The paperwork: POA, DNR, and where the documents live.

The short list that actually matters

You do not need a filing cabinet. For a parent's care, a small number of documents do almost all the work, and the rest can wait. Here is the short list worth having in one place, with what each one does.

• 1.Durable power of attorney for finances. Lets someone your parent names pay bills and manage money if she cannot. "Durable" means it survives her losing capacity, which is the whole point of having it.
• 2.Healthcare proxy, sometimes called a medical power of attorney. Names the person who makes medical decisions when your parent cannot speak for herself.
• 3.Living will or advance directive. Writes down her wishes about care near the end of life, so the proxy is carrying out her instructions rather than guessing.
• 4.DNR or POLST, if she has chosen one. A medical order about resuscitation and treatment that travels with her. A POLST is signed by a doctor and is the one paramedics follow.
• 5.Insurance cards. Medicare, any supplement or Advantage plan, and the prescription drug plan.
• 6.A current medication list. Not a legal document, but the paper the hospital asks for first, every single time.

The one nobody can find at 2 AM does not exist

A healthcare proxy that is signed, correct, and sitting in a drawer nobody can name is the same as no proxy at all. This is the failure that actually happens. Not that families never do the paperwork, but that the paperwork exists and cannot be produced in the twenty minutes when it matters.

When your dad is on a gurney and the doctor asks whether there is a DNR, "I think so, somewhere at his house" does not count. The document has to be findable by more than one person, fast, from wherever they are. Decide where things live before the night you need them, because you will not be sorting through drawers at 2 AM.

Originals, copies, and who needs which

Some documents only carry weight as originals. Others are fine as copies, and copies are what you actually want floating around.

• 1.The hospital wants to see the healthcare proxy and any DNR or POLST. A copy usually gets you started. Keep the POLST original reachable, since it is the order paramedics act on.
• 2.The bank often wants the original durable power of attorney, or its own form, before it will let anyone touch the account. Ask the bank early, not the day you need to move money.
• 3.Siblings and the named healthcare proxy should each hold a copy, or at least know exactly where the originals are and how to get them.
• 4.The home care agency should have copies of the proxy and any DNR on file, so a caregiver is not guessing during an emergency.

Give them one home, and tell everyone where it is

The system does not have to be sophisticated. One box does the job: a fireproof document box on a known shelf, the short list inside, each document in a labeled folder. What makes it work is not the box. It is that everyone who might need it knows the box exists and knows where it sits.

Tell your siblings. Tell the person named as healthcare proxy. If your parent still manages her own affairs, this is her box and her call, and you are helping her set it up rather than taking it over. Keep a second copy of the essentials somewhere off-site or reachable from a phone, so a house you cannot get into does not lock the documents inside.

Review it once a year

Documents go stale quietly. The proxy your mom named ten years ago may have moved away. The insurance changed at the last open enrollment. The medication list is almost never current. Once a year, on a date you will remember, open the box and check three things: are the people named still the right people and still reachable, are the insurance cards current, and does the medication list match what she actually takes today. Twenty minutes once a year is the difference between a folder that helps and a folder that misleads.

When to call a lawyer, and when to call the doctor

This guide is a map, not legal advice, and a few of these documents are worth doing right.

• 1.Power of attorney and a healthcare proxy are usually straightforward, but the wording and signing rules vary by state, and a mistake can void them. An elder law attorney is the right person, and the cost is small next to getting it wrong.
• 2.A DNR or POLST is a medical decision, not a paperwork errand. Your parent's doctor is the person to have that conversation with, and the doctor is the one who signs the POLST.
• 3.If your parent already lacks the capacity to sign, do not download a form and hope. That situation needs a lawyer, and possibly a court, and the sooner the better.

Common questions