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Part of sensible estate planning is having an advance health care directive that contains living will language, and a durable power of attorney for financial decisions, all targeted at making your wishes known for how you want your medical care and other affairs to be handled.
However, not everyone has a broad support group or family members to whom they can appoint as agents to carry out or to make material decisions affecting their health and well-being. Some elder law lawyers and other senior advocates are recommending care committees in some situations that can be helpful and beneficial to seniors. However, a care committee can be created in any situation where seniors are concerned about their elderly care. These committees create care by consensus.
Creating the Care Committee
As an individual who may be in declining health or who is about to enter a nursing home or similar facility, a care committee is essentially an extension of a health care power of attorney. You appoint an agent or person who is authorized to make decisions about your health care and use of your financial resources if you become disabled or incapacitated. Incapacity can physical or mental and may include dementia or significant loss of mental faculties so that you are no longer able to make reasonable decisions about your welfare.
A document can be drafted by your elder law lawyer that outlines the terms and conditions under which the care committee will operate. It can be an appendix to your health care proxy that takes effect upon your request or when you are determined by two licensed physicians that you are mentally incapacitated and unable to make these types of decision on your won any longer.
Committee members should consist of at least your appointed Health Care Agent as well as a health care professional, such as a geriatric care manager or licensed social worker, who specializes in senior care. Your agent must be over the age of eighteen and is usually a spouse, or adult child, or a trusted friend if you have no immediate family. Other members are generally other family members or friends whom you may have relied on for support and advice. These members should be younger than yourself and capable and willing to carry out your intentions.
What the Care Committee Does
When entering into a long-term-care arrangement either in your own home or in a nursing home or senior care facility, a care plan will be needed that includes your medical and mental diagnosis, medications, special needs, if assistive medical devices such as a wheelchair or walker are needed, diet requirements, and anything else appropriate and necessary for your comfort and care.
Your care committee members can discuss your current care plan or draft one with the assistance of your Elder Law Lawyer and it should be reviewed, on a monthly basis if you wish, though it must be reviewed at least every 90-days if you are in a nursing home. You can request a review at your direction or have one scheduled at certain intervals, or if your health status changes. If you are incapacitated, then your agent should schedule these reviews.
Most care committees become effective when you can no longer articulate your intentions. If it is impractical for all committee members to meet in-person, some can do so by Skype or FaceTime or conference call. Your health status is discussed and if your current care plan does not meet with your current specific needs it should be modified. Once a consensus is reached, a care manager can see that the nursing home is notified and that the instructions are followed carefully.
If there are disagreements among committee members, then your agent should be the one who makes the final decision. It can be difficult for some committees to work effectively since you have members who are not used to working together. Still, the care committee members should be focused on what is in your best interests.
Special Needs Trusts
Special needs trusts are set up for individuals who are disabled physically or mentally. They allow the beneficiaries to receive additional funds for certain activities while not interfering with that person’s entitlement to public/government benefits. The trustee is authorized with a fiduciary duty to have sole discretion to administer the trust funds and protect the beneficiaries’ assets.
A care committee operates as a check on the trustee’s duties. They can review the accounting records and if necessary, vote to remove and replace the trustee if there is a breach of fiduciary duty or evidence of fraud or other crimes.
Consult Elder Law Lawyer Patricia Bloom-McDonald
If you are considering a care committee, consult with elder law lawyer Patricia Bloom-McDonald on whether it can work for you. Attorney Bloom-McDonald has been an elder law advocate and estate planning professional who has been advising and counseling seniors and families for decades. Call her today if you have questions about any aspect of elder law.