I serve as both a Medical Advocate and a Professional Fiduciary for clients in Island County WA and other nearby counties. You can learn more about me through my writing in this article for secondjourney.org :
 Medical Advocate
A Medical Advocate is a person who accompanies a client to medical appointments, helps them to understand what is being said about their healthcare, helps them to think through their decisions, advocates for the client within the medical system by knowing the values and wishes of the client and seeing that physicians and hospital staff understand what their patient wants and doesn't want.
Professional Fiduciary
A Professional Fiduciary is a trained and experienced person who holds the best interests of a client, along with the client's particular values and wishes concerning their financial wellbeing, and fulfills those interests by handling any bill-paying, banking, investment oversight, correspondence, and any other administrative tasks and estate management at times when the client is unable to do so.
Advance Directives
Should you become physically or mentally incapacitated in the future, the most certain way for your healthcare and your finances to be handled in the ways you would have chosen for yourself, and to avoid a Court-established guardianship in which your civil rights may be lost, is to complete documents called Advance Directives.
These documents include a Durable Power of Attorney for Healthcare, a Durable Power of Attorney for Financial Decisions, a Healthcare Directive, a Values Declaration, a Physician-Ordered Life-Sustaining Treatment (POLST) form, and a Will.
The POLST form, available in Washington, Oregon, Pennsylvania, California, Utah, and several other states, is an at-a-glance document recognized and honored by paramedics, hospitals, emergency rooms and nursing homes, stating your do/do-not resuscitate orders and other emergency life-sustaining orders. This document must be discussed with and signed by a physician. In my opinion it is the single most-valuable Advance Directive you can create.
Your Will should be discussed with an attorney, especially if you have a complex estate.
And the remaining documents can be composed and distributed by you, with advice from anyone familiar with the purposes and the practicable language that will accomplish what you intend.
Please do NOT wait until "someday when you're old" to create these documents. That day may be painfully too late. Even people in their 30's or younger should have made these arrangements for their futures. All such documents can be altered or revoked as life circumstances change, but they cannot be created after your capacity is compromised.
I have helped dozens of people gain peace of mind by correctly creating the documents that state their wishes, their values, and their choice of whom they trust to speak for them should they not be able to speak and act for themselves.
Circles of Caring
As I have worked among the elders of our society in their homes, in hospitals, in nursing homes, and in homeless shelters, my own aging and mortality have taken up more and more of my thoughts. Often this is what it sounds like:
These changes that I notice in my body - do they mean I am already old - or is there time to prepare for my aging?
Who will care about me when I am old?
What will happen when I can't care for myself?
Will I still have my mind? Please, God, let me still have my mind.
What if I actually DO live to be 100?
 And it sounds like this:
Who cares about who I have been, who I am now, and who I am becoming?
Who shares my interests? Who inspires me?
Who listens to my story, honors my history, and invites me into their story?
Now that my family is scattered/preoccupied/gone, who feels like "kin" to me?
How can I pass on the wisdom I've accumulated through my life's experiences?
[From A Harvest of Years ©2004 by Cynthia Trenshaw and PeerSpirit, Inc.
Available for purchase at www.peerspirit.com]
 I became an advocate of proactive aging when those kinds of questions roused me in the night, and when I discovered that I'm not alone in my concerns. I realized that I yearned not so much for answers, but for a way to explore my concerns out loud, in a circle of people who could listen deeply, who could hold and honor my deepest questions. These questions were explored in Circle of Caring, an organization I helped to found. Read an article in the Seattle Times on Circle of Caring.
Such a circle can happen when people dare to switch from socializing to dialogue - what I call "circle talk." This profound way of being together was pioneered by Christina Baldwin and Ann Linnea, of PeerSpirit, Inc. [See Calling the Circle: The First and Future Culture by Christina Baldwin, available at www.PeerSpirit.com] Now, as a teaching colleague of PeerSpirit, I help groups learn a simple yet deeply meaningful format of gathering in intentional circles. I am especially interested in helping to form "proactive aging circles" to meet the growing needs of people like myself who, in the middle of the night, struggle with all those nagging questions, and who long for others with whom to share them.
The issues of pro-active aging have also led me, and others, to consider how to arrange for our needs to be met in ways not currently available to us. Who will connect us with the community resources we need, how will our social and spiritual preferences be taken into account, who will help with follow-through when the roofer or the caregiver don't do what we expected? We are hoping to create a quality-of-life-advocacy program for ourselves, an agency that will already know our needs and our values, our friends and our families, and be able to advocate for us when advocacy seems more than we can manage for ourselves.
And, while we're at it, how about creating the kind of community among ourselves that begins with profound relationships and grows into the bricks and mortar of a senior co-housing project? That, too is on our minds and on our community drawing boards.
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