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OTHER NAMES Authorization of Care Elder Care Directive Caregiver contract

What is an Elder Care Authorization?

This document grants a caretaker temporary custody of an older adult who needs elder care.

When to use an Elder Care Authorization:

  • You want to designate someone to take care of an elderly adult person.
  • You want to provide specific authority and powers to the caretaker.
  • You want to provide emergency contact information.

Sample Elder Care Authorization

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Elder Care Authorization

 

I, the undersigned , hereby grant:

 

(the "Caretaker),

,

 

the authority to take temporary care of the following adult: . I grant this authority in my capacity as 's . My contact information is as follows:

 

,

 

This grant of temporary authorization to provide elder care shall begin on , and shall remain effective until terminated by the undersigned.

 

The Caretaker shall have the power to:

 

Other instructions:

In an emergency situation, please contact the following person:

 

Name:

Address:

,

Phone Number:

 

If that person is not available, please contact the following alternate choice:

 

Name:

Address:

,

Phone Number:

 

 

 

 

By: Date:

 

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