Financial and Legal Concerns

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Experience shows that people under stress often lose sight of, or don't have time to focus on, normal day-to-day responsibilities.

For instance, many well partners report that paying bills takes a back seat to managing the more pressing demands of the patient and children's needs. While this is understandable, ignoring financial responsibilities can damage your credit rating and result in large interest and penalty charges.

So try to think ahead. If possible, sit down with your partner and review your finances. If you are able, consult with a trusted friend, credit counselor, accountant, or financial planner. It may be helpful to meet with a social worker to review your current situation and stresses. He or she may be able to help direct you to other resources and assistance within the hospital or the community.

In addition, hospitals and treatment centers usually have financial information offices to help you with a variety of billing and insurance concerns. If you are not sure how to reach this office within your treatment center, ask a member of your health care team or connect through the hospital's operator.

It often is helpful to review details of your health, disability, and other insurance policies, including coverage, deductibles, options for increasing or changing coverage, and payment plans. This way, you won't be caught off-guard by unexpected expenses or coverage exceptions. Most people are not familiar with these details, and it will be helpful to get a better understanding of these important documents.

Once you have a clearer understanding of your financial situation, decide with your partner if you can delegate any part of your financial management to someone else. If you are comfortable with this, you might ask a close friend or relative to temporarily take over paying the bills and responding to other immediate financial concerns. If you are in the position to hire someone to assume responsibility for managing household expenses, consider this as well. Some banks and law offices offer this service.

Patients will be asked to make many decisions about their medical care, including accepting or rejecting specific medical treatments.

By federal law, hospitals must ask all patients if they have named someone to make medical decisions, including decisions about life support, for them in the event that they become unable to do so themselves. In Massachusetts, this is called designating a "health care proxy." Other states refer to this as naming a "medical power of attorney." Often patients select their partners as their health care proxy, so you might prepare for this possibility.

As a first step, consider bringing this up with your partner. If he or she wants to name you, the partner, as the health care proxy, this will be a time for a conversation about preferred treatment options and to consider with the patient what care decisions would be consistent with his or her wishes, or religious or moral beliefs. It is helpful if your partner puts these guidelines in writing and gives them to you (or to whoever is named the proxy).

While patients often complete a form called a "Living Will" that includes this type of information, these documents are not legally binding in Massachusetts. Recording general guidelines about the decisions of care and leaving them with the proxy is considered a more reliable approach. In any case, it is critical that the proxy understand what is important to the patient.

If your partner is being treated in a Massachusetts facility, you can obtain a copy of the Health Care Proxy form through your health care team. Forms and related information also can be downloaded from a variety of websites, including:

After completing the proxy form, your partner should sign it in the presence of two adult witnesses, make multiple copies, and then file the original in a place where it will be easily found. Your partner should also provide copies to all interested parties (physician, proxy, family, and/or attorney). A copy needs to go into the patient's medical record. If your partner is hospitalized, bring a copy for the inpatient record. If you need more information, ask your partner's treatment team.

Well partners have the legal right to request time off from work to care for family members.

This option is guaranteed by the federal Family and Medical Leave Act (FMLA). If you have questions about this law, or the implications of your requesting a leave, contact a hospital social worker, the treatment center's financial information office, the Human Resources department at your workplace, or an attorney.