Caring for Mom
A Practical Workbook for Caregivers
Diane Moore, Ed.D.
Caring for Mom
Table of Contents
This book is for informational use and is based on the author’s experience. The information in
this book should not be considered as a substitute for the advice of a qualified professional in
the appropriate field. The author expressly disclaims responsibility for any adverse effects
arising from the use or application of the information contained herein.
CARING FOR MOM: A PRACTICAL WORKBOOK FOR CAREGIVERS. Copyright ©2012 by Diane
Moore. All rights reserved. This book has been uploaded to www.caringformom.org, a
caregiving website managed by Diane Moore. The book may be downloaded from the website
for free and printed and/or customized for the reader’s personal use. Any forwarding of a
downloaded version to another person will be considered a violation of the copyright.
For information contact Dr. Diane Moore at diane@caringformom.org
HARMONY RODRIGUEZ, MLS
“This book is a great help for people at a loss as to how to organize their parent’s affairs! This is
a thorough guide to remembering all the balls we juggle for ourselves in day-to-day living, and it
supports the caregiver trying to apply that knowledge to their parent’s needs – a very practical
guide! “
“I think we are all initially overwhelmed when we start down the caregiver road. I would
suggest that a person start with the one system [in the book] that seems the most relevant and
gradually work from there. “
CAROL CHAPMAN, M ED.
“Your book is amazing! It is so relaxed and conversational. I think it will be a great comfort to
people who need it. I can’t wait to share it with my sister and office assistant. Thank you from
hundreds who will read and benefit and thank you from me.”
Caring for Mom
Table of Contents
Caring for Mom: A Practical Workbook for Caregivers
Table of Contents
1. Introduction 2
2. Taking Care of Yourself 7
a. Self Care Inventory and Planner 9
3. Living “Independently” in the Family Home 11
a. Clothing & Size Information 14
b. Gardener Information 15
c. Grocery List 16
d. House Information 19
e. Media and Communications Information
f. Travel List 25
4. Leaving the Family Home 27
a. Furnishings for One Bedroom Apartment in Senior Living Facility 29
b. Disposal of Furnishings and Appliances 31
c. Renting the House 33
d. Sale of the House 36
5. Choosing a Senior Facility 37
a. Initial Visit Checklist 40
b. Comparing Care Facilities – Follow-up Visits 45
c. Summary Comparison Chart for Care Facilities 46
Caring for Mom
Table of Contents
6. Address Changes 48
a. Change of Address: Sample letter 50
b. Change of Address to Caregiver’s Address: Sample letter 51
c. Change of Address Master List 52
d. Making Address Labels: Directions for Word 53
7. Living in a Senior Facility 54
a. Visitor List for Resident of a Senior Facility 56
b. Daily Schedule Sample 57
c. Emergency Contact Information 59
d. Notes to Staff (Generic Form) 60
e. Trip Itinerary for Caregiver and Emergency Contact Information 61
8. Doctors and Other Service Providers 62
a. Master Appointment Schedule for Service Providers 65
b. Notes from Doctor’s Visit 67
c. Medical Expenses and Insurance Payments 68
9. Medications and Assistive Devices 69
a. Over the Counter Medicines for Various Symptoms 71
b. Prescriptions Ordering Tracker 72
c. Request to Doctor for Prescription Renewal 74
d. Over the Counter Medications and Vitamins Tracker 75
e. Assistive Devices Tracker 76
10. The Attorney and Legal “Stuff” 77
Caring for Mom
Table of Contents
11. Setting up the Finances 80
a. Accessing Accounts – Sample Letter 83
b. Mom’s Sample Budget 84
c. IOU for Reimbursement to Caregiver 86
d. Bill Payment Tracker 87
12. Keeping Track of Important Items and Information 90
a. Location of Important Items and Information 92
b. Income Tax Organizer 98
c. Insurance Policies 100
d. Personal Property Inventory 103
i. Antiques, Artwork, Furnishings, Furs, Jewelry, etc. 103
ii. Cars 104
iii. Pets 105
e. Summary of Important Information 106
13. Preparing for the Inevitable 108
a. Making Final Arrangements 110
b. Death Arrangements Notice to Care Facility 111
c. Places to Notify Upon Death 113
d. Things to Gather Upon Death 115
14. Works Cited 117
Caring for Mom
Taking Care of Yourself
Preface
Many thanks to the caregivers who spent precious time reviewing this book and providing
helpful suggestions. They include Gloria Chinea, Dottie Edwards, Ruth Hemming, Jennifer
Hendricks, Anita Linton, Linda Moore, Harmony Rodriguez, Dorothy Scovil, Karen Staples, Carol
Chapman, Amy Utsunomiya and Joy Uyeki. Thank you to Jim Gilden and Louise Kertesz for the
encouragement and to Beverley Simmons for headers and page numbers.. Thank you to Dina
Pielaet for donating her time and enabling the book to be published by sharing her special
talents in photography, publishing, and technology. A very special thanks to my life partner and
mentor in caregiving, Lyn Utsunomiya – counselor extraordinaire!!
And finally, thank you, Mom! You’ve spent your life teaching me by word and example.
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Caring for Mom
Taking Care of Yourself
Introduction
My Mom is ninety-three. Eight years ago I got the call that my father had died suddenly. I flew
to their home in Oregon and helped Mom make the funeral arrangements and deal with the
paperwork required by various agencies and companies. We talked about her living in the
family house with winter weather, no supporting relatives and few friends. She agreed that it
would be a good idea to move to a senior mobile home park across the street from my home in
Southern California.
I immediately went to the Area Agency on Aging office and gathered information on senior
services, organizing it into a notebook that would be a “welcome to your new home” book for
my Mom.
That began a journey that I wouldn’t trade for the world. Yes, it entailed many hours of work
and worry on top of the pressures of my job and my life – probably much like those you are
experiencing in your life right now. It impacted my family. But it also provided many hours of
enjoyment as we worked and played together shopping for groceries, going to the movies,
eating a special dinner or knitting on a Sunday afternoon. We got to know one another again in
a different way and became fast friends.
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Taking Care of Yourself
It has been a progressive journey. Since she moved to California Mom has lived in my home, a
senior mobile home park, an independent senior living facility, and now she now lives in a
senior residential care facility. She has lost weight and lost memory, but, luckily, she has not
lost her sense of humor.
I take comfort, as may you, in knowing that I am not alone in this venture. Gail Sheehey, in her
book Passages in Caregiving: Turning Chaos into Confidence, says nearly 50 million American
adults are taking care of their parents, relatives or partners. (10) She goes on to say that “the
average family caregiver in the United States is a 48 year-old woman who holds down a paid
job. . . One-third of family caregivers are actually on duty forty or more hours a week. Onethird also still have children or grandchildren under the age of eighteen living with them and
take care of two or more people, usually parents. Not surprisingly, one-half report a high level
of burden and nearly one-half say their own health is fair or poor. And this role lasts for an
average of five years. (12) The American Association of Retired Persons (AARP) says that the
number is expected to double over the next 25 years. “For many Americans, life at 40, 50 or 60
years old will include care for an aging parent or relative. As the nation grows older, the need
for care giving will be as common as the need for child care.” (AARP Hew Hampshire Web site)
This book is designed to help you as you take on the role of caregiver. Being an organized
person who is juggling many balls, I created a number of systems and check lists to simplify
taking care of my mom. I’m sharing them with you in the hope that they will save you many
hours of work and frustration. Although I have grouped the systems under headings, you need
not read the book in any order, but simply look in the index for the area that will be of help. I
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Caring for Mom
Taking Care of Yourself
know implementing the systems looks overwhelming as a whole, but I’ve included all I can think
of in order to meet the various needs of different families. Start by choosing just one system
that will help you get organized. If you’re the sole caregiver, keep it simple. Then each week
choose another system to implement, and before long, you will be saving time, minimizing your
frustration, and feeling less stress as you go about the tasks of caregiving.
You might be lucky enough to have an extended family to share the care. If you decide to
involve your family, Hugh Delehanty and Elinor Ginzler’s book Caring for your Parents: The
Complete AARP Guide has a good chapter on how to hold family discussions and share the
work. You can find a system for care sharing in the book by Cappy Capossela and Sheila
Warnock called Sharing the Care: How to Organize a Group to Care for Someone Who is
Seriously Ill. Also, a private, free family scheduling calendar service is available at
www.lotsahelpinghands.com.
Hoping that various members of your family may take on specific responsibilities, I have
duplicated information in some areas so that everyone would have what they need to do their
job.
I created the check lists found in this book in Microsoft Office Word 2007. They can be used in
several ways. You can photocopy them and fill them in by hand, keeping paper copies in your
filing system. Or, if you like using the computer, you can copy them to your computer,
customize them to your situation, and fill them in, updating them in your computer. (Many of
the checklists are in table format. The “Help” section of Word provides instructions on how to
add or delete rows and columns to customize your table.)
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Caring for Mom
Taking Care of Yourself
At the back of the book, you will find a list of sources that I mention in this book. I did not
include an extensive bibliography of resources on caregiving since such lists become obsolete
quickly so feel free to use your friendly internet search engine to find up-to-date sources. I
can’t resist, however, sharing five books that I think are exceptionally useful. I wish I had read
them at the beginning of my caregiving journey. They are the following:
1. Delehanty’s Caring for Your Parents: The Complete AARP Guide which is filled with
many anecdotes and practical tips.
2. Johnson’s “Navigating the Health Care System” which is a detailed description of what
to expect from a hospital, hospice and nursing home based on personal experience.
3. Loverde’s The Complete Eldercare Planner which helps you to set and prioritize goals,
create action plans for each step in the caregiving process. It also lists many resources
with an extensive list of web sites at the back.
4. McCullough’s My Mother, Your Mother: Embracing “Slow Medicine,” The
Compassionate Approach to Caring for Your Aging Loved Ones which, being written from
a doctor’s and caregiver’s perspective, provides much useful information about
interacting with the medical community as a caregiver. It focuses on how to provide
“slow medicine” care (palliative compassionate care vs. crisis driven medical
intervention care) and has a list of “slow medicine” websites in the appendix.
5. Sheehy’s Passages in Caregiving: Turning Chaos into Confidence which focuses on the
psychological aspects of the various stages in caregiving.
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Caring for Mom
Taking Care of Yourself
6. Zukerman’s Eldercare for Dummies which, although now somewhat dated, provides
hundreds of resources for various aspects of caregiving. It is easy to thumb through and
find basic information right when you need it.
Finally, I would like to recommend an article by Louise Kertesz entitled “Resources for
Caregivers, or, ‘Who has time to read when you’re going through all that stuff?’” which can be
found at http://atyourlibrary.org/fitness/resources-caregivers. It is a current select list of
websites, US government sites and books on caregiving, having just been written a few months
ago.
As I provided drafts of this book to caregivers to read and give me feedback, I was surprised
that those who were single or in recent relationships said that they would be filling out some of
the checklists with information about themselves that friends, new partners or family members
could use in the event of their sudden illness or death. So, when you catch your breath, you
might think about doing the same for yourself.
I struggled with the conventions of naming your parent and yourself throughout the book. I
settled on the scenario most familiar to me, a daughter taking care of a mother. Please do not
be offended if this does not fit your situation.
You have my best wishes as you and your parent go on this journey together. . . . . and don’t
forget to laugh along the way.
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Caring for Mom
Taking Care of Yourself
Taking Care of Yourself
I’m such a typical caregiver – I never thought of starting this book with a chapter on taking care
of myself. It took my friend Dorothy, who is on her second stint of caregiving and who is a
psychotherapist, to remind me that we need to actively work on taking care of ourselves so we
can be our best in the role of caregiver.
Actually, Virginia Bell and David Troxel in their book A Dignified Life, back up even further by
suggesting that “before assuming responsibility for caring for someone with dementia [or, I
would add, any other chronic illness], you should first think about your own health, your
attitudes about caregiving, your financial resources and your coping skills. Are you up for the
task? There is no shame if your answer is ‘no.’ In fact, realizing this can do the person a great
service because you may be able to arrange a caregiving situation that will be more optimal.”
(52)
Assuming that you inventory your own abilities, family and community resources, and financial
resources and determine that you will take on the role of caregiver, one of the most important
things that you can do is to also work out a long-term plan to take care of yourself.
As Dorothy reminds me, this includes making some leisure time to engage in hobbies, play with
friends, exercise, develop our spirituality and do anything that replenishes our reserves. We
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Caring for Mom
Taking Care of Yourself
must remember to take our medications and make our doctor appointments. If we’re feeling
exhausted or depressed, we need to get some mental health help through a support group, a
therapist, a pastor, a counselor or a friend. In sum, without recharging our batteries we are
guaranteed to feel resentful and stressed, which can lead to us becoming ill and being unable to
optimally fulfill our role.
Too often we say there isn’t time, but we have to figure out a way to make time. Local adult
day care centers provide respite care. We can ask for help from siblings or our partner to
spread out the work. A home aide or a masseuse can come to the home of our parent for an
hour or so regularly. Family friends can visit on a regular schedule. Not only will these options
free up time for us, but they will also provide new faces and new experiences for our loved one.
And finally, Dorothy reminds me not to feel guilty about taking time for myself. I’ve tried to
follow her lead by walking early each morning, doing exercises every other day, learning to
water color, practicing the ukulele, going out to lunch with friends, and camping once a month.
It has taken a lot of organization to do these things, and at times I worry, but I’m a much nicer
person to be around, and I’m more patient and effective with Mom because I do them.
In this section you will find a self care inventory and planner that will help you to figure out how
to incorporate some activities in your life that will give you joy.
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Taking Care of Yourself
Self Care Inventory and Planner
Taking ten minutes to complete the following self care inventory and plan could
start you on the road to more enjoyment and less stress as you take control of
your life and do some things for yourself.
1. Inventory
List below the activities, hobbies, or interests that would refresh you and
replenish your reserves as you go about meeting the responsibilities in your
life. Then guess the amount of time each would take per week and the
approximate cost. Finally, prioritize the activities. I’ve provided you with
my sample list.
Diane’s Activities
Amount of time
per week
Water color class
3 hours
Reading for pleasure
5 hours
Practicing Ukulele
2 hours
Walk around park in AM 2.5 hours
Exercises
3
Attending church
2
Out for lunch with friends 2
Cost per week Priority
$25
$20 per novel
0
0
0
$25 donation
$17
Your Activities Amount of time Cost per week Priority
per week
9
3
6
7
2
4
1
5
Caring for Mom
Taking Care of Yourself
1. Plan
Take the top priority activity and develop a plan for making the time to do
it. This likely will entail looking at your time commitments at work, home
and as a caregiver and figuring out a way to free yourself up for just a little
bit of time. Get up an hour earlier of you need to. Ask for help if you need
to. Say “no” if you need to. Whatever you do, try to do it without guilt,
remembering that you are doing it for a worthy purpose.
2. Implement Your Plan
Now take whatever steps are required to put your plan into action. If you
are feeling unsure about how your plan will work out, commit yourself to
try it out for a short period of time after which you will evaluate how it has
worked and what impact it has had on you and those around you.
3. If your plan worked as well as mine did, you’re ready to work on your second
priority activity, moving down the list as you feel confident and successful.
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Caring for Mom
Living Independently
Living “Independently” in the Family Home
After becoming a widow at eighty-six, my Mom moved all of her belongings to a mobile home
in a senior park across the street from me. She lived independently for several years, paying
her own bills, keeping up her files, cooking her own food, walking to exercise and knitting
classes at the club house, and doing well with minimal help from me.
However, as time progressed and she could no longer drive, Mom depended on me for more
and more. I tried to tactfully evaluate her needs, but I’ve since learned that there are
professional geriatric care managers who can help you evaluate what help your parent needs at
each stage and provide referrals. I found one in my community by going to the website of the
National Association of Professional Geriatric Care Managers (www.caremanager.org).
At the very least, you should do a regular scan of Mom in her environment to look for signs that
she needs help, is unsafe or is being abused, because, if she is like my Mom, she will not ask for
help, and she will try to cover up inadequacies. If you are living in another town, holiday visits
are a good time to do this unobtrusively. Rosemary McClure wrote an excellent article in the
Los Angeles Times, December 18, 2010 entitled “Holiday Visit with a Purpose” in which she lists
things to look for in your parent such as confusion, frequent falls, or undernourishment; things
to look for if she is being taken care of by others including unexplained bruises or bed sores,
recent changes in spending patterns, or being afraid of the caregiver; and resources for help
including the Center of Excellence on Elder Abuse and Neglect (www.centeronelderabuse.org).
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Living Independently
There are many services to help your parent stay at home including such things as in-home or
senior concierge services for things like grocery shopping or housekeeping, adult day care,
advocacy groups, senior information services, food and nutrition services, transportation,
mental health resources, home rehabilitation services, senior centers, support groups, and
home health care agencies. You can find many of these services in your yellow pages or
through your local Area Agency on Aging office. For example, I had an occupational therapist
come to the house and make accommodation and safety suggestions. As a result of this visit, I
purchased a Life Line for my Mom so she could summon immediate emergency help by
pressing a button on a pendant. This gave us both great peace of mind.
After analyzing your parent’s need for help and financial resources, you may decide to hire staff
to work in the home on a regular basis. Bell and Troxel have an excellent chapter entitled
“Finding Help,” which describes some of the things to take into consideration if you are going to
use this option (224-232). From my own perspective, advantages of this option are that there
will be no need to move your parent to another location or to disrupt their routine. Some
disadvantages are that you will need to make physical accommodations to the home to enable
your parent to move around safely. You will also need to determine how to provide staffing –
through a home health care service or by becoming your own personnel director and hiring
staff yourself which brings its own set of issues including interviewing, hiring, bonding, insuring
training, supervising, evaluating, firing, paying, etc. Finally, as your parent becomes housebound the possibility of loneliness, depression, and lack of mental and physical stimulation
increase.
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Caring for Mom
Living Independently
Another option is to move your parent in with your family or with relatives. Historically, many
cultures see this as the preferred way of taking care of the elderly. It has the advantages of
providing a number of people to care for and interact with your parent, and it can potentially
cost less than other options. Obvious disadvantages include the potential for added stress
upon yourself and the family as all adapt to a new member who has many needs.
No matter where your parent lives, it is important that you know when there is an emergency
and it is vital that you can quickly gain access to her. I call Mom or see her daily to visit and to
assess how things are going. Experts in elder abuse suggest that you set up a code phrase that
your parent could use in the event that something is wrong and she cannot talk in front of a
staff member, salesman, etc. With regard to access, when Mom was living independently, I
carried copies of her house and car keys on my key ring, and I kept a plastic access card to her
mobile home park gate in my wallet. I had an extra electronic garage door opener in my car.
In this section you will find the following check sheets that I created while Mom was living
independently to help her shop for clothing and food, keep up the house, and pack for our girls’
overnight trips to San Francisco.
a. Clothing & Size Information
b. Gardener Information
c. Grocery List
d. House Information
e. Media and Communications Information
f. Travel List
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Caring for Mom
Living Independently
Clothing & Size Information
Revised Date:______________
Item
Brand
Size Store
Item # Description Notes
Example: St. John’s Bay 4-10 Penney’s 00873 Cotton blend White
Socks
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Caring for Mom
Living Independently
Gardener Information
Name:
____________________________________________________
Address:
____________________________________________________
____________________________________________________
Home Phone: _______________________ Cell: ______________________
Day of Week Gardener Works: ________________
Payment Amount: ______________ Payment Due Date(s): ____________
Gardener’s List of Weekly Chores
Example
1.
2.
3.
4.
5.
6.
7.
Dig up weeds in gravel on side of driveway
Do the same on the other side of the house in the gravel along the porch
Edge along sidewalk – back and porch side
Mow lawn and clean up clippings
Dig up weeds in nasturtium bed
Take all weeds to garbage dumpster
Sweep or blow walks and driveway
15
Caring for Mom
Living Independently
I helped Mom make a grocery list in preparation for our weekly shopping. I used
the following customized grocery list so that I could look back and see when we
last purchased something. (When my partner Lyn’s mother passed, we found 42
rolls of toilet paper in her garage. It seems she liked to walk to the store, but
didn’t want to carry too much weight.)
I grouped items by types; however, you could also organize them by aisle
numbers in the store. Most stores have a store directory which lists items
alphabetically and notes the aisle.
Grocery List
Revised Date:____________
.... .... .... .... .... ....
Date Shopped
Baked Goods
Coffee Cake
Bread
Brownie mix
Chips
Cookies
English muffins
Baking supplies
Flour
Sugar
Dairy
Butter
Cheese, cheddar
Cheese, cottage
Eggs
Ice cream
Milk
16
.... ....
Caring for Mom
Living Independently
Yogurt
General merchandise
Paper towels
Laundry Detergent
Tissue
Toilet paper
Groceries
Applesauce
Coffee
Pickles
Soups
Tea
Liquor
Beer
Wine
Meat
Bologna
Chicken
Flank steak
Ham
Hamburger
Liverwurst
Pork
Salami
Salmon
Steak
Produce
Apples
Asparagus
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Caring for Mom
Living Independently
Bananas
Blueberries
Broccoli
Cabbage
Carrots
Celery
Cucumber
Grapes
Green onions
Lettuce
Onions
Potatoes, sweet
Potatoes, white
Radishes
Spinach
Squash
Strawberries
Tomatoes
Refrigerated/frozen
Frozen dinners
Ice cream
Pot pies
Sodas
Diet Soda
Personal items
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Caring for Mom
Living Independently
House Information
Address:_________________________________________________________
Approximate Value:_________ Date: ________Appraiser:_________________
Appliance Manuals’ Locations:________________________________________
Homeowner’s Association
Name:________________________ Address:______________________
Phone:________________________ Account #:____________________
Monthly Dues:__________________ Date Due:_____________________
Insurance (homeowner’s for fire, etc.)
Company: _______________________
Address: _____________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Riders (for jewelry, etc.):____________ Cost for Riders:________________
Specialized House Insurance (for earthquakes, etc.)
Company: _______________________
Address: ______________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Landlord
Name:________________________ Address:______________________
Phone:________________________ Account #:____________________
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Caring for Mom
Living Independently
Monthly Rent:__________________ Date Due:_____________________
Mortgage
Mortgage Company:_____________ Address:______________________
______________________________ Phone:________________________
Account #:____________Date Started: ________Date Ends:___________
Principle Left:______________ Monthly Payment: ___________________
Monthly Payment Due Date: ______Annual Interest Paid:_____________
Neighbor Contact Information
Name--------------------- Address--------------------------------------- Phone--- Cell------
Real Estate Taxes -- Parcel #:__________________________________________
Appraised Value _______Bi-annual Cost _______Dates Due:____________
Security
Key(s): _____________________________ Location:__________________
Security Company: ____________________ Security Code:______________
Address:_________________________________________________
Phone:________________________ Account #:________________
Cost:__________________________ Date Due:_________________
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Caring for Mom
Living Independently
Upkeep
Carpet Cleaning
Date: ____________Company:______________________________
Address:________________________________________________
Phone:_________________________________________________
Electrician Name:____________________ Phone:__________________
Address:________________________________________________
Gardener (See Gardener List of Chores Sample Checklist)
Name:_________________________ Phone:___________________
Address:_______________________ Schedule:_________________
Cost:__________________________ Due:_____________________
Handy Person Name: _________________ Phone:__________________
Address:________________________________________________
House Cleaner Name:_________________ Phone:__________________
Address:________________________________________________
Schedule:_______________________ Cost: ______Due:_________
Paint Exterior
Last Painted:___________ Paint Brand:______________
Type: ________Color Name: ______Trim Color Name:___________
Cost:____________________ Company:_____________________
Phone:__________________ Address:______________________
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Caring for Mom
Living Independently
Paint Interior
Last Painted:____________ Paint Brand:_______________
Type: ________Color Name:______ Trim Color Name:___________
Cost:____________________ Company:_____________________
Phone:__________________ Address:______________________
Plumber Name:_______________ Phone:_______________________
Address:________________________________________________
Roof Date Installed:_____________ Company:_____________________
Address:__________________ Phone:________________________
Window Washer Name: __________ Phone:________________________
Address:________________________________________________
Other:
Utilities
Electric
Name:____________________ Account #:_____________________
Phone:____________________ Address:_______________________
Monthly Cost:______________ Due Date:______________________
Garbage
Name:____________________ Account #:_____________________
Phone:____________________ Address:_______________________
Monthly Cost:______________ Due Date:______________________
Collection Day/Time________________________________________
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Caring for Mom
Living Independently
Gas
Name:____________________ Account #:_____________________
Phone:____________________ Address:_______________________
Monthly Cost:______________ Due Date:______________________
Telephone, TV Cable, etc. (See Media & Communications Checklist)
Name:____________________ Account #:_____________________
Phone:____________________ Address:_______________________
Monthly Cost:______________ Due Date:______________________
Water/Sewer
Name:____________________ Account #:_____________________
Phone:____________________ Address:_______________________
Monthly Cost:______________ Due Date:______________________
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Caring for Mom
Living Independently
Media & Communications Information
Cable/Satellite TV Company:__________________________________________
Address:_______________________ Phone:_______________________
Account #:___________ Cost:___________ Date Due:_______________
Cell Phone Company:_______________________________________________
Address: ______________________Phone:_______________________
Account #:___________ Cost:___________ Date Due:_______________
Cell Phone Security Code:______________________________________
Computer Security Code:____________________________________________
DSL Line (for internet access) Company:________________________________
Address:_______________________ Phone:_______________________
Account #:___________ Cost:___________ Date Due:_______________
Email Address:_______________________ Security Code:__________________
Newspaper:_______________________________________________________
Address:_____________________________________________________
Phone:_________________________ Approx Delivery Time:___________
Account #:____________Cost: __________Date Due:________________
Subscriptions (magazines or on-line)
Name---------------- Address-------------------------- Account----- Cost -- Due-----
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Caring for Mom
Living Independently
Travel List Revised Date:_________________
Sheehy has some good information on traveling with elders with disabilities (164166.) My Mom and I went on an annual mother/daughter trip to San Francisco
where we would shop, have a chocolate ice cream soda, go out to a gourmet
restaurant for wine and dinner and laugh ourselves silly. This is the travel list
which she used. You might want to customize it.
Item
Date. . . Date. . . Date. . . Date. . . Date. . . Date. . .
.
.
.
.
.
.
Personal Items
Body lotion
Cane
Case for hearing aids
Deodorant
Extra
hearing
aid
batteries
Medications
Prescriptions
Shampoo
Soap
Sunglasses & case
Sunscreen
Tissues
Toothbrush
Toothpaste
Clothing
Hat with brim
Heavy jacket
Light weight jacket
Long pants
Long sleeved shirts
Pajamas
Shorts
Short sleeve shirts
Socks
Sweater
25
Caring for Mom
Living Independently
Underwear
Miscellaneous
Book
Magazine
Money
Wallet with cards
26
Caring for Mom
Leaving the Family Home
Leaving the Family Home
By age eighty-seven, Mom was beginning to feel lonely in the house by herself. I realized that
she was not eating correctly, and that food preparation was becoming more difficult for her.
She could no longer garden or keep up with many of the tasks associated with owning a home.
I broached the idea of moving to a senior independent living facility where meals, laundry
services and housekeeping were provided, but she was not interested. So, knowing how
difficult change is for all of us, I waited for the opportune time and suggested we go to visit
Sylvia, Mom’s friend who had just moved to such a facility. We had lunch there, and Sylvia gave
Mom the grand tour, to no avail. But, before long, Mom decided that she wasn’t going to be
able to handle being on her own forever, and as she said, “I’d best get on with it, since I’m not
getting any younger.”
Our first project was to decide what to keep and eventually move into her one bedroom
apartment in a senior residential facility and what to dispose of. That began an emotional time
for me. I had no inkling of the attachment I had to still having a family home to go to and to the
“things” that filled it, but Mom seemed to be ready for the next stage of her life. She moved
into the senior residential facility and within two months was calling it home, praising the food
and enjoying the activities. I was so grateful for her flexibility and openness to new things. I
took a lesson from her about accepting change and aging gracefully.
My friend Beverley told me the story of how she and her three brothers and sisters helped her
mother dispose of their parents’ furnishings and heirlooms. Beverley took a picture of each
piece, listened to Mom’s story of its history, and wrote up the story, putting it together with the
27
Caring for Mom
Leaving the Family Home
picture. Her Mom sent the set of pictures to each child and asked them to write her which
pieces they wanted. Mom then made her decisions and wrote each child a letter telling him or
her what she was giving to them. It worked perfectly, except that when they all arrived at the
home to pack it up, they had missed the secret closet that held all the silver, and had to resort
to the short straw method to empty it.
I developed and used the charts below to help us collect things to move, dispose of furnishings,
rent Mom’s mobile home for a time, and eventually sell it.
a. Furnishings for One Bedroom Apartment in Senior Living Facility
b. Disposal of Furnishings and Appliances
c. Renting the House
d. Sale of the House
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Caring for Mom
Leaving the Family Home
Furnishings for One Bedroom Apartment
(Linens and telephone provided)
Room
Bedroom
Item
Notes …………….
Bed
Pillow
Blankets
Night stand
Flashlight for night stand
Night light
Lamp for night stand
Alarm clock
Small dresser
Small desk (use 1 dining room chair)
Office supplies
Bulletin board over desk
Wall calendar on bulletin board
Telephone book
Computer
Printer
Small file cabinet
Framed pictures for throughout house
Bath Room
Toiletries
Scale
Drugs
First aid supplies
Bathtub rubber mat
Living Room
Comfortable chair or love seat
Guest chair
Floor lamp
Small end table
Lamp for end table
Wall clock
Plants
Dining Room
Small round table with fold down leaves
3 small scale dining chairs (use one for desk)
Placemats or table cloth
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Caring for Mom
Leaving the Family Home
Kitchen
Small microwave
Toaster oven
Coffee or tea pot
Pot holders
Cooking utensils
Eating utensils
Can opener
Dishware
Glasses
Food storage containers
Paper products
Dish towel
Sponge
Dish soap
Paper towel holder
Small tool kit
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Caring for Mom
Leaving the Family Home
Disposal of Furnishings and Appliances
A favorite family story is the time my grandparents’ six adult children arrived on a
wintry New Jersey Saturday morning to help with their parents’ sorting and
packing process. Various items were given to each over the day. Upon leaving,
my uncle Ed went to put on his overcoat, only to find that his brother Walt had
left a half an hour ago with it over his arm, thinking it was surplus.
Listed below are the various ways of disposing of furnishings and appliances. If
there is an accumulation of many years of things and several siblings, you might
want to make a chart listing the furnishings and appliances in alphabetical order
with a code next to each which indicates how it is to be disposed of. (See the
sample chart at the end of this page.)
Disposal Possibilities:
 Classified Ad
o Who is going to input the
item?________________________________________
o Asking Price:_________________________
o Final Price:______________________
 Donation to Nonprofit organization
o Name:___________________________
o Date & Time of Collection:___________
o Description of Items and Values (for tax deductions, see latest
regulations):
 Dumpster (Note what items they will not take)
o Dumpster Rental Company:______________________
Phone:________________________
o Cost:___________ Delivery Date:________________
o Pick up Date:____________
 Estate Appraiser who will give you a price to take it all
o Name:____________________________
Phone:_________________________
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Caring for Mom
Leaving the Family Home
o Final Price:_________________________
 Give away to family and friends (list item and name of recipient)
 On-line sites such as Craig’s List
o Who is going to input the
item?________________________________________
o Asking Price:_________________________
o Final Price:______________________
Sample Disposal Chart
G=Good Will
CL=Craig’s List
Item
Disposal Value/Price
Clothing and Shoes
G
$200
Refrigerator—GE, 3 years old C L
$450
32
Caring for Mom
Leaving the Family Home
Renting the House
My Mom moved from her mobile home into a senior independent living facility.
We decided to rent the mobile home for a minimum of a year, using the proceeds
to defray the cost of the facility. This gave her some flexibility if she didn’t like
senior living, and it gave the real estate market time to increase the value of the
home.
I rented the home myself, but you might decide to use a management company.
Steps in renting it yourself:
Determining if you may rent the home: Many senior mobile home parks and
condominiums have rules which do not allow you to rent your home. Be sure to
check before proceeding..
Preparing the Home
Painting Touch Up
Cleaning
Carpets
General House
Windows
Making Decisions
Rental Price
Pets
Smoking
Appliances included?
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Caring for Mom
Leaving the Family Home
Advertising
Classifieds
Fliers
On-Line
Signs in the windows
Choosing a Tenant
Application
References
Lease
Who does gardening
Who does watering
Who pays what utilities
Bookkeeping I keep a simple annual chart of income and one of expenses by hand
on an accounting ledger. You may choose to set up a Microsoft Office Excel
spreadsheet. You will need to total all the columns at the end of the calendar
year and bring the records to your tax preparer. My chart looks like the one on
the next page.
34
Caring for Mom
Leaving the Family Home
Rental Ledger
Company or Item……….. Elect. Gas Water Sewer Space Gardener Repair & Fire
Rent
35
Upkeep
Quake Taxes Misc
Insur Insur
Caring for Mom
Leaving the Family Home
Sale of the House
Selling the house is fairly straightforward once you have chosen a realtor who will
guide you through the process. Below are some items to keep track of as you list
the house and negotiate the final selling price.
Realtor Name:_______________________ Company:_______________________
Phone: ______________________Commission %:____________________
Dates of Contract:______________________ Asking Price:______________
Lowest Acceptable Price:__________________
Escrow Company:____________________ Escrow Account
#:_________________
Escrow Officer:_________________________ Phone:__________________
Attorney (if applicable):________________________ Phone:_________________
Date and Time of Appointment:____________________________________
Mover:__________________________________ Phone:____________________
Estimate:_________ Payment Method:_____________ Date:___________
Arrival Date & Time:_____________ Delivery Date & Time:_____________
Appraiser:___________________ Phone:___________ Date will arrive:________
Time:________________ Appraised Value:__________________________
Inspector:_________________ Phone:___________ Date will arrive:___________
Time:________________ Notes:___________________________________
Repair Contractor: ______________________________Phone:_______________
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Caring for Mom
Leaving the Family Home
Date will arrive:_____________ Time:__________
Notes:________________________________________________________
_____________________________________________________________
37
Caring for Mom
Address Changes
Choosing a Senior facility
Moving from her mobile home to a senior independent living facility was easy since Mom
moved to the one that her friend Sylvia had chosen. However, during the time she was there, I
decided to do some initial investigation of residential care assisted living and skilled nursing
facilities on my own. I thought, correctly as it turned out, that pre-planning for the next stage
when not under emotional and time constraints would pay off in a better decision and much
less stress when the time came to move again.
Each kind of facility provides an array of services. Here are some of the kinds of facilities you
might encounter:
1. Senior independent living is living totally independently in an apartment, mobile home
or home in a senior community.
2. An independent living facility is an apartment in a senior facility with such things as
transportation, meals, housekeeping and recreational activities included.
3. A large residential care assisted living facility is similar with the addition of 24 hour staff
and potential assistance with daily activities such as eating, showering or dressing.
Some assisted living facilities have special units for residents with dementia, providing
special security and services.
4. A small residential care home is an actual house in a neighborhood where a small
number of residents are provided the same kinds of services as in a large assisted living
facility with 24-hour staff.
38
Caring for Mom
Address Changes
5. A skilled nursing facility provides 24-hour skilled nursing care.
l learned that Medicare and insurance do not cover all of these living options, so be sure to
review your parent’s coverage before making a decision. I also learned from my attorney that
when you are signing contracts and paperwork, the facilities will want you to sign an agreement
to use an arbitrator in event of a disagreement. She says you do not have to agree to this, and
she advises that you not limit your options by doing so.
I developed the following check lists in this section and used them as I visited facilities. I’d
suggest you do the same and see how impressed the administrators will be when you arrive
ready to ask all the right questions. In this section you will find the following:
a. Initial Visit Checklist
b. Comparing Care Facilities – Follow-up Visits
c. Summary Comparison Chart for Care Facilities
Looking in the yellow pages, I found that there are local residential care facility “brokers” who
will meet with you, determine your needs, and take you to appropriate facilities and homes. I
also found web sites such as www.discoverassistedliving.com that list and rate facilities. And,
of course, there is help from the traditional research sources including books and magazines
such as the article by Avery Comarow in U.S. News & World Report that ranks nursing homes in
America (72-82).
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Caring for Mom
Address Changes
After I had visited many facilities, I asked Mom if she would like to go with me to some. She
turned me down, but we talked about the pros and cons of a large assisted living facility vs. a
smaller residential care facility, and she voiced a preference, in the event that we needed one.
As it turned out, a year later, mother was suddenly hospitalized, went into full-blown dementia,
and we had to quickly find a place to move her. The emotional chaos was unbelievable, and I
was so grateful I had done my homework. (She subsequently regained her faculties and
abilities, and says she is content with life in her new senior residential care home.)
40
Caring for Mom
Address Changes
Choosing a Senior Facility
Initial Visit Checklist
Agency Name: _______________________________________
Phone:__________________
Address:
___________________________________________________________________
__
Contact Person:___________________________ Managing
Company:___________________ Date:_____________________ Types of
facilities/units available & Number of Rooms in each:
Type of Facility
# Rooms or beds Cost . . . . . . . .
Independent Living
Large Assisted Living
Memory Care Unit
Small Assisted Living Home
Skilled Nursing
Services included in room costs:
Cost for additional services:
Move-in deposit:
Rate increases over the past 5 years:
Waiting list:
Do they take long term care insurance?
Medicare?
41
Caring for Mom
Address Changes
Staffing
Staff
# Day # Night
Doctor
Registered Nurse
Geriatric Nurse Practitioner
Licensed Vocational Nurse
Medical Assistant
Caregiver
Dietician
Physical Therapist
Podiatrist
Beautician
Social Worker
Dentist
Audiologist
Activity Director
Ombudsman
Licensed staff/patient ratio day:
night:
Do they have a training and continuing education program for all staff?
Do they do background checks and random drug tests?
42
Caring for Mom
Address Changes
Do the staff wear nametags?
Amount of staff turnover per year:
Resident’s Room
Size:
Amenities:
Private bathroom?
Do windows open?
Layout and size appropriate for wheel chair:
Facility
Temperature is comfortable:
Good lighting:
Noise level:
Cleanliness of facility:
Special features (pool, patio, etc.)
Outdoor spaces:
Age of facility:
# times bought out in recent past:
Residents
Cleanliness and grooming of residents:
Residents are engaged:
Staff know their names:
Services
Daily activity programs:
43
Caring for Mom
Address Changes
Special programs/activities:
Housekeeping services:
Laundry services:
Pets allowed?
How manage meds?
How does resident get help in an emergency? Call button, pendant etc?
Transportation to doctors, etc.:
Wheel chair transfer help?
What is typical emergency (ambulance/EMT) response time?
Is hospice an option?
Dementia Care?
Bedridden resident care?
Food
Food menus:
Choice of food?
Snacks available?
Guests allowed to dine?
Emergency Plan
Bulletin board with license, evacuation plan, surveys, rights of residents, etc.:
Ombudsman:
Earthquake, fire plan?
44
Caring for Mom
Address Changes
For special units
How keep residents secure?
Policy on restraints:
Notes:
45
Caring for Mom
Address Changes
Choosing a Senior Facility
Comparing Care Facilities – Follow-up Visits
1. Results of talk with residents – what do they like and not like about the
place with regard to:
 Staff –
o Respectful?
Patient?
Helpful?
Kind?
Competent?
Gentle?
o Same with night staff?
 Does it feel like home?
 Food
 Activities
 What would you change about the place?
2. Results of talk with staff
 How do they like working here?
 Amount of turn-over
3. Results of talk with Administrators
 Ask to review licensing and certification reports
 Ask how the facility did on state surveys and/or Area Agency on Aging
surveys
 Ask if any liens or lawsuits have been filed? (County court
records will tell you if there have been any lawsuits against the
center or the staff that has worked there.)
4. Results from unannounced additional visits
46
Caring for Mom
Address Changes
5. Research on complaints and lawsuits
 Check with local Area Agency on Aging & their long-term
ombudsmen’s office
 Better Business Bureau website will list complaints and issues that
people have had with the center in the past
 Check State Health Dept. reports
Choosing a Senior Facility
Summary Comparison Chart for Care Facilities
(You can give letter grades, use pluses and minuses, or make up system that
works for you.)
Criteria
Facility
A
Room Cost
Deposit
Cost for additional services
Overall feeling of Facility
Room size
Private bathroom
Outdoor spaces
Size of facility
Medical staff availability
Staffing ratios
47
Facility
B
Facility
C
Facility
D
Facility
E
Caring for Mom
Address Changes
Variety of Staffing Types (LVN,
RN, etc.)
Likeability of Staff
Other
Other
Notes:
48
Caring for Mom
Address Changes
Address Changes
It seems that every couple of years, Mom is moving. After the first move I decided to use the
advantages of a computer to set up a system that would make future address changes simpler.
To that end, I created an address label file comprised of the addresses for all of the contacts
that needed to know about her new address (companies, service providers, organizations,
magazines, etc.). I customized the letter found in this section entitled “Change of Address:
Sample Letter” which gives her old and new address and phone numbers. Then I mailed a letter
to each contact in an envelope with the appropriate address label affixed.
In order to track the letters I sent, I filled in the “Change of Address Master List” which would
come in handy for the next round of address changes.
As time progressed, I took over paying bills and filing. I customized the letter found in this
section entitled “Change of Address to Caregiver’s Address: Sample Letter” which explains that
I, as a co-trustee, will take over paying bills and gives my address for billing purposes. Thanks to
my trusty address label file, I could print out address labels once again with no fuss. I reused
the master list to figure out what contacts needed the letter, to track that I had sent them a
letter, and to track the address changes. I found that in some cases I needed to send a second
letter.
Finally, I made a label file for all of the relatives and friends in Mom’s old address book. These
came in handy for sending Christmas cards and letters updating people on Mom’s address
changes. I also used the labels to create a “rolodex” address file for Mom’s use which was
much more legible and flexible than her old address book.
49
Caring for Mom
Address Changes
In this section you will find the following:
a.
Change of Address: Sample letter
b. Change of Address to Caregiver’s Address: Sample letter
c.
Change of Address Master List
d. Making Address Labels: Directions for Word
50
Caring for Mom
Address Changes
Change of Address: Sample Letter
Date : __________________________
Regarding my account:_______________________________
As of the above date, my address has been changed. My previous address was:
Street Address:
______________________________________________
City, State, Zip:
______________________________________________
Phone:
______________________________________________
My new address is:
Street Address:
______________________________________________
City, State, Zip:
______________________________________________
Phone:
______________________________________________
Please send all materials to the new address.
Thank you for your assistance in this matter.
Sincerely,
51
Caring for Mom
Address Changes
Change of Address to Caregiver’s Address: Sample Letter
Date:___________________________
Regarding my account:___________________________________
My daughter, __________________________________, who is a co-trustee, will
take over paying my bills effective the date above. To that end, please send any
invoices, statements or correspondence to the following address:
Name of Parent:
______________________________________________________
C/O Name of Daughter:
______________________________________________________
Street Address:
______________________________________________________
City, State, Zip:
______________________________________________________
Daughter’s Phone:
______________________________________________________
I can be reached in person and will continue living at the following address:
Street Address:
______________________________________________________
City, State, Zip:_____________________________ Phone: _________________
Thank you for your assistance in this matter.
Sincerely,
52
Caring for Mom
Address Changes
Change of Address Master List
Date
Change
d
Company…… Address………………
.
…
53
Phone….. Name of
.
Contact………
…
Accoun
t
#..........
Caring for Mom
Address Changes
Making Address Labels: Directions in Microsoft Office Word
Sheets of blank address labels that you can purchase at a stationary store
are very handy to use to create a physical address book, a rolodex, labels
for letters sent to notify people of address changes, etc. Once you have
typed the names and addresses into your computer once, you can copy
them to a customized sheet of address labels and print them out as often
as you want.
Your software program should have a program for making address labels.
Below are the directions for making address labels in Microsoft Office Word
2007:
In Word choose “Mailings”
Then choose “Labels”
Then choose “Options”
Then choose the numbered set that goes with the labels you bought
{For Example: Office Depot 612-271 Inkjet Shipping which are 2”x4” labels}
Then choose “OK”
Then choose “New Document”
54
Caring for Mom
Living in a Senior Facility
Living in a Senior Facility
Once Mom started living in an independent senior facility I found that I needed to be sure that
the staff knew how to contact me in an emergency. To that end, whenever I was going to leave
town, I provided them with a form that contained my trip itinerary, contact information for me,
and contact information for several local people who agreed to be available for non-emergency
issues. I provided them with a chart of permanent emergency contacts such as family members
and close friends.
I also gave them information regarding death arrangements if I were unable to be reached.
(See the form “Death Arrangements Notice to Care Facility” found in the chapter entitled,
“Preparing for the Inevitable.”)
When Mom moved into a residential care facility where she would get care around the clock,
she had just gotten out of the hospital and was quite anxious and confused. I thought that
having a written daily schedule of typical activities might help her orient to her new life. It was
helpful, and I’ve included it in this section along with a form that I use to communicate with the
staff.
Finally, I found the residential care home wanted a list of approved visitors with notes on who
was approved to take Mom from the facility, so I made a chart for that.
In this section you will find the following:
a. Visitor List for Resident in a Senior Facility
b. Daily Schedule Sample
55
Caring for Mom
Living in a Senior Facility
c. Emergency Contact Information
d. Notes to Staff (Generic Form)
e. Trip Itinerary for Caregiver and Emergency Contact Information
56
Caring for Mom
Living in a Senior Facility
Visitor List for Resident of a Senior Facility
For Name:_____________________________ Room________
Revised Date:_______________
(Asterisked Names May Take Resident from the Facility)
Family:
Name:_____________________________ Relationship:____________________
Name:_____________________________ Relationship:____________________
Name:_____________________________ Relationship:____________________
Name:_____________________________ Relationship:____________________
Name:_____________________________ Relationship:____________________
Friends:
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Name:_____________________________
Signed: ____________________________
57
Date:______________________
Caring for Mom
Living in a Senior Facility
Daily Schedule: Sample
The first weeks of living in a new senior residential facility can be confusing and
anxiety producing. Having a personal daily schedule posted on a white board in
the room can be a comfort. Here is the daily schedule I created for my Mom who
is in a residential care facility.
Resident’s Individual Schedule
Revised Date:_____________
Wake Up
Shower
Dress
Eat Breakfast
Read Newspaper
Exercise “Class” – Staff helps with exercises given by Physical Therapist
Morning Activities –
 Help with chores such as folding laundry, drying breakfast silverware, pots
& pans, folding bibs and lunch napkins, etc.
 Play a game (dominoes, etc.)
 Knit
12:00 Lunch
Nap
Walk Outside (in walker with help of staff)
Afternoon Activities
 Snack
 Play a game
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Caring for Mom
Living in a Senior Facility
 Read a novel on the patio
 Puzzles
 Crafts
 Other
5:00
Supper
6:30
TV News
7:00
TV Jeopardy (Channel 7)
7:30
TV Wheel of Fortune (Channel 7)
8:00
Listen to music or read a book
9:00
Bed
59
Caring for Mom
Living in a Senior Facility
Emergency Contact Information
For Name:__________________________________ Room:__________________
Date:_____________________
1. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
Address:______________________________________________________
2. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
3. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
Address:______________________________________________________
4. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
Address:______________________________________________________
5. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
Address:______________________________________________________
6. Relationship:____________________ Name:_______________________
Home Phone:____________________ Cell Phone:____________________
Address:______________________________________________________
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Caring for Mom
Living in a Senior Facility
Notes to Staff
Because there are three shifts of staff in a 24-hour staffed facility, I find
communication difficult. Using the form below seems to work best since it can be
passed from one shift to another.
Date:____________________________
Notes to Staff Regarding Name:________________________ Room:___________
From: Name:_________________________ Relationship:___________________
Note:
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Caring for Mom
Living in a Senior Facility
When I am going to be out of town, I leave the form below with staff. I explain
that the local contact is a friend who is willing to help with non-emergency issues.
My mother gets anxious when I’m not in town, so I give her a copy of the form
and make sure I call her daily. It’s nice to be needed, but I know there are times
when we need to recharge our batteries and get some perspective. I try to give
myself permission to do so without guilt, but, as you know, it’s not as easy as it
seems.
Trip Itinerary and Emergency Contact Information
For Name:____________________________________ Room:________________
Date:____________________________
I will be going on a trip from ________________ to _________________________
During that time I can be reached at Phone:_______________________________
Please use the following as local contact person(s) during this time:
Name:___________________________ Relationship:_______________________
Home Phone:_____________________ Cell Phone:________________________
Name:___________________________ Relationship:_______________________
Home Phone:_____________________ Cell Phone:________________________
Also, please note there is a complete list of emergency contacts on file. Thank
you.
Signed:_______________________________ Date:________________________
62
Caring for Mom
Doctors and Other Service Providers
Doctors and Other Service Providers
As various medical conditions occurred with Mom, I found the need to identify doctors and
hospitals, to choose between treatments and to be an advocate for Mom. My work would’ve
been less traumatic had I known then to contact www.healthcareadvocates.com for help in
finding the best doctors and treatments. (Sheehy 124) I’ve also since found a good chapter
entitled “Managing Medical Care” in Loverde’s book The Complete Eldercare Planner which
includes good information about what to do if your parent refuses medical help.
I recently learned that a local doctor offers “concierge service” which is a fee-based service
including house calls and access to the doctor’s cell phone for 24/7 emergency contact. This is
expensive, since Medicare and insurance do not pay for the concierge fee, although they do pay
their normal rate for any doctor visits or other services. If you are often out of town or living a
distance away, it may be worth the expense to know that a doctor will be on-call at all times for
emergencies.
As I took over setting up appointments and driving Mom to wherever she needed to go, I set up
a master appointment schedule listing the name of each service provider, his or her address,
when the last appointment was, and when the next one is. I’ve found this invaluable as I keep
track of monthly, bimonthly, quarterly, semi-annual, and annual appointments for doctors and
various others.
I also wrote the appointments on Mom’s calendar for her use and integrated the same on my
personal calendar. At the end of the year rather than throw her previous year’s calendar away,
63
Caring for Mom
Doctors and Other Service Providers
I found it helpful to file it in case I needed to look up something that happened the previous
year that I neglected to write down on the master appointment schedule form.
I created a doctor’s visit form which listed all the issues to talk about with the doctor. This kept
us from forgetting things that needed to be discussed and saved the doctor time, since we were
organized and efficient. (Caring for Your Parents has an excellent list of prompts for creating
questions for the doctor’s visit on page 36.) I also used the form to take notes on our visit. I
gave Mom a copy after each visit and she used these notes to remind herself of what the
doctor had said.
I also carry in my purse a small notebook in which I note daily changes in Mom’s mental or
physical health, reminders to myself about things I need to do in the next several days for her,
etc. I consult this when I am preparing for a doctor’s visit with Mom to remind myself of things
to discuss.
I found that I needed to learn about Medicare, help Mom choose a Medicare Part D drug
provider and keep track of medical expenses being paid by Medicare or her supplemental
insurance company. [I’ve since learned that Caring for Your Parents has an easy to understand
chapter on Medicare entitled, “The Medicare Maze.” (109-123)] I’ve created a form to use in
keeping track of medical expenses and insurance payments. It has also come in handy when I
need to put Mom’s medical expenses together for income tax purposes.
When you go to the doctor for the first time, be sure the doctor has a copy of the following (See
the section “The Attorney and Legal ‘Stuff’”):
64
Caring for Mom
1.
Doctors and Other Service Providers
Durable Power of Attorney for Management of Property and Personal Affairs (which
sets up the provisions allowing you to manage your parent's property and personal
affairs)
2.
Advanced Health Care Directive (which states the end-of life wishes of your parent and
allows you and whoever else is named to make health care decisions) Any other more
specific forms which state end-of-life wishes.
3.
Authorization for Use and Disclosure of Protected Health Information (which
authorizes the release of health information and medical records to you and whomever
else is named)
Finally, you can access a form to keep track of your family member’s personal health record at
www.nextstepincare.org/left_top_menu/caregiver_home/
In this section you will find the following:
a. Master Appointment Schedule for Service Providers
b. Notes from Doctor’s Visit
c. Medical Expenses and Insurance Payments
65
Caring for Mom
Doctors and Other Service Providers
Master Appointment Schedule for Service Providers Revised:________________
Name…………. Type
Phone....... Address................... Last Next
Appt. Appt.
Attorney
Audiologist
Barber/
Beautician
Chiropractor
Dentist
Dermatologist
Occupational
Therapist
Ophthalmologist
Optometrist
Orthopedist
Pet’s groomer
Pet’s Veterinary
Doctor
Pet’s Walker
Pharmacist
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Caring for Mom
Doctors and Other Service Providers
Physical
Therapist
Podiatrist
Primary Doctor
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Caring for Mom
Doctors and Other Service Providers
Notes from Doctor’s Visit
Date of Visit:____________________________
Doctor’s Name:_________________________
Issues to talk about with the doctor:
1.____________________________________________________________
2.____________________________________________________________
3.____________________________________________________________
4.____________________________________________________________
5.____________________________________________________________
6.____________________________________________________________
Height:_________________ Weight:_______________________
Blood Pressure:___________________ Temperature:_______________________
Notes:
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Caring for Mom
Doctors and Other Service Providers
Medical Expenses and Insurance Payments
Date… Provider……. Service……………… Copay
Date Medicare Date Insurance Date Patient Date
Amount Paid Payment Paid… Payment Paid… Balance Paid…
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Caring for Mom
Medications and Assistive Devices
Medications and Assistive Devices
While Mom was still living independently, she was able to keep track of her own vitamins and
medications. However, when I eventually found that she was missing some medications and
doubling up on others, I began setting up her vitamins and medications in plastic boxes that I
got from the drug store which had a section for each day of the week. This meant she just had
to remember once a day to empty that day’s section of pills.
This worked for quite a while, but became quite frustrating when the doctor gave me a sample
of a daily patch to improve Mom’s memory. I spent 45 minutes explaining a system that she
could use to meet the directive that a patch could not be placed in the same spot within 14
days. In frustration, she finally sent me home saying she would figure it out herself. When I
arrived home the phone was ringing. It was my Mom asking what the patches were for. When
I told her, “When you stop asking me that question, I’ll know they are working,” she had a good
laugh.
I not only had to set up the medications, but I also had to remember to order the prescriptions
from a mail order company. I developed a prescriptions ordering tracker to help me with this
task. I added a section on it for over-the-counter vitamins and minerals that she took as well.
Now I knew when to order or purchase everything, and I also had a list to take to the doctor’s
visits and hospital, since they inevitably wanted to know everything Mom was taking.
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Caring for Mom
Medications and Assistive Devices
Since this tracker had everything in one place, it allowed the doctor to review it and make sure
that there were no drugs which would interfere with others.
To that same end, I asked the doctor for suggestions for over-the-counter medicines for the
various everyday ailments that Mom got sporadically. (To my dismay, I found out that the
aspirin that she had been taking for aches interfered with a prescription arthritis medication
that she took daily.) I made a chart listing each symptom and appropriate treatments. Later,
this was very helpful to the staff at the residential care facility.
Assistive devices are everything from canes and walkers to raised toilet seats. It’s a good idea to
try out different types before making a purchasing decision. I was able to borrow a walker and
raised toilet seat for up to six months from my local chapter of the Easter Seal Society. You
might ask around for similar organizations in your community. If you can’t borrow an item, you
might consider renting it from a medical supply store.
When it came time to return the items, I went on a hunt of our downtown thrift stores to
purchase “gently used” items that I had borrowed or rented. I created a chart to keep track of
borrowed and rented items.
In this section you will find the following:
a. Over the Counter Medicines for Various Symptoms
b. Prescriptions Ordering Tracker
c. Request to Doctor for Prescription Renewal
d. Over the Counter Medications and Vitamins Tracker
e. Assistive Devices Tracker
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Caring for Mom
Medications and Assistive Devices
Over the Counter Medicines for Various Symptoms
Instructions from Doctor: ________________________ Date:_________________
Symptoms and appropriate treatments
Constipation:
Cough, Nasal Stuffiness and/or Chest Congestion:
Diarrhea and/or Nausea:
Fever:
Hay Fever/Allergy:
Sore muscles:
Sore throat:
See the Doctor if you have any of the following:
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Medications and Assistive Devices
Prescriptions Ordering Tracker
Prescriptions
Dose Dose Dose Drug Name. . . .
AM PM EVE . . .
Use. . . . . .
..
# pills
In
bottle
#
Refill RX #. . . .
refills after . .
Company or Drug Store Information:
Name:_________________________ Address:_________________________________
Phone:_____________________
Name:_________________________ Address:_________________________________
Phone:_____________________
73
Company Phone……….
Or Drug
Store
Caring for Mom
Medications and Assistive Devices
Name:_________________________ Address:_________________________________
Phone:_____________________
Name:_________________________ Address:_________________________________
Phone:_____________________
Patient Reorder Information:
Birth Date:__________________ Credit Card Number :___________________________ Expiration
Date:_____________
Prescription Insurance ID Number:________________________________________
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Caring for Mom
Medications and Assistive Devices
Request to Doctor for Prescription Renewal
Date:
______________________
To:
Dr._____________________________________
From:
_______________________________________
Subject: Renewal of Prescription for (Name of Patient):___________________
Please renew a prescription for (Name of Medication):_____________________
You can fax it to (Name of Pharmacy):__________________________________
at FAX Number: _______________or call at Phone Number:________________
They require that the prescription include the following information:
Name of Patient: ___________________
Date of Birth: ______________________
Member ID #:_______________________
Mailing Address: _________________________________________________
Phone: ___________________________
Please let me know when it has been sent in. Thank you.
Caregiver’s Name:_______________________________
E Mail Address:_________________________________
Phone:________________________________________
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Caring for Mom
Medications and Assistive Devices
Over the Counter Medications and Vitamins Tracker
Dose Dose Dose Name. . . . . . . . . Use. . . . . . . …….. # pills Date
Store. . . .
AM PM
EVE
In bot- Purtle
chased
Drug Store Information:
Name:___________________________________
Address:_________________________________
Phone:__________________________________
Name:___________________________________
Address:_________________________________
Phone:__________________________________
Name:__________________________________
Address:_________________________________
Phone:__________________________________
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Caring for Mom
Medications and Assistive Devices
Assistive Devices Tracker
Item
Source
Date Checked
Out
Source Information:
Name:__________________________________
Address:_________________________________
Phone:__________________________________
Name:__________________________________
Address:_________________________________
Phone:__________________________________
Name:__________________________________
Address:_________________________________
Phone:__________________________________
77
Notes on
Item’s
Condition
Date to be
Returned
Caring for Mom
The Attorney and Legal Stuff
The Attorney and Legal “Stuff”
Luckily my Mom and I went to an attorney together while she was still able to think clearly, so
she was able to understand and sign all the documents which were required to enable me to
take care of her and her finances.
Trying to be helpful, our attorney even told Mom how she could get a limited use driving
license. I was hoping that her hearing aids were not working properly, but she heard it all just
fine. Later, I had to ask the doctor to tell her that she should no longer be driving. She took it
well, and I breathed a sigh of relief.
There are attorneys who specialize in elder issues. To find one you can call the National
Academy of Elder Law Attorneys, Inc. (NAELA) at (703) 942-5711 or enter your zip code into
their on-line directory at www.naela.org/member/directory (Sheehy 293)
You will need to talk with your attorney about your unique situation and the laws applicable in
your state. Basically, you should have the following drawn up, signed, and notarized. Leave the
original with the attorney and keep a copy in your files. Give copies of #3, #4 and #5 below to
your doctor and hospital.
1. A Revocable Living Trust (which allows the assets to be inherited without being tied up in
probate court) You will also want to talk with the attorney about the maximum amount
that can be inherited without paying taxes on the inheritance. There are ways to protect
money above the maximum amount.
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Caring for Mom
The Attorney and Legal Stuff
2. A Will (which states who will inherit what)
3. Durable Power of Attorney for Management of Property and Personal Affairs (which sets
up the provisions allowing you to manage your parent's property and personal affairs)
4. Advanced Health Care Directive (which states the end-of life wishes of your parent and
allows you and whoever else is named to make health care decisions) Give a copy to the
doctors and hospital. Your state may have a form that is more detailed.
California just created the form “Physician Orders for Life-Sustaining Treatment”
(POLST) which spells out the patient’s wishes regarding CPR, medical interventions and
artificially administered nutrition. Even more detailed is the pamphlet created by Aging
with Dignity entitled “Five Wishes.” It includes the patient’s wishes for who will make
medical decisions when the patient can’t, the kind of medical treatment they want or
don’t want, how comfortable they want to be, how they want people to treat them, and
what they want their loved ones to know. In any case, the more detailed the directive,
the better for the patient, the doctor and the caregiver.
5.
Authorization for Use and Disclosure of Protected Health Information (which authorizes
the release of health information and medical records to you and whomever else is
named)
6.
Certification and Abstract of Trust Agreement (Many companies asking for a copy of the
trust will accept this one page abstract in its place.)
Your attorney will tell you such things as which accounts to put in the name of the trust, how to
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Caring for Mom
The Attorney and Legal Stuff
list beneficiaries on accounts, how to set up checking and credit card accounts so that you can
write checks and get account information, and how to sign as your parent's legal trustee.
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Caring for Mom
Setting Up the Finances
Setting up the Finances
There came a time when I needed to take over paying bills, keeping records, filing and helping
Mom make financial decisions. Luckily, Mom and I had been to the attorney, so with the
“Durable Power of Attorney for Management of Property and Personal Affairs” in hand, I was
allowed to manage Mom’s property. I created a letter from Mom (see “Accessing Accounts –
Sample Letter”) that I sent along with a “Change of Address to Caregiver’s Address” form to
various banks and companies, informing them that I would now be paying her bills. Note that
financial institutions usually require a copy of the power of attorney.
I was now ready to create a budget so we would know what the yearly expenses and income
were. I spent hours going over Mom’s expenses and income to create an annual budget. As a
“depression child” she was a saver who constantly worried about money. I went over the
budget many times, showing her that she would be solvent until she was 110 years old, but she
still didn’t believe me. So I asked if we could review her budget with Pat, a friend of mine who
is financially savvy, and Mom agreed. Pat blessed the budget without a change, and Mom
continues to tell me how smart Pat is.
As I began creating the budget, I estimated a figure for the upcoming year’s expenses by
reviewing Mom’s check register and credit card statements for the past year and summing up
all items that were not one-time expenses. I added to that any additional anticipated expenses
for the upcoming year and added a “miscellaneous” expense factor for good measure.
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Caring for Mom
Setting Up the Finances
In estimating a figure for the upcoming year’s income, I added Mom’s social security payments
and her draw from her retirement fund account. Your parent may also have such things as
stock dividends, income tax refunds, income from rent on a home or savings interest.
To determine Mom’s solvency over the next ten years, I projected her income and matched it
with the average cost of a nursing home (the most expensive living arrangements we might
ever have to use) over the next ten years. I didn’t take into consideration inflation, figuring
income would likely rise while costs rise, although I know they do not rise at the same rate.
I calculated the budget with an adding machine, pencil and a yellow pad, but you might find it
easier to create an Excel spreadsheet. In this section you will find Mom’s sample annual
budget. The book Caring for Your Parents has an example of a monthly income and expense
sheet and one for calculating net worth. (202-203)
In researching last year’s expenses I found boxes of old papers, filed and unfiled, that I needed
to sort through. As I started to toss things it dawned on me that there were items of
information on them that could be used by ID thieves, so I retrieved and cross-shredded them.
I find as I purchase various everyday items for Mom from the grocery store, etc. that I wind up
using my own money because there are a few of her things mixed in with mine. I keep track of
these expenses using an IOU sheet found in this section and reimburse myself monthly. I file
the IOU in case there is ever a question about the checks written by me to me.
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Caring for Mom
Setting Up the Finances
Once I had the authority to pay bills and a budget to know how much I had to work with, I took
over payment of Mom’s bills, setting up a free credit union checking account for bill paying and
another one for her personal use. Both of our names are on the accounts so either of us can
write checks. I have her social security check electronically deposited to the bill account.
I created a bill payment tracker chart which allowed me to track expenses. If you compare it to
Mom’s Sample Budget, you will see they are basically the same. At the end of the year, I use it
to refine next year’s budget.
In this section you will find the following:
a. Accessing Accounts – Sample Letter
b. Mom’s Sample Budget
c. IOU for Reimbursement to Caregiver
d. Bill Payment Tracker
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Caring for Mom
Setting Up the Finances
Accessing Accounts: Sample Letter
This is a sample letter to a bank initiating power of attorney for bill paying. This
will enable you to pay your parent’s bills.
Parent’s Name
c/o Daughter’s Name
Street Address
City, State, Zip
Daughter’s Phone and/or E Mail
Bank Name:__________________________________________________
Street Address:_______________________________________________
City:_________________________ State:___________ Zip:__________
August 17, 2009
Dear Sirs and Madams:
I would like to have my daughter, _____________________, listed on your
records as my power of attorney who can deal with you as needed regarding my
Visa account #____________________________________________________.
To that end, I have enclosed the appropriate pages of my Durable Power of
Attorney for Management of Property and Personal Affairs.
Thank you.
Sincerely,
Parent’s Name
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Caring for Mom
Setting Up the Finances
Mom’s Sample Budget Revised January 1
EXPENSES
Schedule
Payee
Due
Date
Closing Date
Estimated Amount
Total
Monthly
Residential Care
Home Fee
Master Card
1
Phone
14
Church
Misc
Total Monthly
Expenses
1 & 15
Medical
Insurance
1/1
Newspaper
10
$4,500
16 th
previous
month
14 th
previous
month
$300 [drugs, etc.]
APPROXIMATE
$28
$40
$200
*$5,068
MonthX12=
$60,816
Jan
1 st previous
month
$543
$543 Jan
2/15
$29
$29 Feb
4/10
$350
$1,200
$1,550 Mar
Feb
Mar
Accountant
Income Taxes
April
Medical
Insurance
Newspaper
4/1
1 st previous
month
$543
4/15
$29
$ 572 April
0 May
Newspaper
6/15
$29
$29 June
Liability
Insurance
Medical
Insurance
7/1
May
June
July
7/1
1 st previous
month
1 st previous
month
Aug
85
$125
$543
$668 July
Caring for Mom
Setting Up the Finances
Newspaper
8/15
$29
$29 Aug
0 Sept
Medical
Insurance
Newspaper
10/1
10/15
$29
$572 Oct
0 Nov
Newspaper
12/15
$29
$29 Dec
Sept
Oct
1 st previous
Month
$543
Nov
Dec
TOTAL
YEARLY EXPENSE
$64,837
INCOME
INCOME SOURCE
DATE MONTHLY AMOUNT ANNUAL TOTAL
3rd
Social Security
Draw on Retirement Fund Account 15th
$990
$11,880
$5,000
$60,000
Total Annual
$71,880
BUDGET SUMMARY
Annual Income
Annual Expenses
$71,880
64,837
$ 7,043
Amount left for additional miscellaneous expenses
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Caring for Mom
Setting Up the Finances
IOU for Reimbursement to Caregiver
I purchase things for Mom with my money. I keep the following IOU list of
expenses, pay myself from her check book at the end of the month, and file the
list in case anyone in the future should question the monthly checks.
The list is in Microsoft Office Word table format, but you could save yourself
adding up the total each month by creating it in Excel.
Month:________ Year:_________
IOU
Amount
Date…… Item
Description……………………….………………………………………
Total Paid by Check #_________
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Caring for Mom
Setting Up the Finances
Bill Payment Tracker
Monthly Bills
Payee…………….. Closing Due Amount Date Date Date Date Date Date Date Date Date Date
Date
Date
Paid Paid Paid Paid Paid Paid Paid Paid Paid Paid
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Caring for Mom
Setting Up the Finances
Bill Payment Tracker
Non-Regular Bills
Payee…………….. Closing Due Amount Date Date Date Date Date Date Date Date Date
Date
Date
Paid Paid Paid Paid Paid Paid Paid Paid Paid
Jan
Feb
Mar
April
May
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Caring for Mom
Setting Up the Finances
Payee…………….. Closing Due Amount Date Date Date Date Date Date Date Date Date
Date
Date
Paid Paid Paid Paid Paid Paid Paid Paid Paid
June
July
Aug
Sept
Oct
Nov
Dec
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Caring for Mom
Keeping Track of Important Items and Information
Keeping track of important items and information
Taking over another person’s “life” is not easy. All of the zillion details you take for granted in
your own life – who are your insurance companies, where are the policies, where do you keep
the paid invoices, when are they due – become part of a frustrating Easter egg hunt when you
begin paying bills and making decisions for your parent.
I began by creating a master list of important items and information. As I found each piece of
information, I added it to the list and coded where each could be found – in the attorney’s
office, in the file at the house, at a relative’s house, in the safe, in a safety deposit box, in her
wallet, etc. I simultaneously set up alphabetical files for the file cabinet. By using the master
list of important items and information, I can access anything quickly and effortlessly.
I also customized an income tax organizer which lists all of the information specific to Mom’s
taxes that I need to collect and bring to the tax accountant.
I found a number of insurance policies that come due at different times – car, drug, health,
house, vision, etc. – and I was continually searching for policies and due dates, so I created a
master list of insurance policies including pertinent information on each policy. I added the due
dates to the bill payment tracker and the amounts to the annual budget.
Because Mom had some items of personal property such as antiques, artwork, furnishings, furs,
and jewelry that were of value, I created an inventory form for these. I also took pictures of
each and put them in the safe in case of theft or fire. I had major items appraised and put them
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Caring for Mom
Keeping Track of Important Items and Information
on an insurance rider. Finally, Mom wants specific items to go to various family members so I
noted that on the inventory.
When she was still driving, I collected all the information on her car and put it on a form so I
now knew when to get her tires rotated, what pressure should be in her tires, etc.
Although Mom no longer had her cocker spaniel, I developed a pet form that you can use to
track important information for your parent’s pet.
Finally, there were some pieces of important information that I needed to provide family
members in the event that I was out of town and an emergency arose. I put these on the
“Summary of Important Information” form and noted who received it and when, so I could give
them an updated form periodically.
In this section, you will find the following:
a.
Location of important items and information
b. Income Tax Organizer
c.
Insurance Policies
d. Personal Property Inventory
1. Antiques, Artwork, Furnishings, Furs, Jewelry, etc.
2. Cars
3. Pets
e. Summary of Important Information
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Caring for Mom
Keeping Track of Important Items and Information
Location of Important Items and Information
Important items and information such as credit cards, paid invoices, a will or
jewelry might be found in one of the following locations:
Attorney’s Office (See Column 1 in table below)
Name:_________________________Phone:______________________________
Address:___________________________________________________________
File(s) in House (See Column 2 in table below)
Location:___________________________________________________________
Relative’s House (See Column 3 in table below)
Name:_________________________Phone:______________________________
Address:___________________________________________________________
Safe (See Column 4 in table below)
Location of Safe:
Location of Code for Safe:
Location of Key for Safe:
Safety Deposit Box (See Column 5 in table below)
Number:______________________ Location of Key(s):____________________
Bank Name:___________________
Phone:_____________________________
Address:___________________________________________________________
Hours of Operation:__________________________________________________
Wallet (See Column 6 in table below)
Other (See Column 7 in table below)
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Caring for Mom
Keeping Track of Important Items and Information
List each item and check the box which indicates its location in the checklist
below.
Location of Important Items and Information Checklist
Item---------------------------------------------------- 1--- 2--- 3--- 4--- 5--- 6--- 7---
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Caring for Mom
Keeping Track of Important Items and Information
Possible Important Information Items to list in table above:
Address Changes checklist
Advanced Health Care Directive
Attorney Notes
Authorization for Use and Disclosure of Protected Health Information
Bank or Credit Union Statements
Bill Payment Tracker
Birth Certificate
Budget
Calendars – Old
Cash
Car Registration
Credit Card Bills
Cell Phone Company
Certification and Abstract of Trust Agreement
Choosing a Senior Facility checklist
Clothing and Size Information Chart
Credit Cards
Death Arrangement Paperwork
Death Certificate of Spouse
Disposal of Furnishing and Appliances Sheet
Divorce Paperwork
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Caring for Mom
Keeping Track of Important Items and Information
Driver’s License
Drug Receipts
Emergency Contact Information
Family Misc. (Pictures, Letters, etc.)
Gardener Information Sheet
Grocery List Checklist
Guarantees for items purchased
Handicapped Plaque Information
Handicapped Plaque Location
Home Purchase/Sale Information
Hospital Receipts
House Information Sheet
Identification Card
Income Tax Organizer Chart
Income Tax Receipts for Current Year
Income Tax Records Last 7 years
Insurance Policy – Car
Insurance Policy –Dental
Insurance Policy –Drug
Insurance Policy –Health (Medicare Supplemental)
Insurance Policy –Homeowner’s (Fire, etc.)
Insurance Policy –House (Earthquake, etc.)
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Caring for Mom
Keeping Track of Important Items and Information
Insurance Policy –Liability
Insurance Policy – Life
Insurance Policy –Long Term Care
Insurance Policy –Medicare
Insurance Policy –Pet
Insurance Policy –Vision
IOU for Reimbursement to Caregiver Chart
Jewelry Appraisals and Receipts
Jewelry Location
Living Will
Magazine Subscriptions
Manuals for Appliances
Marriage Certificate
Master Appointment Schedule for Service Providers
Master Card Bills
Media and Communications Checklist
Medical Expenses and Insurance Payments Tracker
Medicare Information
Medication and Assistive Devices Checklist
Miscellaneous
Mortgage Paper Work
Newspaper Bills
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Caring for Mom
Keeping Track of Important Items and Information
Notes from Doctor’s Visits
Passport
Personal Property Inventory
Paycheck Stubs
Phone Company Bills
Powers of Attorney (for Healthcare, etc.)
Real Estate Tax Information
Rental Agreement
Renting the House Check list
Sale of House Paper Work
Senior Residence Financial Receipts and Contracts
Senior Residence Notes to Staff
Social Security Card
Summary of Important Information
Travel List
Trust
Visiting Nurses Information
Visitor List for Resident of a Senior Facility
Voter Registration
Wallet Contents Photocopy
Wallet
Will
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Caring for Mom
Keeping Track of Important Items and Information
Income Tax Organizer
Although we have an accountant, it’s my job to organize Mom’s tax information
and records preparatory to our tax appointment. Since it’s a miserable job, I put
on my favorite music and promise myself an ice cream sundae upon completion.
I have created a simple organizing system, making an index card for each topic
below. Then I go through the files, putting appropriate records with each index
card. Once the records are grouped by topics, I fill in the tax accountant’s
worksheet and attach whatever documentation is required.
1099’s





Dividends and distributions from Stocks and Bonds
State income tax refund
Credit Union
Bank
Other
W-2 Wage and Tax Statement from Social Security




Gross
Federal Tax
State Tax
Other
Receipts





Adaptive Devices (Llifeline, Walker, etc.)
Attorney Fees
Credit Card statements
Dentist
Doctor
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Caring for Mom












Keeping Track of Important Items and Information
Donations
Drugs
Glasses
Hearing Aids & Batteries
Medical Expenses – mileage
Medicare Part D premiums
Property Taxes
Refund state taxes
Rental Records
Stock, Bond, Mutual Fund Accounts
Tax preparation previous year
Other
Revised Date: ________________________________
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Caring for Mom
Keeping Track of Important Items and Information
Insurance Policies
Car Insurance
Company: _________________________ Agent: _________________________
Policy #: ___________________________ Phone: ________________________
Address: ____________________________________ Date Due:______________
Type (comprehensive, etc):____________ Deductible: ____________________
Dental Insurance
Company: __________________________ Policy #: _______________________
Co-Pay Amount Per Office Visit: _________ Phone: ________________________
Address: _________________________________ _ Date Due:________________
Health Insurance (Might be a policy to supplement Medicare)
Company: __________________________ Policy #: _______________________
Co-Pay Amount Per Office Visit: _________ Phone: ________________________
Address: ___________________________________ Date Due:_______________
House or Renter’s Insurance
Homeowner’s or Renter’s Insurance
Company: _______________________
Address: _____________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Riders (for jewelry, etc.):____________ Cost for Riders:________________
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Caring for Mom
Keeping Track of Important Items and Information
Specialized House Insurance (for earthquakes, etc.)
Company: _______________________
Address: ______________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Liability Insurance
Company: _______________________
Address: ______________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Long Term Care Insurance
Company: _______________________
Address: ______________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
Insured Value: __________________
Date Due: _______________
Amount of Deductible:__________
Medicare Insurance Part A & B
Policy #:__________________________________________
Medicare Insurance Part D (Drug)
Company: _______________________
Address: ______________________
Phone:__________________________
Policy #: ______________________
Date of Policy:________ Cost:____________
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Date Due: _______________
Caring for Mom
Keeping Track of Important Items and Information
Pet Insurance
Company: __________________________ Policy #: _______________________
Co-Pay Amount Per Office Visit: _________ Phone: ________________________
Address: __________________________________ Date Due:________________
Vision Insurance
Company: __________________________ Policy #: _______________________
Co-Pay Amount Per Office Visit: _________ Phone: ________________________
Address: __________________________________ Date Due:________________
Other:
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Keeping Track of Important Items and Information
Personal Property Inventory -- Antiques, Artwork, Furnishings, Furs, Jewelry, etc.
Take pictures of all furnishings and special items.
Item-------------- Description and Location--------------- Approx Person to Inherit
Value + If Designated
+ If you have the item appraised, include the appraisal date & appraiser contact
information. Also consider getting a rider on the home insurance policy to cover
the item. (See Insurance Checklist)
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Keeping Track of Important Items and Information
Personal Property -- Cars
Car
Year: _________________ Brand: __________________Model:______________
Color: ________________ VIN:_____________________
Dealership Purchased from: __________________________________
Address:__________________________________________________
Phone:___________________
License Plate #:_______________________Location(s) of keys:______________
Location of Registration Paperwork: ___________________________________
Due Date: _____________
Insurance (See Insurance Checklist) Company:__________________________
Policy Number:__________________
Type of Gasoline Used:______________________ Weight of Oil:_____________
Mechanic’s Name:_____________________
Address:_____________________________________Phone:_________________
Location of Maintenance
Diary:_______________________________________________
Tire Pressure:_______________
Tire Company:___________________
Tire Brand: _________________
Last Purchased:_________________
Rotation Date: _____________
Mileage at Rotation:______________
Notes:
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Keeping Track of Important Items and Information
Personal Property--Pets
Pet(s)
Name:______________________________ License #:______________________
Description:_________________________ Birth Date:______________________
Vet Name:__________________________ Address:_______________________
Phone:_________________________ Office Hours:____________________
Pet Emergency Clinic:_________________ Address:_______________________
Phone:_________________________ Office Hours:___________________
Groomer:__________________________
Address:_______________________
Phone:_________________________ Description of Service:____________
Schedule:_______________________ Cost:__________________________
Dog Walker: ________________________ Address:_______________________
Phone:_________________________ Description of Service:___________
Schedule:______________________
Cost:__________________________
Food & Vitamins
Name
Amount Given AM
Amount Given PM
Where Purchased?
What For?
Date Given
Date Due
Immunizations
Name
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Keeping Track of Important Items and Information
Summary of Important Information revised Date______
I keep this summary of important information handy at all times and take it with
me on trips. You never know when you might receive an emergency phone call
and need the information. Starred items are those that I provide to the
Residential Care Facility.
*Attorney: Name, Phone Number, Address
___________________________________________________________________
___________________________________________________________________
Birth Date : _______________________________________________________
*Clergy: Name, Phone Number, Address
___________________________________________________________________
___________________________________________________________________
*Death Arrangements
 Name of Funeral Home, Phone Number, Address
_____________________________________________________________
_____________________________________________________________
*Dentist Name:__________________________ Phone:_____________________
Address:_________________________________________________________
*Doctor (Primary) Name:_______________________ Phone:_________________
Address:_________________________________________________________
Driver’s License or ID Card #:_______________________
Medical Insurance – See wallet for cards
 Medicare #: _______________________________
 Supplemental Health Insurance
o Name: _____________________________
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Caring for Mom
Keeping Track of Important Items and Information
o Policy #: ____________________________
o Phone #:____________________________
Medicare Part D Drug Provider – See wallet for card
o Name: _____________________________
o Policy #: ____________________________
o Phone #:____________________________
*Medications – See separate list for complete listing
Social Security Number: ________________________
Wallet Contents – List and attach photo copies:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_________________________________
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Caring for Mom
Preparing for the Inevitable
Preparing for the Inevitable
When my Dad died, I had no preparation for the emotional tidal wave that would overcome
me. At the same time, I had to make all the arrangements and deal with mountains of paper
work and phone calls to get everything settled. I spent many frustrating hours trying to find
accounts, lists of people to contact, and a myriad of other little pieces of information that were
necessary to tie up loose ends.
I decided that the next time I would be as prepared as possible. To that end, I have discussed
with Mom her wishes in relation to such things as hospice, end of life care (documented in the
Advanced Health Care Directive), an obituary, a religious service, burial ceremony, etc. and we
have prepaid for her cremation. I’ve since found an excellent section in Rachelle Zukerman’s
Eldercare for Dummies entitled “Ensuring a Good Death,” that lets you know what to expect
during the death process. I found a section which lists the tasks that you need to do to settle
financial affairs after the death of your loved one particularly helpful, and I plan to use it as a
template. (318-319) Zukerman says you should collect all the things I’ve listed in the chapter
entitled “Keeping Track of Important Items and Information”; notify insurance companies,
Social Security, the Veteran’s Administration, past employers, the bank (and I would add any
appropriate investment companies); cancel credit cards, clubs (and I would add subscriptions);
list all debts; contact the probate court to begin the probate process (and I would add contact
the family attorney who should have the original copy of the will and trust). I found that I
needed six official copies of the death certificate to accomplish the above, but you may want to
get up to ten copies to be on the safe side. You can always order extra copies, but it takes time.
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Caring for Mom
Preparing for the Inevitable
In this section you will find “Making Final Arrangements” which includes the questions that I
asked as I chose a funeral home or crematorium. Delehanty’s book Caring for Your Parents has
an informative chapter on these topics as well on pages 157-171.
I’ve also included a form to inform the care facility of the final arrangements I’ve made in the
event that they have trouble contacting me while I’m traveling.
You will also find two charts entitled “Paces to Notify Upon Death” and “Things to Gather Upon
Death” which I created recently upon the death of a good friend.
Finally, I know that having the pages in this book filled out and in one place means that I have
all of the information I could possibly need at my finger tips as I negotiate final arrangements.
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Caring for Mom
Preparing for the Inevitable
Making Final Arrangements
Although it is difficult, discussing funeral arrangements ahead of time with your
parent assures that you will be fulfilling her wishes when the time comes. If you
both feel comfortable making arrangements now, you will be able to make
decisions without having to do so under emotional turmoil and pressure.
Following are some questions you might ask as you discuss arrangements with a
funeral home or crematorium.
1. What is the cost for each service provided?
2. Can we complete paperwork and leave it on file to allow for your
immediate response whenever death occurs?
3. Do we have to pay up front? If not, what are the advantages of doing so?
4. If we pay up front, what happens if you go out of business?
5. Assuming you pick up the deceased, what happens if they die out of the
state or out of the country?
6. Do you cremate on the premises? Within what time frame?
7. How do I go about making arrangements for a cemetery plot?
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Preparing for the Inevitable
Death Arrangements Notice to Care Facility
Date:
___________________
To:
Name of Care Facility: ______________________________________
From:
Your Name and Relationship:_________________________________
Subject:
Arrangements Regarding Future Demise of Name of person (and
room number if in a facility):___________________________________________
If Name of Person:___________________________ were to pass away while at
your facility, please do the following:
 Assuming I am home, please call me at home number:__________________
or cell number:_________________________________________________
 If I am traveling during this time, I have left you an itinerary with my
contact information. If you cannot reach me, please contact person’s name
and relationship:______________________________________________ at
home :(___) __________________ or cell: (___) ______________________
 If I cannot be reached immediately, please call Name of Funeral
Home:________________________________________________________
at Phone Number:____________________________________
 Signed paper work is in their office, located at: _______________________
They are available 24 hours a day, 7 days a week. They will pick up and
transfer Name of Person: ____________________________ to their facility.
Sincerely,
(Your Name)
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Caring for Mom
Places to Notify Upon Death (Alphabetical)
Those in bold face often require a certified death certificate.
Date
Notified
Accountant or tax preparer *
Air mileage accounts
Attorney **
Auto insurance company
Bank – Checking and Savings accounts ***
Brokerage Companies for stocks and bonds
Cell phone company
Computer related components – DSL provider
E mail accounts, I tunes, etc.
Credit cards – cancel unless you’re named on the
account and want to keep it
Dentist and other health care professionals
Dept of Motor Vehicles -- Auto registration (transfer
title to survivor)
Driver’s license
Employer – yours and spouse’s
Financial advisor
Funeral director
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Death
Certificate Sent
Notes
Caring for Mom
Health insurance company
Insurance agent (also change beneficiaries on your
insurance policies and update names of insured)
Investments – Mutual Funds, 401’s,
Annuities, etc.
IRA custodians or trustees regarding designated
beneficiaries and post-death distribution options
IRS
Landlord
Life Insurance Companies
Long term care insurance company
Magazine subscriptions
Medicare
Mortgage company
Past employers regarding pension plans
Pension Plans
Real Estate Official for deed, title, etc.
Social Security ****
Stock broker
Storage Company
Trust Accounts
Veteran’s Association – May get burial expense
allocation
Workplace *****
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*Other things to do
*Talk to accountant or tax preparer about need to file estate tax, inheritance tax, federal and
state income taxes for deceased for the year of death, separate income tax returns for trusts,
changes in real estate taxes.
** Talk to attorney about filing will with probate court and need to file on any out of state real
estate, updating and revising your own will, appointing a new executor for the remaining estate
*** Re-title jointly held bank accounts and other assets such as cars, stocks, bonds, real estate
****Report the death to Social Security by calling 1-800-772-1213. If benefits were being
directly deposited to bank, ask bank to return funds received for the month of death to Social
Security. Return any social security checks that come by mail. Check if eligible for death benefit
and survivor’s benefits.
*****Workplace -- Make arrangements to collect belongings, salary and vacation or sick pay
owed, ask about continuing health insurance coverage and potential survivor’s benefits
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Caring for Mom
Things to Gather Upon Death (Alphabetical)
Item
Location. . . . . Notes. . . . .
Automobile and boat registrations
Bank records:
Bank or Credit union statements
Certificates of deposit
Money-market account statements
Outstanding loan statements
Safety deposit box records and keys
(change ownership of box)
Belongings from workplace
Birth certificate
Credit cards
Death certificates (certified copies)
Deed to cemetery plot
Funeral Plans including proof of prepayment for services
Insurance Policies :
Accidental death & dismemberment insurance
Annuities
Auto credit life insurance
Credit card insurance
Individual and group life insurance
Mortgage insurance
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Caring for Mom
Investment records:
Annuity statements
Bonds
Stocks
Marriage certificate
Military discharge papers
Papers of authenticity for valuables such as art, jewelry
Pension and profit-sharing plan statements – 401K, IRA, etc.
Real Estate Records:
Deed and deed of trust
Mortgage contract
Promissory notes
Property appraisal
Real estate tax notices
Registration for car, boat, etc.
Social security card
Tax returns
Trust
Will
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Caring for Mom
Works Cited
AARP New Hampshire. April 20, 2010. Prepare to Care: A Planning Guide for
Families. [http://www.aarp.org/relationships/caregiving/info.-042010/prepare to care.html]
Bell, Virginia and David Troxel. A Dignified Life: The Best Friends Approach to
Alzheimer’s Care, A Guide for Family Caregivers. Deerfield Beach, FL:
Health Professions Press, Inc, 2002.
Capassela, Cappy and Sheila Warnock. Sharing the Care: How to Organize a
Group to Care for Someone Who is Seriously Ill. New York: Fireside, 1995.
Comarow, Avery. “Taking The Measure of the Latest Rankings: How Thousand of
Homes Were Assessed and 173 Were Selected for this Issue.” U.S. News &
World Report, Feb. 2010: 72-82.
Delehanty, Hugh and Elinor Ginzler. Caring for Your Parents: The Complete
AARP Guide. New York: Sterling Publishing Company, 2005.
Johnson, Paulette. “Navigating the Health Care System,” The Monitor, Autumn
2011: 1-4. [www.vcccdra.org/html.newsletter.html]
Kertesz, Louise. “Resources for Caregivers, or, ‘Who has time to read when you’re
going through all that stuff?’” [http://atyourlibrary.org/fitness/resourcescaregivers]
Loverde, Joy. The Complete Eldercare Planner, Second Edition: Where to Start,
Which Questions to Ask, and How to Find Help. New York: Three Rivers
Press, 2009.
McCullough, Dennis. My Mother, Your Mother: Embracing “Slow Medicine”—
The Compassionate Approach to Caring for Your Aged Loved Ones. New
York: Harper Collins Publishers, 2009.
Sheehey, Gail. Passages in Caregiving: Turning Chaos into Confidence. New York:
Harper Collilns, 2010.
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Zukerman, Rachelle. Eldercare for Dummies. Hoboken, NJ: Wiley Publishing,
Inc., 2003.
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About the Author
Diane Moore has a doctorate in educational management and has worked as a Dean at Ventura
College for twenty years. Three years before retirement she became a caregiver for her elderly
mother. She used her knowledge of management theory and the management skills she
developed over the years to create systems that would make caregiving as effortless and
enjoyable as possible. For the past eight years she has researched the field, consulted with
many caregivers to get their advice, and refined the systems as she cares for her mother. Now
she is ready to share them with you, in the hopes that using them will ease your burden and
enhance your life and that of your loved one.
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