What Is Legal Advocacy?

elder care lawPlanning ahead for all stages of life include understanding legal terminology. I will break down some of the more important terms.

Why Is Estate Planning Important?

  • Provides for person health care and affairs/assets in case of incapacitation
  • Leaves a legacy for property and memories for loved ones and special causes
  • Manages and reduces taxes (state and federal) for maximal asset transfer to heirs and benficiaries

ElderCompass highly recommends meeting with an attorney versed in elder law to plan a will and trust. Establishing wishes regarding end of life, finances, and property distribution may provide peace of mind, and family-advocates clear direction.

As you read further, these terms are all used when planning your legal documents. Become familiar with these basic terms to make your experience with legal professionals more efficient and less stressful.

Advance Directive:

Statement made by an individual, usually in a written document, concerning medical treatments to be provided and decision –maker to be appointed of the patient becomes incapacitated or terminally-ill.

Durable Power of Attorney for Healthcare (Proxy Statement):

Legal document prepared by an individual authorizing a family member or friend to make health care decisions on their behalf in case of incompetence.

Do Not Resuscitate Order (DNR):

Physician order, inserted into an individual’s patient records and wishes documentation that Cardiopulmonary Resuscitation (CPR) shall not be used as a lifesaving procedure.

Cardiopulmonary Resuscitation (CPR):

Emergency treatment that compresses the heart and forces air into the recipient’s lungs. This process is used when the heart  or breathing stops.


In the context of healthcare, ability of a patient or individual to make independent decisions about health or medical treatments.

Conservator (Guardian of Assets):

Person appointed by the court to manage financial or legal affairs of an incapacitated individual.

Extraordinary Medical Measures:

Medical treatment that would not provide a distinct benefit, would serve  a patient’s best interest, or would be considered unreasonable in improving or saving a person’s life.


Court-appointed fiduciary responsible for a minor or incompetent person.

Informed Consent:

Legal condition whereby a person can be said to have agreed or given consent to allow something to happen based on full appreciation and understanding of the facts and implication of the action.

Marital Trust:

Trust that mandates the income of the trust be paid to the surviving spouse.

Power of Attorney:

Written document executed by one person who authorizes another person to act on his or her behalf.


Legal process of administering and distributing an estate after death.


Fiduciary arrangement set up by a grantor whereby property is held and managed for a named beneficiary by a third party, known as a trustee.


Person or organization holds legal title to property held in a trust. The Trustee holds and manages the property for the benefit of the trust beneficiary or beneficiaries.


Legal document that specifies how a person wishes to distribute probate property and provides other instructions in the event of death.


Planning ahead is a favor to both seniors themselves and family/advocates.  End-of-life documentation can provide relief to those left behind. Keep legal documents in a safe place and ensure appropriate family members and advocates have copies and key contact information.



7 Easy Steps To Help Your Elder

senior financial documentsAs an elder advocate and or caregiver, there are simple things you can do to make sure your elder receives timely and quality care. Being an advocate includes planning ahead and being prepared to make decisions on behalf of your elder. Consider obtaining legal advocacy documents called Power of Attorney for Health and a separate one for Finance, if you do not yet have them.

Visit us again next week as we discuss legal advocacy in more detail and important conversations to have with your elder that are crucial to maintaining their wishes.

7 Easy Steps To Help Your Elder:

1. Gather important documents.  

Prepare your own “face sheet” that includes: Complete full name, (and maiden name if applicable), date of birth, Social Security Number, home address, types of insurance [Medicare, Medicare Supplements, Long term Care, Life Insurance etc.] and all contract numbers. To protect identity, keep this information in a secure place.

2. Record.

All current and recent treating physician contact information, as well as hospitals and/or rehabilitation centers where care may have been received.

3. Make copies.

Driver’s license or state identification card, Medicare card, and any other supplemental insurance cards. Again, keep this information in a secure place.

4. Obtain and sign HIPPA (Health Information Privacy Protection Act) forms.

Sign these with your elder, from medical offices so you can communicate about health-related information.

5.  Gather contact and account information.

Banks, investment firms, and credit unions- remember to secure this information to maintain security.

6. Contact.

Insurance agents and inform them you are advocating for your elder.

7. Complete a medication list.

This should include all names, time, dose, indication of medication.

Being prepared can make elder care that much easier,  in times of crisis especially.

Join us next week as we continue the advocacy conversation. Plan ahead so any health situation can be managed and you can be available to provide support efficiently.

When Should Do Not Resuscitate Orders Be Written?

The topic is more important than you may think. It’s not a pleasant one, but it is worth discussing as we live longer and more medically-complex lives. Medical technology can keep us and those we love, alive longer. But what does this life look like to you? How does it affect yours and your family’s lifestyle? Your spirituality?  Your finances and financial legacy? We actually have the potential to influence and choose how we want to live the last weeks or days of our lives!

Do Not Resuscitate Law

In Michigan, we have the Do-Not-Resuscitate Procedure Act. This act informs health care professionals NOT to revive individuals who have signed a do-not-resuscitate order document.  It is for those individuals who do not want any special efforts made to prolong their life if their breathing or heart stops.  The document can be customized to include or exclude certain measures like chest compressions, use of certain drugs to help re-start the heart etc. and whether to include the use of breathing devices.  A competent adult can obtain and complete this order after discussing with his or her physician. The physician must also sign the order. People whose religion opposes medical treatment do not need a doctor’s signature.

The Do Not Resuscitate Form

The form/order should be placed in a prominent and visible place where one resides. Have discussions with family, friends, and caregivers and inform them about the signed do-not-resuscitate order; tell them where to find it. All advocates should carry a signed copy with them. Bracelets indicating specific wishes are also suggested.

Frequently Asked Questions:

Where do I get the form? The forms are available at most hospices and online. Click here to see an example of one.

Can I be forced to sign a Do-Not-Resuscitate order? Absolutely not. No one may require it as a condition for care or treatment.

Can I change my mind after I sign it? Yes, it may be cancelled at any time by any means of communication possible.

Will my insurance coverage be affected if I  sign such an order? No, the law says that your insurance provider cannot change, stop, refuse to renew, or invoke a suicide exemption or exclusion.

Keep up to date!

Do-Not-Resuscitate orders have changed and may continue to change as our health care technology evolves. Such orders used to, or may still apply  in your state, only in health care facilities such as hospitals and rehabilitation/nursing homes. People were not covered outside of such facilities, such as those at home with terminal illness. Licensed health professionals were required to try and revive anyone who had no heart beat or sign of breathing. In our state, when an order is present or a bracelet is worn, emergency responders cannot start resuscitation.

Make your wishes known today. Have that challenging conversation with your loved ones. Live the way you want to live while you are here on earth. You and your Elder will have peace of mind that the last season of life will be as they wished.

What Is A Nursing Assessment Anyway?

A clinical assessment is a necessary component of mapping a care strategy for your loved one.

As a clinician I perform a nursing assessment every day I work. A nursing assessment is a comprehensive evaluation of each realm of life. This type of evaluation is essentially the same for skilled nursing visits, benefit determinations, or a home safety/private duty assessment. Each time I meet a patient or client in their home I pay attention to the smallest of details…

Starting with home safety (about which I have recently blogged.) Is the environment clean? Is the home maintained and can the patient get in/out of their home safely? Heating and cooling adequate? Emergency exits and Plan I case of fire? Emergency numbers/contacts posted by the phone-can your Elder USE the phone? Smoke and Carbon Monoxide detectors (change the batteries on their birthday)? What is the bathroom like? Non-skid mats on the floor, approved shower chair, grab bars? Is there an emergency personal response system? I usually have the patient show me how they walk to/from the bathroom and can then get an accurate evaluation of their actual status/ability. Some folks are known to say, “Everything is just fine.”

After the ice is broken with non –clinical discussion, questioning ensues regarding functional status; including activities of daily living (ADLs.) Can they dress themselves including fastening and buttons? What about transferring in/out chair & bed? (Do they bother with a bed because it is too low or too high and instead sleep in a recliner chair?) Do they require hands on assistance from anyone or from an adaptive device like walker/ wheelchair/raised toilet seat/ and or grab bars? How is bathing achieved? Is the shower or bathtub used safely or does the individual use a basin for bathing? Is hygiene practice frequent enough for proper health? Is the patient able to control bladder and bowel function? (Check out the bathroom for underclothing that has been rinsed out and drying in the shower/tub.) Can they cook/obtain proper nutrition? Can they eat independently? A TUG test is performed (Timed Up and GO) previously described as the time in seconds it takes to rise from the chair, walk 10 feet and return to the chair and sit. The TUG is a mobility test to assess whether an individual is functioning well and safely. Scores of 25 sec or more have been to proven to be accurate indicators of whether an individual will experience falls and the often grave consequences following them.

Do they drive (should they drive?) Who manages the money? Is there social participation that prevents isolation often present in the older population? A social assessment should include what support systems may be in place. Is there a medical doctor or advance practitioner actively managing health care?

A physical assessment includes a complete set of vital signs including heart rate, blood pressure, temperature, and respiration rate. Does the patient have dizziness/weakness/fatigue/tremors/ fainting/lethargy/unsteady gait/impaired gait/impaired vision/impaired coordination/shortness of breath/ urinary frequency or urgency/incontinence of bladder or bowel/loss of appetite/loss of range of motion or cognitive defects? What is the current medication list-including over-the-counter medications? I inquire how the meds are taken and stored. Are there any expired meds in the house? Does the patient understand for what and how each med is prescribed? Is there a pill box for organizing and a check and balance system for taking the medication? What disease processes are actively affecting the patient? Does a history of other diagnosis (co-morbidities) also influence current status, i.e. cancer, fractures, dementia, diabetes mellitus, hypertension, heart disease etc. A nursing assessment steps away from the medical model because it is holistic in nature. As we care for our Elders in their homes or current living arrangement, we MUST consider all aspects of their lives: health, social, functional, and financial. Disease process does not exist in a vacuum.