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Elder Orphans' Documents

Back in 2015, I wrote about elder orphans – old people who have no family or are estranged from their family and, either way, have no one they feel comfortable asking to handle health, legal and financial issues on their behalf if they become incapacitated or when they die.

Definition of Elder Orphan
In 2016, I carried on at some length here about a definition of elder orphans which is more complex for some people than can be obvious but has also been made more complicated than it needs to be.

Plus, some people who write about elder orphans – even some medical professionals who weigh in - are quite hysterical about how awful being an elder ophan is. That just is not true and I wrote about that last year. It's still worth a glance.

For today's purposes, the first paragraph above will do as a definition.


The Witnessed Documents
I have been remiss in not following up further on this issue. But a TGB reader recently emailed explaining that she, like me, is an elder orphan, that she had read the 2015 post in which I admitted to having made almost no arrangements for someone to make decisions for me or for my final wishes. She wondered if I have made any progress.

Happily for me, I have. I'm not finished but I've completed work on the major documents and, thanks mostly to my excellent attorney, John Gear, who pressured me in the kindliest way to get these documents done, it was not too painful.

I now have, duly executed:

Last Will and Testament
Durable Power of Attorney
Oregon Health Information Release Authorization

The documents, in order, (1) distribute my assets upon my death, (2) give my named agent (who, in my case, is also my heir) permission to act on my behalf in legal and financial matters, and (3) is an authorization to release my health information to my health care surrogate (same person).

Having recently found a new physician, I have also completed and signed a POLST, a Physicians Orders for Life-Sustaining Treatment laying out what medical interventions I do and do not want in an extreme or end-of-life situation, and naming my surrogate so that medical professionals, in whatever condition I'm in, can contact her.

A POLST is a state-specific document in the U.S., called a MOLST in some states, that can be updated and/or revoked or changed, etc. if you choose. It is registered with the state for easy access by medical professionals.

That sounds like it should cover everything, but no. There are financial documents I have now completed too.


Financial Documents
At my death and upon presentation of my death certificate, my named beneficiaries will have full access to my accounts as if they were me. Both my local bank where I keep a checking and savings accounts and my investment advisor supplied the forms which I have executed and they now have in my records.

If your money matters are larger and more complex than mine there could be more to do. Consult your attorney and/or financial person.

Letter of Final Instructions for Survivors
This is a big deal - at least in size. It is an enormous document. It includes wishes for handling of remains, memorial service or funeral and complete list of property, various kinds of accounts, online assets, passwords, personal and family information and much more.

Although I have a file in which I'm collecting information, I haven't done this yet and I will probably break it up into two or three documents. (In my first draft of today's post, I made some lists of the items needed but it went on for several pages.

So instead of that, take a break now for a moment and follow this link [pdf] to the website of a financial consultant who posted a sample letter of instruction form.

Although it is nearly 20 years old – no spaces for email addresses or online information - it is amazingly thorough otherwise and extremely useful as a guide for collecting all the information your survivors will need and want.

According to my attorney (and many others), the final instruction letter should NOT be kept with your will which itself should not be in a safe deposit box because the bank will not release the contents of box until they have a death certificate. (A lot of people keep their will and other important documents in the freezer, sealed tightly in plastic.)

However you choose to store these documents, be sure the people you have selected to handle your end-of-life needs have copies or can easily get to them.

Also, you should review all your documents every year or so and update them as necessary. Your birthday a good reminder to do this.

Finding Your Surrogate
This blog post does not and is not meant to cover everything. There are other kinds of documents and an amazing array of different end of life choices.

Also, I understand that the biggest difficulty for elder orphans can be finding the person(s) to rely on to handle your affairs at the end. That's part of what took me so long and I have no advice to help you on that – only my personal experience.

My choice is an old friend I have known since she was a child who is now a mother. It is not ideal that I am on the west coast and she is on the east coast but I trust her completely and she has agreed to take this on for me.

My one worry is how difficult it might be to disrupt her life when I die or, moreso, if I am incapacitated and she needs to make life and death decisions as my health surrogate.

In just the past couple of weeks it occurred to me that there is one person nearby who I have come to know over three years who I would trust completely to make the right medical decisions for me and who is, like my east coast friend, enough younger than I am to probably outlive me.

Perhaps, I have been thinking, I could name him to be my health surrogate, leaving the rest to my friend on the east coast. However, he is also one of my various professional healthcare providers so even though we've become almost friends, it might not be appropriate to even ask him about doing this. I don't know. I continue to ponder it.

Meanwhile, writing this post has lit a fire under me to get that letter of instruction done. That will take awhile. An easier task is to arrange and pre-pay my green cremation. My east coast friend knows what to do with the ashes.



Can you designate a surrogate without asking / telling them?

Thank you, Ronni, for presenting this today. I've been struggling with this for a long time (and I'm older than you!). I was confused about POLST and/or MOLST and while I do have some of these forms completed, also want to redo my will. And am pleased to see the link to the letter of instruction form. I've saved it to print and plan to use it--it's quite comprehensive. All this has been nagging at me for a long time--it will be such a relief to have it taken care of. This is a huge help.

As far as I know, there is nothing to prevent naming a surrogate without telling them but would you really want to do that?

Imagine if it were you, finding out suddenly, that you are being asked to decide, for example, whether to pull the plug on a friend or use all possible means to keep the person alive or something in between.

Some surprises are fun. Personally, I don't think this one would be.

Such important and useful information, thank you. Amazed that so many people won't even consider doing a Will, far less anything else.

What a great and detailed outline for this important part of life.
It's easy to understand the reluctance of us elders to face the inevitable end of our lives. Still most of us have had to go through the problems left behind of those who have gone before us when we had to clean up the legal details that could have been avoided.

Personally, because of those examples, I have kept my legal work up to date almost religiously.

Two good friends of different ages are named as executrix and alternate, every doctor I visit has a copy of my Advance Health Care Directive and there are extras scattered around. Neptune has my bought-and-paid-for cremation and disposal plans.

Finally, this is a heck of a lot easier to do when we are in good health, and I can attest to the feeling of enormous well being to have all this accomplished.

With the outline you have provided, Ronni, and the courage to just "do it", I"m sure some of your readers will make those plans.

Back when we couldn't get married (we're gay) we did one set of this, quite complicated. Then the world let us get married and we redid it (easier) ... Now it has been several years and we probably ought to revisit, especially the various surrogate people as changes in people's lives and circumstances are inevitable.

And this is in a long partnership, although neither of us has blood relatives who would step in automatically. So we too are sort of "elder orphans." Happy ones, but trying to be responsible.

Thanks for the sample Ronni. My paperwork is mostly up-to-date. I find myself revising my Polst/Advanced Health Care direction as I find some situations I had not thought about. I am still consolidating some of the other information I have but isn't organized well. I have lots of family so am not an orphan elder but the advice is still right on. One son has a safe in his house and that is where, other than my attorney, is where I keep the other papers. Perhaps the non-family personal rep might have something like that available and will share.

Just in time! To date, I have only a holographic will, and health power of attorney. I'm stymied by who to ask to be executor..........I think North Carolina wants more than one. Okay, thanks again, this is so timely!

Will, living trust, health-care directive, durable power of attorney--been there, done that. Your column today, though, is the first I've heard of POLST/MOLST. Thanks for that--I'm off to email my friend the attorney/executor/surrogate to ask about what I need there.

Great info. I've taken care of these matters some years ago, and found that an annual review is and updates if needed is very important. Things change more than we sometimes think. One question for you or readers: Is a will written, witnessed, and notarized one one state good in all other states?

Property laws in particular can vary from state to state and there can be other differences. If you move to a new state, it's important to have your documents checked by an attorney and updated if necessary to be valid in your new location.

One obvious need would be a new POLST or MOLST, as they are state specific.

One place to begin gathering information is ElderLaw Answers.

Another vehicle is the transfer on death (TOD) designation which lets beneficiaries receive assets at the time of the person's death without going through probate. With TOD registration, the named beneficiaries have no access to or control over a person's assets as long as the person is alive.

I have in place a will, a Living Will (Advance Directive) which as I understand it is the same as a POLST/MOLST, a Durable Power of Attorney, and a Medical Power of Attorney. My son, who will be my executor and has power of attorney, is now a co-signer on my bank accounts and safe deposit box so he will have access to them when I die. Originals of all documents are in the safe deposit box and copies at home in a file cabinet. My doctors all have copies of the Living Will. (I'm in Colorado.)

I'll have to read up on letters of final instruction. I wrote up some notes some years ago, but need to review and expand them.

I am lucky and grateful to have four siblings, three of them younger than I. And the younger sister settled my parents' estates, so is familiar with what's involved.

I hear your ducks in a row quacking at me, Ronni! Though I'm one of the fortunate ones, having a plethora of relatives nearby from grand kids to siblings still those end of life directions need to be made.

When I've been Very Ill. Following an e-coli infection which ended up causing a bowel issue, I was aware that my POLST hadn't been filled out-it's one of the most important documents an elder needs. And it has to be given a lot of thought. At first I decided I wouldn't want ANY heroic life saving interventions- until I was in the hospital and needed oxygen. Without it I might not have recovered my serious illness. So give good logical thought to filling out that POLST.

Now that it appears our Medicare isn't going to be radically changed soon I feel like I can breath again. It was so EVIL of the GOP and the Trump/Ryan IDIOTS to put so many seniors in the position of being fearful of their governments machinations.

It isn't however time for us to sit back and quit writing letters and making phone calls. There are still many issues in the budget table that are looking at being cut. Locally our Meals in Wheels gets little federal support I've read it's 3% of their pitiful budget. However the potential loss of even that little impacts hundreds of local seniors and the disabled who rely on one hot meal a day. I've volunteered at MoW as a packager and driver and know personally from being in the receiving end how important it is. My neighbor, a really nasty woman I've lived opposite from for 40 years, now gets MoW every day. She's managed to alienate her children and grand children and has no one now caring for her. I try to take her garbage cans to the street in Sunday's when I take mine out but often as not she sucks her dogs on me and yells that I'm always stealing her garbage. She's been mentally deranged forever so other than the dogs barking and growling at me I don't take her yelling personally. She does make me sad though.

Be well

I've been wondering about looking for a local fiduciary to handle health care decisions and final arrangements. Has anyone done that? Trusted friends are scattered about the country. I don't know how they could get a hospital to listen to them, on the phone, if I were unable to authorize it.

Wouldn't it be nice if there was one place one could go to have all of this done all at once. Sort of "End of Life One Stop Shopping" store.

I have always been a plan ahead person, and found your blog today very interesting and the comments all worth reading, I feel for Elle, who has a neighbor, who could probably use some love. Or maybe a visit from her Church/or Social Service agency.
Also agree with the paperwork and getting the ducks in a row, I shared this page with my FB friends, I have many in similar situations. I gave my Mom a book to keep her passwords in, but it hadn't been filled in at last check.
This is what I wrote on my share, "
" Get your Ducks in a Row, read through this, the author is an elder orphan, and sharing with others who may have no family or estranged from their family, or just want to make sure someone in their family is going to follow their directions. Have the Talk." Also, if you haven't filled in the Five Wishes booklet, get one, they have them available for all the states, Google it.

Most of this appears to be dealing with end-of-life issues. What do we do if our declining health forces us into some sort of rehabilitation place or nursing home. I suppose we need to start shopping for that also? No one to help with financing......sell all I have and hope I don't end up in a state facility! Fingers crossed I simply go fast and drop dead, clean as a whistle. No problems then, as long as all other documents in order.

Very good reminders to get in gear, thanks Ronni. I am truly an "elder orphan" as an only child. There are no relatives to do this and the one person I would have trusted passed away in 2016.

My question is this: Can hiring an attorney to be the one for final decisions work? Or would that be a conflict of interest issue.

Going to look it up but thought maybe someone else may have run into this and can offer a direction.

Last Will includes who will raise minor children. I recommend that my clients have a Plan A and a Plan B. If your first choice of guardian is unable to serve, then you have a second choice included.

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