. It took my friend Dorothy, who is on her second stint of caregiving and who is a psychotherapist, to remind me that we need to actively work on taking care of ourselves so we can be our best in the role of caregiver. Actually, Virginia Bell and David Troxel in their book A Dignified Life, back up even further by suggesting that “before assuming responsibility for caring for someone with dementia [or, I would add, any other chronic illness], you should first think about your own health, your attitudes about caregiving, your financial resources and your coping skills. Are you up for the task? There is no shame if your answer is ‘no.’ In fact, realizing this can do the person a great service because you may be able to arrange a caregiving situation that will be more optimal.” (52) Assuming that you inventory your own abilities, family and community resources, and financial resources and determine that you will take on the role of caregiver, one of the most important things that you can do is to also work out a long-term plan to take care of yourself. As Dorothy reminds me, this includes making some leisure time to engage in hobbies, play with friends, exercise, develop our spirituality and do anything that replenishes our reserves. We must remember to take our medications and make our doctor appointments. If we’re feeling exhausted or depressed, we need to get some mental health help through a support group, a therapist, a pastor, a counselor or a friend. In sum, without recharging our batteries we are guaranteed to feel resentful and stressed, which can lead to us becoming ill and being unable to optimally fulfill our role. Too often we say there isn’t time, but we have to figure out a way to make time. Local adult day care centers provide respite care. We can ask for help from siblings or our partner to spread out the work. A home aide or a masseuse can come to the home of our parent for an hour or so regularly. Family friends can visit on a regular schedule. Not only will these options free up time for us, but they will also provide new faces and new experiences for our loved one.And finally, Dorothy reminds me not to feel guilty about taking time for myself. I’ve tried to follow her lead by walking early each morning, doing exercises every other day, learning to water color, practicing the ukulele, going out to lunch with friends, and camping once a month. It has taken a lot of organization to do these things, and at times I worry, but I’m a much nicer person to be around, and I’m more patient and effective with Mom because I do them.In this section you will find a self care inventory and planner that will help you to figure out how to incorporate some activities in your life that will give you joy.Self Care Inventory and Planner Taking ten minutes to complete the following self care inventory and plan could start you on the road to more enjoyment and less stress as you take control of your life and do some things for yourself. Inventory List below the activities, hobbies, or interests that would refresh you and replenish your reserves as you go about meeting the responsibilities in your life. Then guess the amount of time each would take per week and the approximate cost. Finally, prioritize the activities. I’ve provided you with my sample list.Diane’s ActivitiesAmount of timeper weekCost per weekPriorityWater color class3 hours$253Reading for pleasure5 hours$20 per novel6Practicing Ukulele2 hours07Walk around park in AM2.5 hours02Exercises 304Attending church2$25 donation1Out for lunch with friends2$175 Your ActivitiesAmount of timeper weekCost per weekPriority PlanTake the top priority activity and develop a plan for making the time to do it. This likely will entail looking at your time commitments at work, home and as a caregiver and figuring out a way to free yourself up for just a little bit of time. Get up an hour earlier of you need to. Ask for help if you need to. Say “no” if you need to. Whatever you do, try to do it without guilt, remembering that you are doing it for a worthy purpose. Implement Your PlanNow take whatever steps are required to put your plan into action. If you are feeling unsure about how your plan will work out, commit yourself to try it out for a short period of time after which you will evaluate how it has worked and what impact it has had on you and those around you. If your plan worked as well as mine did, you’re ready to work on your second priority activity, moving down the list as you feel confident and successful.Living “Independently” in the Family HomeAfter becoming a widow at eighty-six, my Mom moved all of her belongings to a mobile home in a senior park across the street from me. She lived independently for several years, paying her own bills, keeping up her files, cooking her own food, walking to exercise and knitting classes at the club house, and doing well with minimal help from me.However, as time progressed and she could no longer drive, Mom depended on me for more and more. I tried to tactfully evaluate her needs, but I’ve since learned that there are professional geriatric care managers who can help you evaluate what help your parent needs at each stage and provide referrals. I found one in my community by going to the website of the National Association of Professional Geriatric Care Managers (). At the very least, you should do a regular scan of Mom in her environment to look for signs that she needs help, is unsafe or is being abused, because, if she is like my Mom, she will not ask for help, and she will try to cover up inadequacies. If you are living in another town, holiday visits are a good time to do this unobtrusively. Rosemary McClure wrote an excellent article in the Los Angeles Times, December 18, 2010 entitled “Holiday Visit with a Purpose” in which she lists things to look for in your parent such as confusion, frequent falls, or undernourishment; things to look for if she is being taken care of by others including unexplained bruises or bed sores, recent changes in spending patterns, or being afraid of the caregiver; and resources for help including the Center of Excellence on Elder Abuse and Neglect ().There are many services to help your parent stay at home including such things as in-home or senior concierge services for things like grocery shopping or housekeeping, adult day care, advocacy groups, senior information services, food and nutrition services, transportation, mental health resources, home rehabilitation services, senior centers, support groups, and home health care agencies. You can find many of these services in your yellow pages or through your local Area Agency on Aging office. For example, I had an occupational therapist come to the house and make accommodation and safety suggestions. As a result of this visit, I purchased a Life Line for my Mom so she could summon immediate emergency help by pressing a button on a pendant. This gave us both great peace of mind.After analyzing your parent’s need for help and financial resources, you may decide to hire staff to work in the home on a regular basis. Bell and Troxel have an excellent chapter entitled “Finding Help,” which describes some of the things to take into consideration if you are going to use this option (224-232). From my own perspective, advantages of this option are that there will be no need to move your parent to another location or to disrupt their routine. Some disadvantages are that you will need to make physical accommodations to the home to enable your parent to move around safely. You will also need to determine how to provide staffing – through a home health care service or by becoming your own personnel director and hiring staff yourself which brings its own set of issues including interviewing, hiring, bonding, insuring training, supervising, evaluating, firing, paying, etc. Finally, as your parent becomes house-bound the possibility of loneliness, depression, and lack of mental and physical stimulation increase.Another option is to move your parent in with your family or with relatives. Historically, many cultures see this as the preferred way of taking care of the elderly. It has the advantages of providing a number of people to care for and interact with your parent, and it can potentially cost less than other options. Obvious disadvantages include the potential for added stress upon yourself and the family as all adapt to a new member who has many needs. No matter where your parent lives, it is important that you know when there is an emergency and it is vital that you can quickly gain access to her. I call Mom or see her daily to visit and to assess how things are going. Experts in elder abuse suggest that you set up a code phrase that your parent could use in the event that something is wrong and she cannot talk in front of a staff member, salesman, etc. With regard to access, when Mom was living independently, I carried copies of her house and car keys on my key ring, and I kept a plastic access card to her mobile home park gate in my wallet. I had an extra electronic garage door opener in my car.In this section you will find the following check sheets that I created while Mom was living independently to help her shop for clothing and food, keep up the house, and pack for our girls’ overnight trips to San Francisco. Clothing & Size InformationGardener InformationGrocery ListHouse InformationMedia and Communications InformationTravel ListClothing & Size Information Revised Date:______________ItemBrandSizeStoreItem #DescriptionNotesExample:SocksSt. John’s Bay4-10Penney’s00873Cotton blendWhiteGardener InformationName:____________________________________________________Address:________________________________________________________________________________________________________Home Phone: _______________________ Cell: ______________________Day of Week Gardener Works: ________________Payment Amount: ______________ Payment Due Date(s): ____________Gardener’s List of Weekly ChoresExampleDig up weeds in gravel on side of driveway Do the same on the other side of the house in the gravel along the porch Edge along sidewalk – back and porch sideMow lawn and clean up clippingsDig up weeds in nasturtium bedTake all weeds to garbage dumpsterSweep or blow walks and drivewayI helped Mom make a grocery list in preparation for our weekly shopping. I used the following customized grocery list so that I could look back and see when we last purchased something. (When my partner Lyn’s mother passed, we found 42 rolls of toilet paper in her garage. It seems she liked to walk to the store, but didn’t want to carry too much weight.) I grouped items by types; however, you could also organize them by aisle numbers in the store. Most stores have a store directory which lists items alphabetically and notes the aisle.Grocery List Revised Date:____________ . . . . . . . .. . . .. . . .. . . .. . . .. . . .. . . .Date ShoppedBaked GoodsCoffee CakeBreadBrownie mixChipsCookiesEnglish muffinsBaking suppliesFlourSugarDairyButterCheese, cheddarCheese, cottageEggsIce creamMilkYogurtGeneral merchandisePaper towelsLaundry DetergentTissueToilet paperGroceriesApplesauceCoffeePicklesSoupsTeaLiquorBeerWineMeatBolognaChickenFlank steakHamHamburgerLiverwurstPorkSalamiSalmonSteakProduceApplesAsparagusBananasBlueberriesBroccoliCabbageCarrotsCeleryCucumberGrapesGreen onionsLettuceOnionsPotatoes, sweetPotatoes, whiteRadishesSpinachSquashStrawberriesTomatoesRefrigerated/frozenFrozen dinnersIce creamPot piesSodasDiet SodaPersonal itemsHouse InformationAddress:_________________________________________________________Approximate Value:_________ Date:________Appraiser:_________________Appliance Manuals’ Locations:________________________________________Homeowner’s AssociationName:________________________Address:______________________Phone:________________________Account #:____________________Monthly Dues:__________________Date Due:_____________________Insurance (homeowner’s for fire, etc.) Company: _______________________ Address: _____________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________ Riders (for jewelry, etc.):____________Cost for Riders:________________Specialized House Insurance (for earthquakes, etc.) Company: _______________________ Address: ______________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________LandlordName:________________________Address:______________________Phone:________________________Account #:____________________Monthly Rent:__________________Date Due:_____________________MortgageMortgage Company:_____________Address:____________________________________________________Phone:________________________Account #:____________Date Started: ________Date Ends:___________Principle Left:______________Monthly Payment:___________________Monthly Payment Due Date: ______Annual Interest Paid:_____________Neighbor Contact InformationName---------------------Address---------------------------------------Phone---Cell------Real Estate Taxes -- Parcel #:__________________________________________Appraised Value _______Bi-annual Cost _______Dates Due:____________SecurityKey(s): _____________________________Location:__________________Security Company:____________________Security Code:______________Address:_________________________________________________Phone:________________________Account #:________________Cost:__________________________Date Due:_________________UpkeepCarpet CleaningDate:____________Company:______________________________Address:________________________________________________Phone:_________________________________________________ElectricianName:____________________Phone:__________________Address:________________________________________________Gardener (See Gardener List of Chores Sample Checklist)Name:_________________________Phone:___________________Address:_______________________Schedule:_________________Cost:__________________________ Due:_____________________Handy Person Name: _________________Phone:__________________Address:________________________________________________House Cleaner Name:_________________Phone:__________________Address:________________________________________________Schedule:_______________________Cost: ______Due:_________Paint Exterior Last Painted:___________Paint Brand:______________Type: ________Color Name: ______Trim Color Name:___________Cost:____________________Company:_____________________Phone:__________________Address:______________________Paint Interior Last Painted:____________Paint Brand:_______________Type: ________Color Name:______ Trim Color Name:___________Cost:____________________Company:_____________________Phone:__________________Address:______________________Plumber Name:_______________Phone:_______________________Address:________________________________________________Roof Date Installed:_____________Company:_____________________Address:__________________Phone:________________________Window Washer Name:__________Phone:________________________Address:________________________________________________Other:UtilitiesElectricName:____________________Account #:_____________________Phone:____________________Address:_______________________Monthly Cost:______________Due Date:______________________GarbageName:____________________Account #:_____________________Phone:____________________Address:_______________________Monthly Cost:______________Due Date:______________________Collection Day/Time________________________________________GasName:____________________Account #:_____________________Phone:____________________Address:_______________________Monthly Cost:______________Due Date:______________________Telephone, TV Cable, etc. (See Media & Communications Checklist) Name:____________________Account #:_____________________Phone:____________________Address:_______________________Monthly Cost:______________Due Date:______________________Water/SewerName:____________________Account #:_____________________Phone:____________________Address:_______________________Monthly Cost:______________Due Date:______________________Media & Communications InformationCable/Satellite TV Company:__________________________________________Address:_______________________Phone:_______________________Account #:___________Cost:___________Date Due:_______________Cell Phone Company:_______________________________________________Address: ______________________Phone:_______________________Account #:___________Cost:___________Date Due:_______________Cell Phone Security Code:______________________________________Computer Security Code:____________________________________________DSL Line (for internet access) Company:________________________________Address:_______________________Phone:_______________________Account #:___________Cost:___________Date Due:_______________Email Address:_______________________ Security Code:__________________Newspaper:_______________________________________________________Address:_____________________________________________________Phone:_________________________Approx Delivery Time:___________Account #:____________Cost:__________Date Due:________________Subscriptions (magazines or on-line)Name----------------Address--------------------------Account-----Cost --Due-----Travel List Revised Date:_________________Sheehy has some good information on traveling with elders with disabilities (164-166.) My Mom and I went on an annual mother/daughter trip to San Francisco where we would shop, have a chocolate ice cream soda, go out to a gourmet restaurant for wine and dinner and laugh ourselves silly. This is the travel list which she used. You might want to customize it.ItemDate. . . . Date. . . .Date. . . .Date. . . .Date. . . .Date. . . .Personal ItemsBody lotionCaneCase for hearing aidsDeodorantExtra hearing aid batteriesMedicationsPrescriptionsShampooSoapSunglasses & caseSunscreenTissuesToothbrushToothpasteClothingHat with brimHeavy jacketLight weight jacketLong pantsLong sleeved shirtsPajamasShortsShort sleeve shirtsSocksSweaterUnderwearMiscellaneousBookMagazineMoneyWallet with cardsLeaving the Family HomeBy age eighty-seven, Mom was beginning to feel lonely in the house by herself. I realized that she was not eating correctly, and that food preparation was becoming more difficult for her. She could no longer garden or keep up with many of the tasks associated with owning a home.I broached the idea of moving to a senior independent living facility where meals, laundry services and housekeeping were provided, but she was not interested. So, knowing how difficult change is for all of us, I waited for the opportune time and suggested we go to visit Sylvia, Mom’s friend who had just moved to such a facility. We had lunch there, and Sylvia gave Mom the grand tour, to no avail. But, before long, Mom decided that she wasn’t going to be able to handle being on her own forever, and as she said, “I’d best get on with it, since I’m not getting any younger.”Our first project was to decide what to keep and eventually move into her one bedroom apartment in a senior residential facility and what to dispose of. That began an emotional time for me. I had no inkling of the attachment I had to still having a family home to go to and to the “things” that filled it, but Mom seemed to be ready for the next stage of her life. She moved into the senior residential facility and within two months was calling it home, praising the food and enjoying the activities. I was so grateful for her flexibility and openness to new things. I took a lesson from her about accepting change and aging gracefully.My friend Beverley told me the story of how she and her three brothers and sisters helped her mother dispose of their parents’ furnishings and heirlooms. Beverley took a picture of each piece, listened to Mom’s story of its history, and wrote up the story, putting it together with the picture. Her Mom sent the set of pictures to each child and asked them to write her which pieces they wanted. Mom then made her decisions and wrote each child a letter telling him or her what she was giving to them. It worked perfectly, except that when they all arrived at the home to pack it up, they had missed the secret closet that held all the silver, and had to resort to the short straw method to empty it.I developed and used the charts below to help us collect things to move, dispose of furnishings, rent Mom’s mobile home for a time, and eventually sell it. Furnishings for One Bedroom Apartment in Senior Living FacilityDisposal of Furnishings and Appliances Renting the HouseSale of the HouseFurnishings for One Bedroom Apartment (Linens and telephone provided)RoomItemNotes …………….BedroomBedPillowBlanketsNight standFlashlight for night standNight lightLamp for night standAlarm clockSmall dresserSmall desk (use 1 dining room chair)Office suppliesBulletin board over deskWall calendar on bulletin boardTelephone bookComputer PrinterSmall file cabinetFramed pictures for throughout houseBath RoomToiletriesScaleDrugsFirst aid suppliesBathtub rubber matLiving RoomComfortable chair or love seatGuest chairFloor lampSmall end tableLamp for end tableWall clockPlantsDining RoomSmall round table with fold down leaves3 small scale dining chairs (use one for desk)Placemats or table clothKitchenSmall microwaveToaster ovenCoffee or tea potPot holdersCooking utensilsEating utensils Can openerDishwareGlassesFood storage containersPaper productsDish towelSpongeDish soapPaper towel holderSmall tool kitDisposal of Furnishings and AppliancesA favorite family story is the time my grandparents’ six adult children arrived on a wintry New Jersey Saturday morning to help with their parents’ sorting and packing process. Various items were given to each over the day. Upon leaving, my uncle Ed went to put on his overcoat, only to find that his brother Walt had left a half an hour ago with it over his arm, thinking it was surplus.Listed below are the various ways of disposing of furnishings and appliances. If there is an accumulation of many years of things and several siblings, you might want to make a chart listing the furnishings and appliances in alphabetical order with a code next to each which indicates how it is to be disposed of. (See the sample chart at the end of this page.)Disposal Possibilities:Classified AdWho is going to input the item?________________________________________Asking Price:_________________________ Final Price:______________________Donation to Nonprofit organizationName:___________________________ Date & Time of Collection:___________Description of Items and Values (for tax deductions, see latest regulations):Dumpster (Note what items they will not take)Dumpster Rental Company:______________________ Phone:________________________Cost:___________ Delivery Date:________________ Pick up Date:____________Estate Appraiser who will give you a price to take it allName:____________________________ Phone:_________________________Final Price:_________________________Give away to family and friends (list item and name of recipient)On-line sites such as Craig’s List Who is going to input the item?________________________________________Asking Price:_________________________ Final Price:______________________Sample Disposal ChartG=Good WillCL=Craig’s ListItemDisposalValue/PriceClothing and ShoesG$200Refrigerator—GE, 3 years oldC L$450Renting the HouseMy Mom moved from her mobile home into a senior independent living facility. We decided to rent the mobile home for a minimum of a year, using the proceeds to defray the cost of the facility. This gave her some flexibility if she didn’t like senior living, and it gave the real estate market time to increase the value of the home.I rented the home myself, but you might decide to use a management company.Steps in renting it yourself:Determining if you may rent the home: Many senior mobile home parks and condominiums have rules which do not allow you to rent your home. Be sure to check before proceeding..Preparing the HomePainting Touch UpCleaningCarpetsGeneral HouseWindowsMaking DecisionsRental PricePetsSmokingAppliances included?AdvertisingClassifiedsFliersOn-LineSigns in the windowsChoosing a TenantApplicationReferencesLeaseWho does gardening Who does wateringWho pays what utilitiesBookkeeping I keep a simple annual chart of income and one of expenses by hand on an accounting ledger. You may choose to set up a Microsoft Office Excel spreadsheet. You will need to total all the columns at the end of the calendar year and bring the records to your tax preparer. My chart looks like the one on the next page.Rental LedgerCompany or Item………..Elect.GasWaterSewerSpaceRentGardenerRepair &UpkeepFire InsurQuakeInsurTaxesMiscSale of the HouseSelling the house is fairly straightforward once you have chosen a realtor who will guide you through the process. Below are some items to keep track of as you list the house and negotiate the final selling price.Realtor Name:_______________________ Company:_______________________Phone: ______________________Commission %:____________________Dates of Contract:______________________ Asking Price:______________Lowest Acceptable Price:__________________Escrow Company:____________________ Escrow Account #:_________________ Escrow Officer:_________________________ Phone:__________________Attorney (if applicable):________________________ Phone:_________________Date and Time of Appointment:____________________________________Mover:__________________________________ Phone:____________________Estimate:_________ Payment Method:_____________ Date:___________Arrival Date & Time:_____________ Delivery Date & Time:_____________Appraiser:___________________ Phone:___________ Date will arrive:________Time:________________ Appraised Value:__________________________ Inspector:_________________ Phone:___________ Date will arrive:___________ Time:________________ Notes:___________________________________ Repair Contractor: ______________________________Phone:_______________Date will arrive:_____________ Time:__________ Notes:_____________________________________________________________________________________________________________________Choosing a Senior facilityMoving from her mobile home to a senior independent living facility was easy since Mom moved to the one that her friend Sylvia had chosen. However, during the time she was there, I decided to do some initial investigation of residential care assisted living and skilled nursing facilities on my own. I thought, correctly as it turned out, that pre-planning for the next stage when not under emotional and time constraints would pay off in a better decision and much less stress when the time came to move again.Each kind of facility provides an array of services. Here are some of the kinds of facilities you might encounter: Senior independent living is living totally independently in an apartment, mobile home or home in a senior community. An independent living facility is an apartment in a senior facility with such things as transportation, meals, housekeeping and recreational activities included. A large residential care assisted living facility is similar with the addition of 24 hour staff and potential assistance with daily activities such as eating, showering or dressing. Some assisted living facilities have special units for residents with dementia, providing special security and services. A small residential care home is an actual house in a neighborhood where a small number of residents are provided the same kinds of services as in a large assisted living facility with 24-hour staff.A skilled nursing facility provides 24-hour skilled nursing care. l learned that Medicare and insurance do not cover all of these living options, so be sure to review your parent’s coverage before making a decision. I also learned from my attorney that when you are signing contracts and paperwork, the facilities will want you to sign an agreement to use an arbitrator in event of a disagreement. She says you do not have to agree to this, and she advises that you not limit your options by doing so.I developed the following check lists in this section and used them as I visited facilities. I’d suggest you do the same and see how impressed the administrators will be when you arrive ready to ask all the right questions. In this section you will find the following:Initial Visit ChecklistComparing Care Facilities – Follow-up VisitsSummary Comparison Chart for Care FacilitiesLooking in the yellow pages, I found that there are local residential care facility “brokers” who will meet with you, determine your needs, and take you to appropriate facilities and homes. I also found web sites such as that list and rate facilities. And, of course, there is help from the traditional research sources including books and magazines such as the article by Avery Comarow in U.S. News & World Report that ranks nursing homes in America (72-82).After I had visited many facilities, I asked Mom if she would like to go with me to some. She turned me down, but we talked about the pros and cons of a large assisted living facility vs. a smaller residential care facility, and she voiced a preference, in the event that we needed one. As it turned out, a year later, mother was suddenly hospitalized, went into full-blown dementia, and we had to quickly find a place to move her. The emotional chaos was unbelievable, and I was so grateful I had done my homework. (She subsequently regained her faculties and abilities, and says she is content with life in her new senior residential care home.)Choosing a Senior Facility Initial Visit ChecklistAgency Name: _______________________________________ Phone:__________________ Address: _____________________________________________________________________ Contact Person:___________________________ Managing Company:___________________ Date:_____________________ Types of facilities/units available & Number of Rooms in each:Type of Facility# Rooms or bedsCost . . . . . . . . Independent LivingLarge Assisted LivingMemory Care UnitSmall Assisted Living HomeSkilled NursingServices included in room costs:Cost for additional services:Move-in deposit:Rate increases over the past 5 years:Waiting list:Do they take long term care insurance? Medicare?StaffingStaff# Day# NightDoctorRegistered NurseGeriatric Nurse Practitioner Licensed Vocational NurseMedical AssistantCaregiverDieticianPhysical TherapistPodiatristBeauticianSocial WorkerDentistAudiologistActivity DirectorOmbudsmanLicensed staff/patient ratio day: night: Do they have a training and continuing education program for all staff?Do they do background checks and random drug tests?Do the staff wear nametags?Amount of staff turnover per year:Resident’s RoomSize: Amenities:Private bathroom?Do windows open?Layout and size appropriate for wheel chair:FacilityTemperature is comfortable:Good lighting:Noise level: Cleanliness of facility:Special features (pool, patio, etc.)Outdoor spaces:Age of facility:# times bought out in recent past:ResidentsCleanliness and grooming of residents:Residents are engaged: Staff know their names:ServicesDaily activity programs:Special programs/activities:Housekeeping services: Laundry services:Pets allowed?How manage meds?How does resident get help in an emergency? Call button, pendant etc?Transportation to doctors, etc.:Wheel chair transfer help?What is typical emergency (ambulance/EMT) response time?Is hospice an option?Dementia Care?Bedridden resident care?FoodFood menus:Choice of food?Snacks available?Guests allowed to dine?Emergency PlanBulletin board with license, evacuation plan, surveys, rights of residents, etc.:Ombudsman:Earthquake, fire plan?For special unitsHow keep residents secure?Policy on restraints:Notes:Choosing a Senior FacilityComparing Care Facilities – Follow-up Visits Results of talk with residents – what do they like and not like about the place with regard to:Staff – Respectful? Helpful? Kind? Competent? Gentle? Patient?Same with night staff?Does it feel like home?FoodActivitiesWhat would you change about the place? Results of talk with staff How do they like working here? Amount of turn-over Results of talk with Administrators Ask to review licensing and certification reportsAsk how the facility did on state surveys and/or Area Agency on Aging surveysAsk if any liens or lawsuits have been filed? (County court records will tell you if there have been any lawsuits against the center or the staff that has worked there.) Results from unannounced additional visitsResearch on complaints and lawsuitsCheck with local Area Agency on Aging & their long-term ombudsmen’s officeBetter Business Bureau website will list complaints and issues that people have had with the center in the pastCheck State Health Dept. reportsChoosing a Senior FacilitySummary Comparison Chart for Care Facilities(You can give letter grades, use pluses and minuses, or make up system that works for you.)CriteriaFacility AFacility BFacility CFacility DFacility ERoom CostDepositCost for additional servicesOverall feeling of FacilityRoom sizePrivate bathroomOutdoor spacesSize of facilityMedical staff availability Staffing ratiosVariety of Staffing Types (LVN, RN, etc.)Likeability of StaffOtherOtherNotes:Address ChangesIt seems that every couple of years, Mom is moving. After the first move I decided to use the advantages of a computer to set up a system that would make future address changes simpler. To that end, I created an address label file comprised of the addresses for all of the contacts that needed to know about her new address (companies, service providers, organizations, magazines, etc.). I customized the letter found in this section entitled “Change of Address: Sample Letter” which gives her old and new address and phone numbers. Then I mailed a letter to each contact in an envelope with the appropriate address label affixed.In order to track the letters I sent, I filled in the “Change of Address Master List” which would come in handy for the next round of address changes.As time progressed, I took over paying bills and filing. I customized the letter found in this section entitled “Change of Address to Caregiver’s Address: Sample Letter” which explains that I, as a co-trustee, will take over paying bills and gives my address for billing purposes. Thanks to my trusty address label file, I could print out address labels once again with no fuss. I reused the master list to figure out what contacts needed the letter, to track that I had sent them a letter, and to track the address changes. I found that in some cases I needed to send a second letter.Finally, I made a label file for all of the relatives and friends in Mom’s old address book. These came in handy for sending Christmas cards and letters updating people on Mom’s address changes. I also used the labels to create a “rolodex” address file for Mom’s use which was much more legible and flexible than her old address book. In this section you will find the following: Change of Address: Sample letterChange of Address to Caregiver’s Address: Sample letter Change of Address Master ListMaking Address Labels: Directions for WordChange of Address: Sample LetterDate : __________________________ Regarding my account:_______________________________ As of the above date, my address has been changed. My previous address was:Street Address: ______________________________________________City, State, Zip:______________________________________________Phone: ______________________________________________My new address is:Street Address: ______________________________________________City, State, Zip:______________________________________________Phone: ______________________________________________Please send all materials to the new address.Thank you for your assistance in this matter.Sincerely,Change of Address to Caregiver’s Address: Sample LetterDate:___________________________Regarding my account:___________________________________My daughter, __________________________________, who is a co-trustee, will take over paying my bills effective the date above. To that end, please send any invoices, statements or correspondence to the following address:Name of Parent:______________________________________________________C/O Name of Daughter:______________________________________________________Street Address:______________________________________________________City, State, Zip:______________________________________________________Daughter’s Phone:______________________________________________________I can be reached in person and will continue living at the following address: Street Address:______________________________________________________City, State, Zip:_____________________________ Phone: _________________Thank you for your assistance in this matter.Sincerely,Change of Address Master ListDate ChangedCompany…….Address…………………Phone…...Name ofContact…………Account #..........Making Address Labels: Directions in Microsoft Office WordSheets of blank address labels that you can purchase at a stationary store are very handy to use to create a physical address book, a rolodex, labels for letters sent to notify people of address changes, etc. Once you have typed the names and addresses into your computer once, you can copy them to a customized sheet of address labels and print them out as often as you want.Your software program should have a program for making address labels.Below are the directions for making address labels in Microsoft Office Word 2007:In Word choose “Mailings”Then choose “Labels”Then choose “Options”Then choose the numbered set that goes with the labels you bought{For Example: Office Depot 612-271 Inkjet Shipping which are 2”x4” labels}Then choose “OK”Then choose “New Document”Living in a Senior FacilityOnce Mom started living in an independent senior facility I found that I needed to be sure that the staff knew how to contact me in an emergency. To that end, whenever I was going to leave town, I provided them with a form that contained my trip itinerary, contact information for me, and contact information for several local people who agreed to be available for non-emergency issues. I provided them with a chart of permanent emergency contacts such as family members and close friends.I also gave them information regarding death arrangements if I were unable to be reached. (See the form “Death Arrangements Notice to Care Facility” found in the chapter entitled, “Preparing for the Inevitable.”)When Mom moved into a residential care facility where she would get care around the clock, she had just gotten out of the hospital and was quite anxious and confused. I thought that having a written daily schedule of typical activities might help her orient to her new life. It was helpful, and I’ve included it in this section along with a form that I use to communicate with the staff.Finally, I found the residential care home wanted a list of approved visitors with notes on who was approved to take Mom from the facility, so I made a chart for that.In this section you will find the following:Visitor List for Resident in a Senior FacilityDaily Schedule Sample Emergency Contact InformationNotes to Staff (Generic Form)Trip Itinerary for Caregiver and Emergency Contact InformationVisitor List for Resident of a Senior FacilityFor Name:_____________________________ Room________Revised Date:_______________(Asterisked Names May Take Resident from the Facility)Family:Name:_____________________________Relationship:____________________Name:_____________________________Relationship:____________________Name:_____________________________Relationship:____________________Name:_____________________________Relationship:____________________Name:_____________________________Relationship:____________________Friends:Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________ Name:_____________________________Signed: ____________________________ Date:______________________Daily Schedule: SampleThe first weeks of living in a new senior residential facility can be confusing and anxiety producing. Having a personal daily schedule posted on a white board in the room can be a comfort. Here is the daily schedule I created for my Mom who is in a residential care facility.Resident’s Individual Schedule Revised Date:_____________Wake UpShower DressEat BreakfastRead Newspaper Exercise “Class” – Staff helps with exercises given by Physical Therapist Morning Activities –Help with chores such as folding laundry, drying breakfast silverware, pots & pans, folding bibs and lunch napkins, etc.Play a game (dominoes, etc.)Knit12:00LunchNap Walk Outside (in walker with help of staff)Afternoon ActivitiesSnackPlay a gameRead a novel on the patioPuzzlesCraftsOther5:00Supper6:30TV News7:00TV Jeopardy (Channel 7)7:30 TV Wheel of Fortune (Channel 7)8:00Listen to music or read a book9:00 BedEmergency Contact InformationFor Name:__________________________________ Room:__________________Date:_____________________Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Address:______________________________________________________ Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Address:______________________________________________________ Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Address:______________________________________________________ Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Address:______________________________________________________ Relationship:____________________ Name:_______________________Home Phone:____________________ Cell Phone:____________________Address:______________________________________________________Notes to StaffBecause there are three shifts of staff in a 24-hour staffed facility, I find communication difficult. Using the form below seems to work best since it can be passed from one shift to another.Date:____________________________Notes to Staff Regarding Name:________________________ Room:___________From: Name:_________________________ Relationship:___________________Note: When I am going to be out of town, I leave the form below with staff. I explain that the local contact is a friend who is willing to help with non-emergency issues. My mother gets anxious when I’m not in town, so I give her a copy of the form and make sure I call her daily. It’s nice to be needed, but I know there are times when we need to recharge our batteries and get some perspective. I try to give myself permission to do so without guilt, but, as you know, it’s not as easy as it seems.Trip Itinerary and Emergency Contact InformationFor Name:____________________________________ Room:________________Date:____________________________I will be going on a trip from ________________ to _________________________During that time I can be reached at Phone:_______________________________Please use the following as local contact person(s) during this time:Name:___________________________ Relationship:_______________________Home Phone:_____________________ Cell Phone:________________________Name:___________________________ Relationship:_______________________Home Phone:_____________________ Cell Phone:________________________Also, please note there is a complete list of emergency contacts on file. Thank you.Signed:_______________________________ Date:________________________Doctors and Other Service ProvidersAs various medical conditions occurred with Mom, I found the need to identify doctors and hospitals, to choose between treatments and to be an advocate for Mom. My work would’ve been less traumatic had I known then to contact for help in finding the best doctors and treatments. (Sheehy 124) I’ve also since found a good chapter entitled “Managing Medical Care” in Loverde’s book The Complete Eldercare Planner which includes good information about what to do if your parent refuses medical help. I recently learned that a local doctor offers “concierge service” which is a fee-based service including house calls and access to the doctor’s cell phone for 24/7 emergency contact. This is expensive, since Medicare and insurance do not pay for the concierge fee, although they do pay their normal rate for any doctor visits or other services. If you are often out of town or living a distance away, it may be worth the expense to know that a doctor will be on-call at all times for emergencies.As I took over setting up appointments and driving Mom to wherever she needed to go, I set up a master appointment schedule listing the name of each service provider, his or her address, when the last appointment was, and when the next one is. I’ve found this invaluable as I keep track of monthly, bimonthly, quarterly, semi-annual, and annual appointments for doctors and various others. I also wrote the appointments on Mom’s calendar for her use and integrated the same on my personal calendar. At the end of the year rather than throw her previous year’s calendar away, I found it helpful to file it in case I needed to look up something that happened the previous year that I neglected to write down on the master appointment schedule form.I created a doctor’s visit form which listed all the issues to talk about with the doctor. This kept us from forgetting things that needed to be discussed and saved the doctor time, since we were organized and efficient. (Caring for Your Parents has an excellent list of prompts for creating questions for the doctor’s visit on page 36.) I also used the form to take notes on our visit. I gave Mom a copy after each visit and she used these notes to remind herself of what the doctor had said. I also carry in my purse a small notebook in which I note daily changes in Mom’s mental or physical health, reminders to myself about things I need to do in the next several days for her, etc. I consult this when I am preparing for a doctor’s visit with Mom to remind myself of things to discuss. I found that I needed to learn about Medicare, help Mom choose a Medicare Part D drug provider and keep track of medical expenses being paid by Medicare or her supplemental insurance company. [I’ve since learned that Caring for Your Parents has an easy to understand chapter on Medicare entitled, “The Medicare Maze.” (109-123)] I’ve created a form to use in keeping track of medical expenses and insurance payments. It has also come in handy when I need to put Mom’s medical expenses together for income tax purposes.When you go to the doctor for the first time, be sure the doctor has a copy of the following (See the section “The Attorney and Legal ‘Stuff’”):Durable Power of Attorney for Management of Property and Personal Affairs (which sets up the provisions allowing you to manage your parent's property and personal affairs) Advanced Health Care Directive (which states the end-of life wishes of your parent and allows you and whoever else is named to make health care decisions) Any other more specific forms which state end-of-life wishes. Authorization for Use and Disclosure of Protected Health Information (which authorizes the release of health information and medical records to you and whomever else is named) Finally, you can access a form to keep track of your family member’s personal health record at left_top_menu/caregiver_home/In this section you will find the following: Master Appointment Schedule for Service ProvidersNotes from Doctor’s VisitMedical Expenses and Insurance PaymentsMaster Appointment Schedule for Service Providers Revised:________________Name………….TypePhone.......Address...................Last Appt.Next Appt.AttorneyAudiologist Barber/BeauticianChiropractorDentist DermatologistOccupational TherapistOphthalmologistOptometristOrthopedistPet’s groomerPet’s Veterinary DoctorPet’s WalkerPharmacistPhysical Therapist Podiatrist Primary DoctorNotes from Doctor’s VisitDate of Visit:____________________________Doctor’s Name:_________________________Issues to talk about with the doctor:1.____________________________________________________________2.____________________________________________________________3.____________________________________________________________4.____________________________________________________________5.____________________________________________________________6.____________________________________________________________Height:_________________ Weight:_______________________Blood Pressure:___________________ Temperature:_______________________Notes:Medical Expenses and Insurance PaymentsDate…Provider…….Service………………CopayAmountDatePaidMedicarePaymentDatePaid…InsurancePaymentDatePaid…PatientBalanceDate Paid…Medications and Assistive DevicesWhile Mom was still living independently, she was able to keep track of her own vitamins and medications. However, when I eventually found that she was missing some medications and doubling up on others, I began setting up her vitamins and medications in plastic boxes that I got from the drug store which had a section for each day of the week. This meant she just had to remember once a day to empty that day’s section of pills.This worked for quite a while, but became quite frustrating when the doctor gave me a sample of a daily patch to improve Mom’s memory. I spent 45 minutes explaining a system that she could use to meet the directive that a patch could not be placed in the same spot within 14 days. In frustration, she finally sent me home saying she would figure it out herself. When I arrived home the phone was ringing. It was my Mom asking what the patches were for. When I told her, “When you stop asking me that question, I’ll know they are working,” she had a good laugh.I not only had to set up the medications, but I also had to remember to order the prescriptions from a mail order company. I developed a prescriptions ordering tracker to help me with this task. I added a section on it for over-the-counter vitamins and minerals that she took as well. Now I knew when to order or purchase everything, and I also had a list to take to the doctor’s visits and hospital, since they inevitably wanted to know everything Mom was taking.Since this tracker had everything in one place, it allowed the doctor to review it and make sure that there were no drugs which would interfere with others. To that same end, I asked the doctor for suggestions for over-the-counter medicines for the various everyday ailments that Mom got sporadically. (To my dismay, I found out that the aspirin that she had been taking for aches interfered with a prescription arthritis medication that she took daily.) I made a chart listing each symptom and appropriate treatments. Later, this was very helpful to the staff at the residential care facility.Assistive devices are everything from canes and walkers to raised toilet seats. It’s a good idea to try out different types before making a purchasing decision. I was able to borrow a walker and raised toilet seat for up to six months from my local chapter of the Easter Seal Society. You might ask around for similar organizations in your community. If you can’t borrow an item, you might consider renting it from a medical supply store.When it came time to return the items, I went on a hunt of our downtown thrift stores to purchase “gently used” items that I had borrowed or rented. I created a chart to keep track of borrowed and rented items.In this section you will find the following: Over the Counter Medicines for Various SymptomsPrescriptions Ordering TrackerRequest to Doctor for Prescription RenewalOver the Counter Medications and Vitamins TrackerAssistive Devices TrackerOver the Counter Medicines for Various SymptomsInstructions from Doctor: ________________________ Date:_________________Symptoms and appropriate treatmentsConstipation: Cough, Nasal Stuffiness and/or Chest Congestion:Diarrhea and/or Nausea:Fever: Hay Fever/Allergy:Sore muscles:Sore throat:See the Doctor if you have any of the following:Prescriptions Ordering TrackerPrescriptionsDoseAMDosePMDoseEVEDrug Name. . . . . . . Use. . . . . . . . # pills In bottle# refillsRefill afterRX #. . . . . .CompanyOr DrugStorePhone……….Company or Drug Store Information:Name:_________________________ Address:_________________________________ Phone:_____________________Name:_________________________ Address:_________________________________ Phone:_____________________Name:_________________________ Address:_________________________________ Phone:_____________________Name:_________________________ Address:_________________________________ Phone:_____________________Patient Reorder Information:Birth Date:__________________ Credit Card Number :___________________________ Expiration Date:_____________Prescription Insurance ID Number:________________________________________Request to Doctor for Prescription RenewalDate: ______________________To: Dr._____________________________________ From: _______________________________________Subject: Renewal of Prescription for (Name of Patient):___________________Please renew a prescription for (Name of Medication):_____________________You can fax it to (Name of Pharmacy):__________________________________ at FAX Number: _______________or call at Phone Number:________________They require that the prescription include the following information:Name of Patient: ___________________Date of Birth: ______________________Member ID #:_______________________Mailing Address: _________________________________________________Phone: ___________________________Please let me know when it has been sent in. Thank you. Caregiver’s Name:_______________________________E Mail Address:_________________________________Phone:________________________________________Over the Counter Medications and Vitamins TrackerDoseAMDosePMDoseEVEName. . . . . . . . .Use. . . . . . . …….. # pills In bot-tleDatePur-chasedStore. . . . Drug Store Information:Name:___________________________________ Address:_________________________________ Phone:__________________________________Name:___________________________________ Address:_________________________________ Phone:__________________________________Name:__________________________________ Address:_________________________________ Phone:__________________________________Assistive Devices TrackerItemSourceDate Checked OutNotes on Item’s ConditionDate to be ReturnedSource Information: Name:__________________________________ Address:_________________________________ Phone:__________________________________Name:__________________________________ Address:_________________________________ Phone:__________________________________Name:__________________________________ Address:_________________________________ Phone:__________________________________The Attorney and Legal “Stuff”Luckily my Mom and I went to an attorney together while she was still able to think clearly, so she was able to understand and sign all the documents which were required to enable me to take care of her and her finances.Trying to be helpful, our attorney even told Mom how she could get a limited use driving license. I was hoping that her hearing aids were not working properly, but she heard it all just fine. Later, I had to ask the doctor to tell her that she should no longer be driving. She took it well, and I breathed a sigh of relief. There are attorneys who specialize in elder issues. To find one you can call the National Academy of Elder Law Attorneys, Inc. (NAELA) at (703) 942-5711 or enter your zip code into their on-line directory at member/directory (Sheehy 293)You will need to talk with your attorney about your unique situation and the laws applicable in your state. Basically, you should have the following drawn up, signed, and notarized. Leave the original with the attorney and keep a copy in your files. Give copies of #3, #4 and #5 below to your doctor and hospital.1. A Revocable Living Trust (which allows the assets to be inherited without being tied up in probate court) You will also want to talk with the attorney about the maximum amount that can be inherited without paying taxes on the inheritance. There are ways to protect money above the maximum amount. A Will (which states who will inherit what)3. Durable Power of Attorney for Management of Property and Personal Affairs (which sets up the provisions allowing you to manage your parent's property and personal affairs) Advanced Health Care Directive (which states the end-of life wishes of your parent and allows you and whoever else is named to make health care decisions) Give a copy to the doctors and hospital. Your state may have a form that is more detailed. California just created the form “Physician Orders for Life-Sustaining Treatment” (POLST) which spells out the patient’s wishes regarding CPR, medical interventions and artificially administered nutrition. Even more detailed is the pamphlet created by Aging with Dignity entitled “Five Wishes.” It includes the patient’s wishes for who will make medical decisions when the patient can’t, the kind of medical treatment 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. In any case, the more detailed the directive, the better for the patient, the doctor and the caregiver.Authorization for Use and Disclosure of Protected Health Information (which authorizes the release of health information and medical records to you and whomever else is named) Certification and Abstract of Trust Agreement (Many companies asking for a copy of the trust will accept this one page abstract in its place.) Your attorney will tell you such things as which accounts to put in the name of the trust, how to list beneficiaries on accounts, how to set up checking and credit card accounts so that you can write checks and get account information, and how to sign as your parent's legal trustee. Setting up the FinancesThere came a time when I needed to take over paying bills, keeping records, filing and helping Mom make financial decisions. Luckily, Mom and I had been to the attorney, so with the “Durable Power of Attorney for Management of Property and Personal Affairs” in hand, I was allowed to manage Mom’s property. I created a letter from Mom (see “Accessing Accounts – Sample Letter”) that I sent along with a “Change of Address to Caregiver’s Address” form to various banks and companies, informing them that I would now be paying her bills. Note that financial institutions usually require a copy of the power of attorney. I was now ready to create a budget so we would know what the yearly expenses and income were. I spent hours going over Mom’s expenses and income to create an annual budget. As a “depression child” she was a saver who constantly worried about money. I went over the budget many times, showing her that she would be solvent until she was 110 years old, but she still didn’t believe me. So I asked if we could review her budget with Pat, a friend of mine who is financially savvy, and Mom agreed. Pat blessed the budget without a change, and Mom continues to tell me how smart Pat is.As I began creating the budget, I estimated a figure for the upcoming year’s expenses by reviewing Mom’s check register and credit card statements for the past year and summing up all items that were not one-time expenses. I added to that any additional anticipated expenses for the upcoming year and added a “miscellaneous” expense factor for good measure.In estimating a figure for the upcoming year’s income, I added Mom’s social security payments and her draw from her retirement fund account. Your parent may also have such things as stock dividends, income tax refunds, income from rent on a home or savings interest. To determine Mom’s solvency over the next ten years, I projected her income and matched it with the average cost of a nursing home (the most expensive living arrangements we might ever have to use) over the next ten years. I didn’t take into consideration inflation, figuring income would likely rise while costs rise, although I know they do not rise at the same rate.I calculated the budget with an adding machine, pencil and a yellow pad, but you might find it easier to create an Excel spreadsheet. In this section you will find Mom’s sample annual budget. The book Caring for Your Parents has an example of a monthly income and expense sheet and one for calculating net worth. (202-203)In researching last year’s expenses I found boxes of old papers, filed and unfiled, that I needed to sort through. As I started to toss things it dawned on me that there were items of information on them that could be used by ID thieves, so I retrieved and cross-shredded them.I find as I purchase various everyday items for Mom from the grocery store, etc. that I wind up using my own money because there are a few of her things mixed in with mine. I keep track of these expenses using an IOU sheet found in this section and reimburse myself monthly. I file the IOU in case there is ever a question about the checks written by me to me. Once I had the authority to pay bills and a budget to know how much I had to work with, I took over payment of Mom’s bills, setting up a free credit union checking account for bill paying and another one for her personal use. Both of our names are on the accounts so either of us can write checks. I have her social security check electronically deposited to the bill account.I created a bill payment tracker chart which allowed me to track expenses. If you compare it to Mom’s Sample Budget, you will see they are basically the same. At the end of the year, I use it to refine next year’s budget. In this section you will find the following:Accessing Accounts – Sample LetterMom’s Sample Budget IOU for Reimbursement to CaregiverBill Payment TrackerAccessing Accounts: Sample LetterThis is a sample letter to a bank initiating power of attorney for bill paying. This will enable you to pay your parent’s bills.Parent’s Namec/o Daughter’s NameStreet AddressCity, State, ZipDaughter’s Phone and/or E MailBank Name:__________________________________________________Street Address:_______________________________________________City:_________________________ State:___________ Zip:__________August 17, 2009Dear Sirs and Madams:I would like to have my daughter, _____________________, listed on your records as my power of attorney who can deal with you as needed regarding my Visa account #____________________________________________________.To that end, I have enclosed the appropriate pages of my Durable Power of Attorney for Management of Property and Personal Affairs. Thank you.Sincerely,Parent’s NameMom’s Sample Budget Revised January 1EXPENSESSchedulePayeeDue DateClosing DateEstimated AmountTotalMonthlyResidential Care Home Fee1$4,500Master Card1016 th previous month$300 [drugs, etc.] APPROXIMATEPhone1414 th previous month$28Church1 & 15$40Misc$200Total Monthly Expenses*$5,068 MonthX12=$60,816JanMedical Insurance1/11 st previous month$543$543 JanFebNewspaper2/15$29$29 FebMarAccountant$350Income Taxes4/10$1,200$1,550 MarAprilMedical Insurance4/11 st previous month$543Newspaper4/15$29$ 572 AprilMay0 MayJuneNewspaper6/15$29$29 JuneJulyLiability Insurance7/11 st previous month$125Medical Insurance7/11 st previous month$543$668 JulyAugNewspaper8/15$29$29 AugSept0 SeptOctMedical Insurance10/11 st previous Month$543Newspaper10/15$29$572 OctNov0 NovDecNewspaper12/15$29$29 DecTOTAL YEARLY EXPENSE$64,837INCOME INCOME SOURCE DATEMONTHLY AMOUNTANNUAL TOTALSocial Security3rd$990$11,880Draw on Retirement Fund Account15th$5,000$60,000Total Annual$71,880BUDGET SUMMARYAnnual Income$71,880Annual Expenses 64,837$ 7,043Amount left for additional miscellaneous expensesIOU for Reimbursement to CaregiverI purchase things for Mom with my money. I keep the following IOU list of expenses, pay myself from her check book at the end of the month, and file the list in case anyone in the future should question the monthly checks.The list is in Microsoft Office Word table format, but you could save yourself adding up the total each month by creating it in Excel.Month:________ Year:_________IOU AmountDate…… Item Description……………………….………………………………………Total Paid by Check #_________Bill Payment TrackerMonthly BillsPayee……………..ClosingDateDueDateAmountDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidBill Payment TrackerNon-Regular BillsPayee……………..ClosingDateDueDateAmountDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidJanFebMarAprilMayPayee……………..ClosingDateDueDateAmountDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidDatePaidJuneJulyAugSeptOctNovDecKeeping track of important items and informationTaking over another person’s “life” is not easy. All of the zillion details you take for granted in your own life – who are your insurance companies, where are the policies, where do you keep the paid invoices, when are they due – become part of a frustrating Easter egg hunt when you begin paying bills and making decisions for your parent.I began by creating a master list of important items and information. As I found each piece of information, I added it to the list and coded where each could be found – in the attorney’s office, in the file at the house, at a relative’s house, in the safe, in a safety deposit box, in her wallet, etc. I simultaneously set up alphabetical files for the file cabinet. By using the master list of important items and information, I can access anything quickly and effortlessly. I also customized an income tax organizer which lists all of the information specific to Mom’s taxes that I need to collect and bring to the tax accountant.I found a number of insurance policies that come due at different times – car, drug, health, house, vision, etc. – and I was continually searching for policies and due dates, so I created a master list of insurance policies including pertinent information on each policy. I added the due dates to the bill payment tracker and the amounts to the annual budget.Because Mom had some items of personal property such as antiques, artwork, furnishings, furs, and jewelry that were of value, I created an inventory form for these. I also took pictures of each and put them in the safe in case of theft or fire. I had major items appraised and put them on an insurance rider. Finally, Mom wants specific items to go to various family members so I noted that on the inventory.When she was still driving, I collected all the information on her car and put it on a form so I now knew when to get her tires rotated, what pressure should be in her tires, etc.Although Mom no longer had her cocker spaniel, I developed a pet form that you can use to track important information for your parent’s pet.Finally, there were some pieces of important information that I needed to provide family members in the event that I was out of town and an emergency arose. I put these on the “Summary of Important Information” form and noted who received it and when, so I could give them an updated form periodically.In this section, you will find the following: Location of important items and informationIncome Tax Organizer Insurance PoliciesPersonal Property InventoryAntiques, Artwork, Furnishings, Furs, Jewelry, etc.CarsPetsSummary of Important InformationLocation of Important Items and InformationImportant items and information such as credit cards, paid invoices, a will or jewelry might be found in one of the following locations:Attorney’s Office (See Column 1 in table below)Name:_________________________Phone:______________________________Address:___________________________________________________________File(s) in House (See Column 2 in table below)Location:___________________________________________________________Relative’s House (See Column 3 in table below)Name:_________________________Phone:______________________________Address:___________________________________________________________Safe (See Column 4 in table below)Location of Safe:Location of Code for Safe:Location of Key for Safe:Safety Deposit Box (See Column 5 in table below)Number:______________________Location of Key(s):____________________Bank Name:___________________Phone:_____________________________Address:___________________________________________________________Hours of Operation:__________________________________________________Wallet (See Column 6 in table below)Other (See Column 7 in table below)List each item and check the box which indicates its location in the checklist below.Location of Important Items and Information ChecklistItem----------------------------------------------------1---2---3---4---5---6---7---Possible Important Information Items to list in table above: Address Changes checklistAdvanced Health Care DirectiveAttorney NotesAuthorization for Use and Disclosure of Protected Health InformationBank or Credit Union StatementsBill Payment TrackerBirth CertificateBudgetCalendars – OldCashCar RegistrationCredit Card BillsCell Phone CompanyCertification and Abstract of Trust AgreementChoosing a Senior Facility checklistClothing and Size Information ChartCredit CardsDeath Arrangement PaperworkDeath Certificate of SpouseDisposal of Furnishing and Appliances SheetDivorce PaperworkDriver’s LicenseDrug ReceiptsEmergency Contact InformationFamily Misc. (Pictures, Letters, etc.)Gardener Information SheetGrocery List ChecklistGuarantees for items purchasedHandicapped Plaque InformationHandicapped Plaque LocationHome Purchase/Sale InformationHospital ReceiptsHouse Information SheetIdentification CardIncome Tax Organizer ChartIncome Tax Receipts for Current YearIncome Tax Records Last 7 yearsInsurance Policy – CarInsurance Policy –DentalInsurance Policy –DrugInsurance Policy –Health (Medicare Supplemental)Insurance Policy –Homeowner’s (Fire, etc.)Insurance Policy –House (Earthquake, etc.)Insurance Policy –LiabilityInsurance Policy – LifeInsurance Policy –Long Term CareInsurance Policy –MedicareInsurance Policy –PetInsurance Policy –VisionIOU for Reimbursement to Caregiver ChartJewelry Appraisals and ReceiptsJewelry LocationLiving WillMagazine SubscriptionsManuals for AppliancesMarriage CertificateMaster Appointment Schedule for Service ProvidersMaster Card BillsMedia and Communications ChecklistMedical Expenses and Insurance Payments TrackerMedicare InformationMedication and Assistive Devices ChecklistMiscellaneousMortgage Paper WorkNewspaper BillsNotes from Doctor’s VisitsPassportPersonal Property InventoryPaycheck StubsPhone Company BillsPowers of Attorney (for Healthcare, etc.)Real Estate Tax InformationRental AgreementRenting the House Check listSale of House Paper WorkSenior Residence Financial Receipts and ContractsSenior Residence Notes to StaffSocial Security CardSummary of Important InformationTravel ListTrustVisiting Nurses InformationVisitor List for Resident of a Senior FacilityVoter RegistrationWallet Contents PhotocopyWalletWillIncome Tax OrganizerAlthough we have an accountant, it’s my job to organize Mom’s tax information and records preparatory to our tax appointment. Since it’s a miserable job, I put on my favorite music and promise myself an ice cream sundae upon completion. I have created a simple organizing system, making an index card for each topic below. Then I go through the files, putting appropriate records with each index card. Once the records are grouped by topics, I fill in the tax accountant’s worksheet and attach whatever documentation is required.1099’sDividends and distributions from Stocks and BondsState income tax refund Credit Union Bank OtherW-2 Wage and Tax Statement from Social SecurityGrossFederal TaxState TaxOtherReceiptsAdaptive Devices (Llifeline, Walker, etc.)Attorney FeesCredit Card statements DentistDoctorDonationsDrugsGlassesHearing Aids & BatteriesMedical Expenses – mileageMedicare Part D premiumsProperty Taxes Refund state taxesRental Records Stock, Bond, Mutual Fund Accounts Tax preparation previous yearOtherRevised Date: ________________________________Insurance PoliciesCar InsuranceCompany: _________________________Agent: _________________________Policy #: ___________________________Phone: ________________________Address: ____________________________________ Date Due:______________Type (comprehensive, etc):____________Deductible: ____________________Dental InsuranceCompany: __________________________Policy #: _______________________Co-Pay Amount Per Office Visit:_________Phone: ________________________Address: _________________________________ _ Date Due:________________Health Insurance (Might be a policy to supplement Medicare)Company: __________________________Policy #: _______________________Co-Pay Amount Per Office Visit:_________Phone: ________________________Address: ___________________________________ Date Due:_______________House or Renter’s InsuranceHomeowner’s or Renter’s Insurance Company: _______________________ Address: _____________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________ Riders (for jewelry, etc.):____________Cost for Riders:________________Specialized House Insurance (for earthquakes, etc.) Company: _______________________ Address: ______________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________Liability Insurance Company: _______________________ Address: ______________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________Long Term Care Insurance Company: _______________________ Address: ______________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Insured Value:__________________Amount of Deductible:__________Medicare Insurance Part A & B Policy #:__________________________________________Medicare Insurance Part D (Drug) Company: _______________________ Address: ______________________ Phone:__________________________Policy #: ______________________ Date of Policy:________ Cost:____________Date Due: _______________ Pet InsuranceCompany: __________________________Policy #: _______________________Co-Pay Amount Per Office Visit:_________Phone: ________________________Address: __________________________________ Date Due:________________Vision InsuranceCompany: __________________________Policy #: _______________________Co-Pay Amount Per Office Visit:_________Phone: ________________________Address: __________________________________ Date Due:________________Other:Personal Property Inventory -- Antiques, Artwork, Furnishings, Furs, Jewelry, etc.Take pictures of all furnishings and special items. Item--------------Description and Location--------------- Approx Value +Person to InheritIf Designated+ If you have the item appraised, include the appraisal date & appraiser contact information. Also consider getting a rider on the home insurance policy to cover the item. (See Insurance Checklist)Personal Property -- CarsCarYear: _________________ Brand: __________________Model:______________Color: ________________ VIN:_____________________Dealership Purchased from: __________________________________Address:__________________________________________________Phone:___________________License Plate #:_______________________Location(s) of keys:______________Location of Registration Paperwork: ___________________________________ Due Date: _____________Insurance (See Insurance Checklist) Company:__________________________ Policy Number:__________________Type of Gasoline Used:______________________ Weight of Oil:_____________Mechanic’s Name:_____________________Address:_____________________________________Phone:_________________Location of Maintenance Diary:_______________________________________________Tire Pressure:_______________ Tire Company:___________________Tire Brand: _________________ Last Purchased:_________________ Rotation Date: _____________ Mileage at Rotation:______________Notes: Personal Property--PetsPet(s) Name:______________________________License #:______________________Description:_________________________ Birth Date:______________________Vet Name:__________________________Address:_______________________ Phone:_________________________ Office Hours:____________________Pet Emergency Clinic:_________________Address:_______________________ Phone:_________________________Office Hours:___________________Groomer:__________________________Address:_______________________ Phone:_________________________Description of Service:____________ Schedule:_______________________Cost:__________________________Dog Walker:________________________Address:_______________________ Phone:_________________________Description of Service:___________ Schedule:______________________Cost:__________________________Food & VitaminsName Amount Given AMAmount Given PMWhere Purchased?ImmunizationsNameWhat For?Date GivenDate DueSummary of Important Information revised Date______I keep this summary of important information handy at all times and take it with me on trips. You never know when you might receive an emergency phone call and need the information. Starred items are those that I provide to the Residential Care Facility.*Attorney: Name, Phone Number, Address ______________________________________________________________________________________________________________________________________Birth Date : _______________________________________________________*Clergy: Name, Phone Number, Address______________________________________________________________________________________________________________________________________*Death ArrangementsName of Funeral Home, Phone Number, Address __________________________________________________________________________________________________________________________*Dentist Name:__________________________ Phone:_____________________ Address:_________________________________________________________*Doctor (Primary) Name:_______________________ Phone:_________________ Address:_________________________________________________________Driver’s License or ID Card #:_______________________Medical Insurance – See wallet for cardsMedicare #: _______________________________Supplemental Health Insurance Name: _____________________________Policy #: ____________________________Phone #:____________________________Medicare Part D Drug Provider – See wallet for cardName: _____________________________Policy #: ____________________________ Phone #:____________________________*Medications – See separate list for complete listingSocial Security Number: ________________________Wallet Contents – List and attach photo copies: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Preparing for the InevitableWhen my Dad died, I had no preparation for the emotional tidal wave that would overcome me. At the same time, I had to make all the arrangements and deal with mountains of paper work and phone calls to get everything settled. I spent many frustrating hours trying to find accounts, lists of people to contact, and a myriad of other little pieces of information that were necessary to tie up loose ends.I decided that the next time I would be as prepared as possible. To that end, I have discussed with Mom her wishes in relation to such things as hospice, end of life care (documented in the Advanced Health Care Directive), an obituary, a religious service, burial ceremony, etc. and we have prepaid for her cremation. I’ve since found an excellent section in Rachelle Zukerman’s Eldercare for Dummies entitled “Ensuring a Good Death,” that lets you know what to expect during the death process. I found a section which lists the tasks that you need to do to settle financial affairs after the death of your loved one particularly helpful, and I plan to use it as a template. (318-319) Zukerman says you should collect all the things I’ve listed in the chapter entitled “Keeping Track of Important Items and Information”; notify insurance companies, Social Security, the Veteran’s Administration, past employers, the bank (and I would add any appropriate investment companies); cancel credit cards, clubs (and I would add subscriptions); list all debts; contact the probate court to begin the probate process (and I would add contact the family attorney who should have the original copy of the will and trust). I found that I needed six official copies of the death certificate to accomplish the above, but you may want to get up to ten copies to be on the safe side. You can always order extra copies, but it takes time. In this section you will find “Making Final Arrangements” which includes the questions that I asked as I chose a funeral home or crematorium. Delehanty’s book Caring for Your Parents has an informative chapter on these topics as well on pages 157-171.I’ve also included a form to inform the care facility of the final arrangements I’ve made in the event that they have trouble contacting me while I’m traveling.You will also find two charts entitled “Paces to Notify Upon Death” and “Things to Gather Upon Death” which I created recently upon the death of a good friend. Finally, I know that having the pages in this book filled out and in one place means that I have all of the information I could possibly need at my finger tips as I negotiate final arrangements. Making Final ArrangementsAlthough it is difficult, discussing funeral arrangements ahead of time with your parent assures that you will be fulfilling her wishes when the time comes. If you both feel comfortable making arrangements now, you will be able to make decisions without having to do so under emotional turmoil and pressure. Following are some questions you might ask as you discuss arrangements with a funeral home or crematorium.What is the cost for each service provided?Can we complete paperwork and leave it on file to allow for your immediate response whenever death occurs?Do we have to pay up front? If not, what are the advantages of doing so?If we pay up front, what happens if you go out of business?Assuming you pick up the deceased, what happens if they die out of the state or out of the country?Do you cremate on the premises? Within what time frame?How do I go about making arrangements for a cemetery plot?Death Arrangements Notice to Care FacilityDate: ___________________To: Name of Care Facility: ______________________________________From: Your Name and Relationship:_________________________________Subject: Arrangements Regarding Future Demise of Name of person (and room number if in a facility):___________________________________________If Name of Person:___________________________ were to pass away while at your facility, please do the following:Assuming I am home, please call me at home number:__________________ or cell number:_________________________________________________If I am traveling during this time, I have left you an itinerary with my contact information. If you cannot reach me, please contact person’s name and relationship:______________________________________________ at home :(___) __________________ or cell: (___) ______________________ If I cannot be reached immediately, please call Name of Funeral Home:________________________________________________________ at Phone Number:____________________________________ Signed paper work is in their office, located at: _______________________ They are available 24 hours a day, 7 days a week. They will pick up and transfer Name of Person: ____________________________ to their facility. Sincerely,(Your Name)Places to Notify Upon Death (Alphabetical)Those in bold face often require a certified death certificate.Date NotifiedDeath Certificate SentNotesAccountant or tax preparer *Air mileage accountsAttorney **Auto insurance company Bank – Checking and Savings accounts ***Brokerage Companies for stocks and bondsCell phone companyComputer related components – DSL provider E mail accounts, I tunes, etc.Credit cards – cancel unless you’re named on the account and want to keep itDentist and other health care professionalsDept of Motor Vehicles -- Auto registration (transfer title to survivor) Driver’s licenseEmployer – yours and spouse’sFinancial advisorFuneral directorHealth insurance companyInsurance agent (also change beneficiaries on your insurance policies and update names of insured)Investments – Mutual Funds, 401’s, Annuities, etc.IRA custodians or trustees regarding designated beneficiaries and post-death distribution optionsIRSLandlordLife Insurance CompaniesLong term care insurance companyMagazine subscriptionsMedicareMortgage companyPast employers regarding pension plansPension PlansReal Estate Official for deed, title, etc.Social Security ****Stock broker Storage CompanyTrust AccountsVeteran’s Association – May get burial expense allocationWorkplace ******Other things to do*Talk to accountant or tax preparer about need to file estate tax, inheritance tax, federal and state income taxes for deceased for the year of death, separate income tax returns for trusts, changes in real estate taxes.** Talk to attorney about filing will with probate court and need to file on any out of state real estate, updating and revising your own will, appointing a new executor for the remaining estate*** Re-title jointly held bank accounts and other assets such as cars, stocks, bonds, real estate****Report the death to Social Security by calling 1-800-772-1213. If benefits were being directly deposited to bank, ask bank to return funds received for the month of death to Social Security. Return any social security checks that come by mail. Check if eligible for death benefit and survivor’s benefits.*****Workplace -- Make arrangements to collect belongings, salary and vacation or sick pay owed, ask about continuing health insurance coverage and potential survivor’s benefitsThings to Gather Upon Death (Alphabetical)ItemLocation. . . . .Notes. . . . . Automobile and boat registrationsBank records: Bank or Credit union statements Certificates of deposit Money-market account statements Outstanding loan statements Safety deposit box records and keys (change ownership of box)Belongings from workplaceBirth certificateCredit cardsDeath certificates (certified copies)Deed to cemetery plotFuneral Plans including proof of prepayment for servicesInsurance Policies : Accidental death & dismemberment insurance Annuities Auto credit life insurance Credit card insurance Individual and group life insurance Mortgage insuranceInvestment records: Annuity statements Bonds StocksMarriage certificateMilitary discharge papersPapers of authenticity for valuables such as art, jewelryPension and profit-sharing plan statements – 401K, IRA, etc.Real Estate Records: Deed and deed of trust Mortgage contract Promissory notes Property appraisal Real estate tax noticesRegistration for car, boat, etc.Social security cardTax returnsTrustWillWorks CitedAARP New Hampshire. April 20, 2010. Prepare to Care: A Planning Guide for Families. [ to care.html]Bell, Virginia and David Troxel. A Dignified Life: The Best Friends Approach to Alzheimer’s Care, A Guide for Family Caregivers. Deerfield Beach, FL: Health Professions Press, Inc, 2002.Capassela, Cappy and Sheila Warnock. Sharing the Care: How to Organize a Group to Care for Someone Who is Seriously Ill. New York: Fireside, arow, Avery. “Taking The Measure of the Latest Rankings: How Thousand of Homes Were Assessed and 173 Were Selected for this Issue.” U.S. News & World Report, Feb. 2010: 72-82.Delehanty, Hugh and Elinor Ginzler. Caring for Your Parents: The Complete AARP Guide. New York: Sterling Publishing Company, 2005.Johnson, Paulette. “Navigating the Health Care System,” The Monitor, Autumn 2011: 1-4. [html.newsletter.html]Kertesz, Louise. “Resources for Caregivers, or, ‘Who has time to read when you’re going through all that stuff?’” [ caregivers]Loverde, Joy. The Complete Eldercare Planner, Second Edition: Where to Start, Which Questions to Ask, and How to Find Help. New York: Three Rivers Press, 2009.McCullough, Dennis. My Mother, Your Mother: Embracing “Slow Medicine”—The Compassionate Approach to Caring for Your Aged Loved Ones. NewYork: Harper Collins Publishers, 2009.Sheehey, Gail. Passages in Caregiving: Turning Chaos into Confidence. New York: Harper Collilns, 2010.Zukerman, Rachelle. Eldercare for Dummies. Hoboken, NJ: Wiley Publishing, Inc., 2003.About the AuthorDiane Moore has a doctorate in educational management and has worked as a Dean at Ventura College for twenty years. Three years before retirement she became a caregiver for her elderly mother. She used her knowledge of management theory and the management skills she developed over the years to create systems that would make caregiving as effortless and enjoyable as possible. For the past eight years she has researched the field, consulted with many caregivers to get their advice, and refined the systems as she cares for her mother. Now she is ready to share them with you, in the hopes that using them will ease your burden and enhance your life and that of your loved one. ................
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