A game plan for the unexpected during the pandemic

It’s 2 a.m., and the phone rings. You get the call that one of your aging parents has been taken to the ER. Are you prepared?

During the current COVID-19 pandemic, the need for a proactive game plan for short- or long-term care needs has never been greater. Since many state or federal regulations currently prohibit family members from being in the ER or visiting a loved one’s hospital room, having a written plan in advance is essential for positive outcomes.

Recently, the Center for Disease Control reported, “for deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death.” Having a written health document prepared in advance could be life-saving.

Compiling a comprehensive document containing health information is the first step in preparing for such unforeseen medical emergencies. This document should include general information such as emergency contacts, health insurance information, health conditions, past surgeries and illnesses, and a medication list.

Preferred Care at Home offers an online version free of charge called Personal Health Record, which can be downloaded by going to www.preferhome.com/NWLA and clicking on the resources tab at the top. This document is a health-history tool, an educational manual and a care playbook wrapped into one.

Completing advance directives is the next step in preparing for an emergency phone call. Advance directives are legal documents that allow people to choose how they want to live once they are no longer able to make decisions or speak for themselves. There are three basic types of advanced directives in Louisiana: Declaration (for lifesustaining measures or “Living Will”), a DNR (Do Not Resuscitate), and Power of Attorney for Health Care. Often a “Living Will” will also include a DNR directive.

In Louisiana, a Declaration or Power of Attorney for Health Care may be written without the assistance of an attorney. However, two witnesses who are not related by blood or marriage or would not be entitled to any portion of the estate are required. Notarization is not necessary. Just because a living will is signed at a hospital, it may not be valid outside of the property or for future events.

A Declaration, or “Living Will,” is a document in which you choose what type of medical treatment(s) you are to receive when you can no longer express your wishes. In this document, you will specify whether you want or do not want life-sustaining procedures and under what conditions. This document will only take effect if you are comatose, incompetent or otherwise mentally or physically incapable of communication.

A Power of Attorney for Health Care is different from a Declaration (living will). It is a legal document in which you choose a person or persons to make decisions and advocate about health care for you when you are no longer able to make decisions or speak for yourself. The person or persons you designate as your agent can only make decisions when you are incapacitated.

Once prepared, copies of all of these documents need to be placed into a wellmarked binder at home and with family members and physicians with additional copies ready to go should you receive a 2 a.m. phone call.

Having a plan for long-term care is the next step in being prepared for what may lie ahead. Long-term care is the support and assistance needed for “hands-on” care called Activities of Daily Living (ADLs), which include assistance with bathing, dressing, toileting, grooming, transferring, ambulating and eating. However, it is often “hands-off” care called Instrumental Activities of Daily Living, which are the ones usually needed first. These may include housekeeping, meal preparation and incidental transportation.

Depending on the situation following a hospital or rehab stay, loved ones may no longer be able to live by themselves without assistance, either short-term or long-term. Home care and facility care are the two most common types of long-term care. Unfortunately, Medicare will only pay for long-term care if skilled services or rehabilitative care is required. Medicare or other health insurance will not pay for nonskilled assistance with daily living activities, so planning for how to cover the cost of longterm care should not be overlooked.

Facility care usually provides physical, mental, nutritional and social activities. However, as we have seen in recent months, conditions in facilities are subject to rules made by governing bodies, which are often not aligned with the personal wishes of families or their loved ones. Isolation and the inability of families to interact with residents can have a number of negative effects on all involved’s mental and physical well-being.

Receiving one-on-one professional inhome care provides the option of remaining at home, close to neighbors and comforted by familiar surroundings. Family members and other loved ones are free to come and go as they please. Having in-home care also allows keeping beloved pets and maintaining a flexible daily schedule.

Preparing for medical emergencies now during the pandemic and the future may be difficult to think about or uncomfortable to discuss. However, making decisions today about the future will provide peace of mind knowing that our loved ones have documented how they choose to live their life … and on their terms.

Scott H. Green a Certified Senior Advisor® and president of Preferred Care at Home of Northwest Louisiana. Green can be reached via email at scottg@preferhome.com