Searching for a Support System (Part 2)

       Last week I was talking about the hypothetical client, Jane Doe.  Jane does not have a family and friend support system to turn to when she can no longer handle her own financial and medical affairs and decision making.  What options does she have?

       Trusted professionals can sometimes be a good person to fill these roles.  That could be Jane’s attorney, accountant or financial advisor.  Many financial advisors, however, are bound by strict licensing rules which limit their ability to serve as agent under a power of attorney for their own family members.  A care manager or social worker could also be a suitable option for health care representative.  This type of professional will be very knowledgeable about care options and will be comfortable making medical decisions.

       In my practice, I have seen several different people serve as fiduciaries for aging seniors.  In a handful of cases it has been a caring neighbor, who maybe lives next door to Jane.  It often begins with the neighbor running errands for Jane, bringing her milk and bread when the neighbor goes to the grocery store or making sure she is OK when the neighborhood loses power.

       In other cases that person has been someone from the church, synagogue or mosque who has come to know Jane.  Sometimes it has been a social worker or other health care worker who works in the field of caring for seniors but has come to know Jane casually but not as a patient.

       Increasingly, I have been asked to serve in the role of either agent under financial power of attorney or health care representative under the health care power of attorney.  When no other alternative exists, I have agreed, but I rely on a team of professionals to help me.

       There are daily money managers who can manage the day to day and month to month money management, making sure the bills are paid.  They can also be invaluable in keeping on top of medical insurance claims.  I rely on financial advisors to guide me on making prudent investment decisions that are age appropriate.  Accountants are needed to complete annual tax returns but are also important because, having often worked with their clients for years, they may have knowledge about Jane Doe that could be helpful.

       On the health care side, I often rely on a geriatric care manager and/or other care professional to keep me informed about Jane Doe’s medical condition and visit and talk with doctors so that when a decision is necessary I have a valued and trusted professional to give me input.  If Jane can no longer live alone I can rely on trusted professionals to recommend the care option that is best suited to Jane’s needs.

       I have found that this team approach works very well.  The agent or health care representative will have a range of professionals at his/her disposal to call upon as needed.  If the agent or health care representative is a professional in one of these disciplines so much the better.  They will have certain professional standards and licensing requirements to comply with that suggests that they’ll be able to do right by Jane.

       But, of course we read and hear stories about seniors who were not cared for properly or who were swindled by a trusted friend or advisor.  So what protections can be put in place to minimize that risk?  We’ll address that one next week.