Your Parent's Paperwork: Six Documents to Find Before You Need Them

For twelve years I did the calls that follow a decision. And the sentence I heard most often, from adult children, at about hour three, was some version of: I don’t know where anything is.

Nobody knows where anything is. That is the normal condition of a family, and it is fine right up until the afternoon it is not.

Six documents. An hour on a Sunday.

The two that cannot be made later

A health care directive. Names who makes medical decisions if your parent cannot, and says what they want. It has different names in different states and your parent’s doctor’s office will know the local one.

A durable power of attorney for finances. Lets a named person deal with the bank, the landlord, the insurer, the utilities.

These two are different in kind from the other four, and this is the single most important paragraph in this piece: they must be signed while your parent still has the capacity to sign them. After that point, the alternative is a court process, which costs money and takes time at the exact moment your family has neither — and while it runs, a bank will not discuss an account with you and a landlord will not discuss a lease.

Both need a lawyer, or at minimum a properly executed state form. I am not one and this is not legal advice; what I can tell you is what happens in a hospital when they do not exist, which is that everything stops.

The four you can assemble yourself

Insurance cards. Photographs of both sides of everything: Medicare, any supplement or Advantage plan, any other coverage. Member numbers, not just the card image.

The medication list. Everything, with doses, including over-the-counter and anything a specialist added. Update it at every admission and every discharge. This document does more work in the first hour of a hospital visit than anything else on this list, and it is the one families most often bring in the form of a carrier bag of bottles.

A one-page contact sheet. Primary doctor, any specialists, pharmacy, insurer, the lawyer or financial adviser if there is one, a neighbour with a key, the landlord or the association. One page. On paper.

The deed or the lease. Where they live and on what terms, plus the property tax or rent arrangement. This is the one nobody thinks of until a decision about the house has to be made in a week.

Where to put them

One folder. Your parent knows about it. At least two other people know where it is.

Not a safe deposit box, which cannot be opened on a Sunday by the person who needs it. Not only on a laptop nobody else can unlock. A copy of both directives goes to whoever is named in them, and — this is the step that gets skipped — a copy of the health care directive goes to the doctor’s office, where a hospital can actually find it.

The most common failure I encountered was not disorganisation. It was an immaculate folder that only the person in the hospital bed could locate.

How to ask

Adult children put this off for a year or more, and it is never because they think the documents do not matter. It is because the request appears to be a conversation about dying.

Ask about a week instead.

“If you were in hospital for a week, what would I need to know to keep everything running?”

That is a question about the mail, the plants, the mortgage payment and the pills — and it produces exactly the same list, without either of you having to sit with the other thing. In nine families, it did not fail once.

If there is more than one of you, do the division of labour at the same time; three siblings did exactly that in Minutes, and the inventory is what made it possible. And do your own paperwork at the same time. Say so, out loud, at the start: I’m doing mine this month, I want to do yours too. It converts the request from something being done to a parent into something a family is doing, and it removes the implication that the older person is the one whose paperwork has become urgent.

What this is not

It is not legal advice, it is not medical advice, and two of these six need a professional.

What it is, is a Sunday. I have watched a great many families spend an afternoon in a corridor doing the version of this that happens under pressure, with a phone, guessing at a member number. The version that happens in a kitchen with a cup of tea takes about an hour and never has to happen again.