FIRST THINGS FIRST!

BE YOUR LOVED ONE'S ADVOCATE, BUT DON'T GET ANGRY WITH MEDICAL PROFESSIONALS! Just a few days after our loved one’s accident, we were asked to have a meeting with his assigned medical staff at the hospital. His situation was not very promising, and we were asked if we knew if he was an organ donor. This is a very hard thing to be approached with when you are confused, upset, and stressed. When our loved one left the hospital to stay at a skilled nursing facility we were told by the neurologist “This is as good as it gets!”. At the skilled nursing facility, we faced many challenges with some of the medical professionals and were asked by a pulmonologist “Is this all he does?”, because he was not familiar with our loved one’s condition outside of his own expertise. When we pulled our loved one out of the skilled nursing facility to bring him home, the comment was “Take good care of him!”. All of these comments upset us greatly. So, if something like this happens to you, just know that it is not directed at YOU. These facilities are understaffed, individuals, just like you, are also stressed, overworked, and have a huge amount of responsibility on their shoulders. Don’t take it personal! Move on … make up your own mind about your loved one! WHAT IS THE SHORT-TERM PROGNOSIS? / WHAT IS THE LONG-TERM PROGNOSIS? Much will depend on the type of treatment and recovery needed by your loved one. This, of course, depends on the severity of the TBI. You will need to assess this situation early on. MEDICAL INSURANCE Does our loved one have insurance? Even though this is mandatory now, many individuals still do not carry medical coverage. If your loved one does not have insurance, immediately apply for Medicaid (some states use a different name.) Your first step will be to contact the social services office in your location and submit the information needed. Be prepared to encounter long waiting times and lots of paperwork. Inform yourself as to what you need to bring with you beforehand. If your loved one has medical insurance, will it be sufficient to accomplish everything you hope to achieve? If you are in a position to do it, add an additional policy immediately! This is especially true if you are looking at skilled nursing facilities and neurological clinics. Find out what medical insurance companies they work with and go from there. You’ll find some information on primary and secondary insurance on this website. Medical insurance will dictate in many ways what help you will be able to receive! Always fight for the best you can get! Be willing to reach out to organizations that offer free or low-cost assistance! Set up a “Go-Fund-Me” page if you need to. Don’t accept the status quo! Be prepared to make many calls to the insurance carrier, facilities, doctors, and case workers. This seems overwhelming at first, but you’ll quickly get into the grove and learn to assert yourself as an advocate for your loved one when necessary. If you are in a position to do it, add an additional policy immediately! You’ll find some information on primary and secondary insurance on this website. MEDICAL POWER OF ATTORNEY Does your loved one have a “Medical Power of Attorney”? A medical power of attorney allows a person to specify who will make medical decisions for them if they are incapacitated. However, once they are incapacitated, they can no longer grant a power of attorney. (Freewill.2023) That being said, it is not impossible to obtain it through the courts, but a little time consuming. MEDICAL DIRECTIVE Does your loved one have a “Medical Directive”? A medical directive is a legal document that contains instructions to be followed regarding a person’s health care decisions if they become incapacitated. The directive will name a person (persons) that can make medical decisions on their behalf. This type of legal document also contains decisions the person may have made beforehand, for example, a request that the person not be resuscitated. As with a medical power of attorney, this document cannot be created after a person becomes incapacitated. Other names for this document are: living will, instruction directive, advance healthcare directive, power of attorney for healthcare, or healthcare proxy. (National Institute on Aging. 2023.) MEDICAL GUARDIANSHIP / CONSERVATORSHIP If your loved one does not have a “Medical Power of Attorney” or a “Medical Directive”, it might be necessary to obtain a “Medical Guardianship”. This type of guardianship can be temporary or permanent. Many people shy away from this type of control because they fear that they will be responsible for everything that concerns their loved one. Guardianships/ Conservatorships can be tailored to your needs and can be set up to cover medical decisions only. Some states restrict the guardian's ability to sign off on mental health treatment for the loved one, while others allow it. Your loved one's physician or psychiatrist will be able to advise you further on this matter. In most jurisdictions, free help is available to work through the maze of documents that need to be prepared and filed with the court. If you are able to, consult with an attorney on this matter, as court assistive programs can only advise on information that needs to be provided, they cannot advise you on the legality of certain issues you must agree to and sign off on. This type of court proceeding will always require assessment by professionals! Get your doctors involved, as they have to prepare statements and sign off on same. The court will most likely involve a court appointed social worker to work with you as well. This process can take a while, but if you are facing a long-term recovery, it is very worthwhile to obtain guardianship / conservatorship to make decision making easier. (Family & Aging Law Center. 2018.) SUPPLEMENTAL SOCIAL SECURITY INCOME (SSI) If you are in a position where your loved one will have a longer recovery and is unable to work, begin the process of applying for Supplements Social Security Income. This can be a long process with affidavits needed from doctors and professionals. There are several steps to be completed, which all include many forms and paperwork. It can take over 12 months to see your first supplemental income check. So, if you feel your loved one qualifies, start early. Get started by downloading forms at SSA.Gov/ssi and then make an appointment at your nearest Social Security Office. (SSA.Gov. 2023.) Karthikeya T M. 2016. “Traumatic Brain Injury”. Retrieved September 19, 2023. https://www.msn.com/en-us/health/condition/traumatic-brain-injury/hp-traumatic-brain-injury?source=bing_condition Freewill. 2023. “What Is A Medical Power of Attorney?”. Retrieved September 5, 2023. National Institute on Aging. 2023. “Advance Care Planning: Advance Directives for Health Care”. Retrieved September 5, 2023. Family & Aging Law Center. 2018. “What you need to Know About … Guardianships & Health Care Powers of Attorney”. Retrieved September 5, 2023. Social Security Administration. 2023. “Supplemental Security Income (SSI)”. Retrieved September 5, 2023.