If your elder loved one is in the process of getting settled in Texas, or is thinking about it, this blog may help. I know there is a LOT of information here! It is longer than our usual blogs and is intended to be a kind of checklist for you, the caregiver, to use.   Some of it may not apply to your loved one’s situation.  Please SHARE this with someone you know who may be helped by it.  I would love to hear from our readers about what you think of the article, what else may be helpful to add, and of course, if you have any corrections or additional information.  

Here is the checklist: 

1. Getting Texas Identification – Driver’s License or Texas ID card if they don’t drive- it helps if you can go to a Megacenter where you can get in line online. Be aware that you will need to take them with you. In addition, the DPS centers are now making people wait outside at busy times so it may be advisable to bring a doctor’s letter if your loved one is unable to do so. (Although the centers are generally good about accommodations.) You can request this from the doctor at the same time that you request a handicap placard (see #2 on this list).    –At the Driver’s License Center: Take ALL documents proving birth name and ALL name changes to the DPS. Birth certificate, marriage license, divorce papers, additional marriage license, prior state’s driver’s license or ID card and something to prove new address (lease or utility bill).  You will also need to prove your U.S. Citizenship.  Look online at the DPS website to be sure to follow all current requirements.
2. Handicap placards – VERY helpful if your loved one qualifies, especially with this Texas heat in the summer! Texas DMV VTR 214 (blue placard, persons with permanent disability.) Print this and take to primary care physician to have him/her fill out the doctor’s portion. It is recommended that if there are 2 people who are going to be driving your loved one, you get 2 placards and keep one in each car. https://www.txdmv.gov/motorists/disabled-parking-placards-plates
3. Legal papers- Bring Last Will & Testament, Trusts, Powers of Attorney & Health Care documents from the previous state. If your loved one is physically and mentally able, it is usually best to have new Texas documents drafted and signed. Especially for Powers of Attorney.  But it may be necessary to have two “active” powers of attorney going at the same time while closing out accounts in the prior state. In other words, don’t shred the old documents yet, even if you have new ones drafted IF there are institutions in the old state that have the old ones on file that name YOU as the Agent. Pay close attention to whether or not your loved one actually has the “legal capacity” to sign new documents (do they really understand what they are signing at the time they sign it?)
4. Identification and insurance cards – Make a copy of their cards for yourself, even if they are living with you, and keep them in a handy file.
5. Veteran’s information. If your loved one or their spouse (current, former, or deceased) is/was a veteran, make sure to get a copy of Veteran’s information, including specifically the form DD-214 (discharge papers from active duty) & proof of any duty in the Reserves.  There may be some benefits available. You can do some research online to see the guidelines for who is eligible, once you have the details of the service. Local Veteran’s administration offices can help you determine this as well.
6. Medicaid- If your loved one is eligible for Medicaid that may be the source of additional benefits.
7. Banking & Taxes– You may decide to stay with the same bank if that particular bank also operates in Texas. It is helpful to have a local Texas checking account with a branch that is convenient to you, even if you keep one or more accounts in the prior state. (But be aware of tax implications/state taxes).  The power of attorney, if you have one, should be written to allow you flexibility to do banking as necessary.   Since Texas does not have state tax, make sure that your loved one’s state taxes for his/her prior state are kept up to date. In other words, you may need to use a CPA from the prior state for the year of the move, if property or accounts still remain there after the move, or if your loved one keeps more than one residence for certain times of the year.  Once the move of person and property to Texas is complete, Texas residency will allow you to file for your loved one as a Texas Resident. Consult a C.P.A. to help you with this, if necessary.
8. Insurance- Medicare supplement insurance is state-specific. So you are going to have to switch your parent over to a Texas medicare supplement plan. Do this right away, even if not in the regular enrollment period.
9. Updating Medicare & Other insurance information– Medicare has it’s OWN Power of Attorney and authorizations. Check the website and make sure that those are filled out in order to allow you to deal with Medicare. “Authorization to Disclose Personal Health Information.   https://www.agingcare.com/articles/personal-information-medicare-needs-148148.htm  -Don’t forget to update address and info for the prescription plan, dental, long term care insurance, life insurance and funeral insurance if applicable.  Some insurance companies may require you to fax your power of attorney every January, even if it is not expired.
10. Online Logins- It REALLY helps to create online logins for everything that you can, especially Medicare and a patient portal at their PCP (Primary Care Physician). It may also help to use your own cell phone number, email number and physical address when you can, even if they do not live with you, because that will prevent you from having to physically go check their mailbox, answering machine, or rely on their explanation of who called and why or what bill is due. And it will decrease their stress as well.
11. Bill paying – Set up online when you can and have paper invoices mailed to you. Use online logins, automatic payment, or at least automated reminders, whenever you can.
12. Assisted Living (if applicable) Generally has levels of care.   The facility will do an evaluation and recommend a certain care level.  Accept all help that you can, including using the facilities pharmacy and especially having the nurse administer all meds. —Be aware that in order to administer medication (or even remind someone to take medication), the facility is going to need up-to-date Doctor’s Orders.  You will save everyone a lot of time by creating a system to keep them updated, which usually means getting a form from the facility prior to each doctor’s visit or having the doctor’s office fax a summary of the visit to the facility at the end of each visit.
13. Independent Living (if applicable) – Find out if there is transportation available and whether your loved one will be physically able to use it. If not, you will be providing the shopping and it is helpful to work out a specific schedule. Pre-printed grocery lists which your loved one can use to “check off” what s/he needs can help you. If you are providing transportation to doctor’s visits as well, you will have to schedule that. It is helpful to keep a large calendar of events at your loved one’s home and keep it updated when you update yours so that you both know what to expect.
14. Keeping Medical History– This is crucial! Keep a current list of all meds, prescription and OTC, and a medical history. Keep one in your loved one’s purse or wallet, in their home and one with you. Update it regularly and have access to it from wherever you are. If you are taking your loved one to the doctor appointments, bring the list every time.
15. Counseling/Therapy- If your loved one is in a senior facility, the facility and the primary care doctor may be able to guide you in setting up home visits for medical needs such as memory care, physical therapy, occupational therapy or psychological counseling. This can help the patient deal with all of the changes going on and can be covered by Medicare when appropriate.
16. Staying organized- It can help to have a specific designated spot in your home where you keep items that are going to your loved one’s home. Stay organized with labeled digital and paper files for their bills, medical paperwork and other information. It helps to have a small file cabinet or box for this purpose. Staying organized is crucial

Having your loved one nearby to be part of your family’s day-to-day life requires adjustments for you, your family, and for your loved one to deal with the loss of what they left behind.  But there are a lot of benefits as well. Holidays together are one big benefit! After the initial adjustment period, your loved one may say, “what took me so long to get here?”

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