This portion is divided into two sections. The first gives information about the kinds of documents an older person may be asked to sign to receive services in or outside the home. The second identifies a number of legal documents an older person and his or her family may be asked to provide to an agency when services are arranged. If the senior does not have these documents in place, this might be a good opportunity to consider completing them as a way to assist with health care and financial matters the older person may encounter in the future.
Documents to Sign for In-home Services
All companies that provide services in your home, whether they are home health care agencies or home repair companies, have a contract or service agreement you or your loved one will be asked to sign.
- Home Health Agencies
If you or your loved one will receive a service covered by Medicare, or another health insurance policy, you will be asked to provide information that will allow the company to bill the insurance provider directly. You will also be asked to sign a service agreement that states the specific services to be provided and the number of hours that care will be provided. If you or your loved one plans to pay privately for a home health aide to assist with personal care (bathing, dressing) and/or light housekeeping services, the contract will specify the actual services to be provided, the number of hours of care that will be provided and the cost (usually on a hourly basis).
- Home Repair Companies
If you or your loved one needs the services of a home repair provider, it is important to use a company that is licensed to provide home repair services. Obtain at least three estimates for the improvements you want. Ask to see each contractor's Home Improvement Commission license and copy the license number and expiration date. Call the Maryland Home Improvement Commission (410-230-6309) to verify the licenses and ask about complaints against the contractors.
When you find a reputable company, they will prepare a contract that specifies the work to be completed and the cost of the project. Don't pay a contractor before you read and sign a contract. Even after signing the contract, do not pay the full amount until the work is complete. In fact, Maryland law prohibits a contractor from receiving more than one-third of the contract price at the time the contract is signed.
- Volunteer Services
Some Departments of Aging and private organizations in Maryland offer in-home volunteer services. In Baltimore County, Home Team volunteers visit older people who are homebound. A Home Team volunteer may be a friendly visitor, run errands or provide transportation to the bank, appointments or the store. Before the volunteer starts working with the senior, a staff person from Home Team will visit the client and introduce the volunteer and discuss the services needed. The senior and the volunteer sign an agreement that specifies the services to be provided. These procedures make it more likely that the relationship between the volunteer and the senior will be a rewarding one. Look for similar procedures when exploring other volunteer services for yourself or your older relative.
- Other Services
You or your loved one may pay for services in the home such as delivery of food, medication delivery, in-home hair care, etc. Some businesses provide free delivery; others may charge a fee. There should not be a contract to sign for these services since they are sporadic.
Documents to Sign for Community Services
There are a number of services one may use to maintain his or her independence in the community. A senior center may be just the place for the independent individual looking for social activities, recreation and education. If the older person needs some assistance or medical monitoring during the day, an adult medical day center may be more appropriate. There will be specific contracts and other legal documents required for each program. For example, senior centers ask for proof of age and residency, and require that some release forms be signed. Adult medical day centers ask for medical information, and have a contract that specifies the services provided and the cost.
Other community-based programs have their own documents, contracts and agreements. Be sure to read each carefully and consult with an attorney if you have questions.
Documents You Should Give to Service Providers
If you or your loved one receives health-related services in the home, there are some legal documents you should provide to the agency so the staff understands what decisions you or your loved one has already made regarding health care.
- Advance Directives: These documents allow a person to make health care decisions in advance, so that those decisions may be carried out in the event that the person is no longer able to give informed consent. The advance directive may specify the type of care the person wants, and/or it may name another individual to give informed consent for medical treatment.
- Do Not Resuscitate (DNR) Order: This document states that the person does not want to be revived if cardiac arrest occurs or if the person stops breathing.
- Order for Guardianship of the Person: This document indicates who was appointed to make medical decisions for a person who was determined by the court to be “disabled” and therefore unable to give informed consent for medical decisions.
The following financial documents are appropriate to share with a health care provider so that bills are sent to the proper person:
- Financial Power of Attorney: The person named in this document is responsible for handling only the person's financial affairs described in the document if the patient is unable, or does not wish to do so. (This may include payment of bills.)
- Order for Guardianship of the Property: This document will indicate who was appointed to make financial decisions for a person who has been determined by the court to be “disabled” and therefore unable to make financial decisions.
If you or your older relative would like more information about the documents described above, contact the Senior Information and Assistance office at your local Department of Aging.
For information about wills, estates and probate or to learn how to register a will, the Maryland Register of Wills offers information and links to local registers.