financial/paperwork ducks in order before chemo
October 1, 2020 8:38 PM   Subscribe

We have a relative who lives a few states away who has learned that in addition to an initial cancer surgery, they will also need to undergo additional surgery, radiation, and chemotherapy to treat a more aggressive than anticipated cancer. They find financial/insurance/short term disability/poa/will/paperwork generally intimidating. What should we be helping them set up prior to cancer treatment?

This relative is in their mid 40s and generally in good health. They are employed, and have health insurance through their employer (in the state of WA). They have no spouse/partner, and no relatives living close by. They have a supportive group of friends through hobbies and their parish who are willing to step up to meet needs. They are very concerned about loss of mental acuity during treatment, and loss of ability to work in the long run.

We traveled to relative for a week to assist after the initial surgery. Now we're planning on traveling out for a weekend to help with paperwork type stuff, as that's what they're struggling with currently. What should we cover?

My thoughts:

set up a will using NOLO software, the one bit we've done before and are familiar with. They own a house and have a few very beloved pets.

living will to specify their medical preferences (also using NOLO?)

durable power of attorney, not sure who they want to designate for this

figure out short term disability for their state

ask them to designate someone to have access to their medical records/care

we have a paid dropbox account, would install dropbox on their phone and computer with a folder for them to upload whatever paperwork they want us to review or work on


Any links to general lists of must dos, or personal anecdotes about what you found helpful to assist a loved one in this situation, are equally welcome!
posted by anonymous to Health & Fitness (5 answers total) 3 users marked this as a favorite
When my friend got her cancer diagnosis, she also got a booklet from the American Cancer Society that had a nice checklist of all the things to get in order before treatment started. You might want to contact them.
posted by eleslie at 5:47 AM on October 2, 2020

Advanced directives, which cover what the patient wants in case of calamities like being in a coma and do not resuscitate orders, should be prepared and on record in the hospital. This may include designating a healthcare power of attorney.

For a patient living alone, some sort of daily checkin is appropriate. Also locate some means of supplying at least one meal a day in case the patient is too fatigued to see to three square meals a day. Meals On Wheels is good for this in many places, but in these Covid times, a local restaurant or diner may be just as good.
posted by SemiSalt at 6:37 AM on October 2, 2020

Medical power of attorney should be first on the list. This is a document that the patient signs after designating what their wishes are around various life-saving measures, but it designates someone who can make decisions if they become too ill or incapacitated to express their own wishes. I was that person for an aunt who had cancer, and was a widow with no children. I'm a nurse, so this was appropriate. I can tell you it made a tremendous amount of difference when she was in a nursing home, as the staff HAD TO LISTEN TO ME. It was because I put my foot down, several times, that her pain medications were upped PRONTO when she was in obvious pain and the staff didn't want to buck protocol and call the doctor at night.

My out-of-town cousin, a financial planner, had her legal power of attorney and dealt with the nursing home, hospital, long-term-care insurance (OMG, what a nightmare!) paid the bills on her home, etc. Having one person designated for medical and another for financial/legal was helpful, as I was not bogged down with all the financial issues. This became even more important when my cousin took possession of her financial records and it became clear that her postman(!) had sought substantial loans from her - she had assets and received all her statements (Merrill, State Street) in the mail. Of course she was a target! It was my cousin who discovered the hand-written promissory note, the record of minimal and sporadic repayment, and approached the Postmaster General's office to report it. My aunt has died, but my cousin continues to receive regular repayment to the estate because she was able to take legal charge of the financial issues.
posted by citygirl at 9:02 AM on October 2, 2020

HR should be able to help them figure out what they need to get short term disability. My husband's employer had way to mix short term disability with vacation time so he could get 100% of his salary for longer. In his case, short term disability was paid by special insurance company (not the state, not the usual insurance plan, not the employer)
posted by metahawk at 5:42 PM on October 2, 2020

If the relative doesn't already have a password manager, this might be good time get one set up. If they are giving someone financial power of attorney, it could really helpful for that person to have on-line access to the accounts so they can make sure bills get paid etc. Something like the family plan for 1Password would allow the relative to put passwords into a joint vault where either they or their POA can access it and then move them out (and change them) later if they want to take back full control.
posted by metahawk at 5:44 PM on October 2, 2020

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