A Year-End Checklist for Family Caregivers in Michigan

Updated October 2026. Written and reviewed by the Lily Hospice clinical team.

Before the year ends, a family caregiver in Michigan should check five things: the Medicare plan (open enrollment closes December 7), the paperwork that names who speaks for your parent, the money programs that reset in winter, the medicines and supplies you will need over the holidays, and whether it is time to ask about hospice.

The last weeks of the year are the busiest weeks a family caregiver has. The holidays arrive, the plan brochures pile up, the pharmacy closes early, and the person you are caring for may be a little weaker than last December. This checklist is for the daughter, son, spouse or neighbor doing that work in Oakland, Macomb or Wayne County. Nothing on it takes more than an afternoon, and most of it you can do from the kitchen table. Work through it in any order. Where a program has a Michigan-specific rule, we say so.

1. The paperwork that names who speaks for your parent

Start here, because everything else is easier when this is settled. In Michigan, the document that lets someone make medical decisions for a person who can no longer speak for themselves is called a patient advocate designation. It is Michigan’s name for a health care power of attorney. It only takes effect when two doctors, or a doctor and a psychologist, decide the person cannot make their own medical decisions, so signing it changes nothing today. If your parent has never signed one, December is a good month to sit down together, and our guide to how to talk to a parent about hospice has scripts for the conversation that often comes first.

If the document exists, find it. Make sure the person named is still the right person, still living and still willing. Put a photo of every page on your phone and give a copy to the primary care doctor’s office. If your parent has strong wishes about CPR, a ventilator or a feeding tube, ask the doctor about MI-POST, Michigan’s portable medical order for people with advanced illness, which travels with the patient between home, hospital and nursing facility. A hospice social worker helps families with all of this at no charge, and our hospice glossary explains each term in plain words.

2. Medicare open enrollment closes December 7

Medicare Open Enrollment runs October 15 to December 7, and changes take effect January 1. For a family thinking about hospice, the most important thing to know is that no plan change is needed for hospice, and no plan change takes it away. Hospice is paid by Original Medicare Part A for every Medicare member, including people in Medicare Advantage plans. A plan change only affects care and prescriptions unrelated to the terminal illness. Our guide to open enrollment and hospice walks through the three things worth checking: next year’s drug list, whether the doctors your parent still sees stay in the network, and whether the premium is changing.

Free, unbiased help is one phone call away. MI Options, the State of Michigan’s counseling line for Medicare and long-term care, is 800-803-7174; its counselors do not sell plans. For what Medicare pays once hospice begins, read Does Medicare cover hospice in Michigan?

3. Medicaid, Extra Help and the renewals that sneak up

If your parent has Michigan Medicaid, or you are thinking about applying because a nursing home is on the horizon, check two dates. Medicaid coverage must be renewed every year, and the renewal packet from MDHHS arrives by mail; a missed packet can end coverage. Many families also do not know that someone who qualifies for Medicaid, or who has a limited income, may qualify for Medicare’s Extra Help with drug costs, which has its own application through Social Security. Our guide to hospice and long-term-care Medicaid in Michigan explains how the two programs work together when someone is in a facility, and How much does hospice cost in Michigan? covers the handful of charges a family might see.

Veterans and surviving spouses: the VA’s pension programs and its hospice benefits are separate from Medicare and often unclaimed. The county veterans service office in each of our three counties files VA claims at no charge, and our veterans page lists them.

4. Winter money programs with Michigan rules

• Winter Protection Plan. From November 1 through March 31, Michigan’s regulated gas and electric utilities cannot shut off service to a customer who is 65 or older, or who receives MDHHS cash or food assistance or Medicaid, or whose household income is at or below 150 percent of the federal poverty level. Seniors do not have to make a set payment during those months, but the balance is still owed and is paid in installments from April on. Enrollment is by calling the utility; it is not automatic.
• Home Heating Credit. Michigan pays a credit toward heating costs to lower-income renters and homeowners, including people who do not otherwise file a Michigan return. The claim form is MI-1040CR-7, and a year’s credit can be claimed until September 30 of the following year. The 2026 claim opens with the new tax forms in January; a free tax site or your Area Agency on Aging can help file it.
• Medical equipment at home. If your parent uses oxygen, a powered bed or a nebulizer, tell the utility now and ask about its medical notification or medical-emergency program. These programs do not guarantee power during a storm, so also write down where the nearest warming center is and what the oxygen supplier’s backup plan is. The hospice nurse goes through this with every family who has equipment in the house.
• Medical expenses and taxes. Keep the receipts. Medical costs a family pays for a parent, including some that are not obvious such as mileage to appointments, may be deductible when they exceed a share of income, and an adult child who provides most of a parent’s support may be able to claim the parent as a dependent. The rules depend on the numbers, so ask a tax preparer in January rather than guessing now; what you can do in December is gather the paperwork.

The three Area Agencies on Aging are the best single phone call for any of these: AgeWays for Oakland and Macomb counties at (800) 852-7795, The Senior Alliance for western and southern Wayne County at (734) 722-2830, and the Detroit Area Agency on Aging at (313) 446-4444.

5. Your job, and the time off the law gives you

Two laws protect a working caregiver in Michigan. The federal Family and Medical Leave Act gives eligible employees of larger employers up to 12 weeks of unpaid, job-protected leave in a year to care for a parent, spouse or child with a serious health condition, and it can be taken in pieces rather than all at once. Michigan’s Earned Sick Time Act, in effect since February 2025, lets employees use paid sick time to care for a family member, not only for their own illness. Most employers must allow up to 72 hours a year of use; small businesses with ten or fewer employees must allow 40, and their accrual began October 1, 2025. If you expect to need time in the new year, ask human resources in December how both are requested, so the forms are not a surprise on a hard day.

6. Medicines, supplies and the holiday pharmacy problem

Pharmacies close early or entirely on Thanksgiving, Christmas and New Year’s Day, and refills that need a doctor’s signature stall when the office is closed. Before the last full week of December, count every prescription and order anything that will run out before January 2. Ask the doctor for a 90-day supply of the routine medicines. If your parent is already on hospice, the nurse arranges comfort medications ahead of the holiday and keeps a small supply in the house, which is one of the reasons families tell us the holidays went better than they feared. Our guide to the holidays when someone you love is dying covers the rest of the day, from shrinking the dinner to deciding who visits.

While you are counting pills, check the other supplies: incontinence products, nutritional drinks, the blood pressure cuff’s batteries, the grab bar that has been loose since summer. Winter also brings falls. Salt the walk, move the bed away from the drafty window, and set the thermostat where your parent is comfortable rather than where you are.

7. The caregiver’s own body

Get your flu shot and, if your doctor recommends it, the updated COVID-19 and RSV vaccines, because the person you care for cannot afford for you to be sick. Book your own overdue appointments in January before the calendar fills. And plan a break. If your parent is on hospice, Medicare covers up to five days of respite care in a facility so the caregiver can rest, and it can be used more than once. If your parent is not on hospice, the Area Agency on Aging can tell you about respite and chore programs in your county. If you are already grieving someone who is still here, which is common and has a name, our guide to anticipatory grief and our list of grief support groups in Oakland, Macomb and Wayne counties are for you.

8. Is it time to ask about hospice?

December is when many families notice the change: the hospital visit in October, the weight that will not come back, the sleeping most of the day, the second pneumonia. None of those alone decides it, and hospice is not a decision a family makes in one afternoon. But asking is free. A hospice nurse can come to the house for an evaluation with no obligation, often the same day, anywhere in Oakland County, Macomb County or Wayne County. Our Is It Time? guide walks through the signs families notice, signs it’s time for hospice lists them condition by condition, and if your parent lives alone, this guide explains how hospice works without a caregiver in the home. Families who start before the holidays usually tell us they wish they had called sooner.

The checklist, in one place

1. Find or sign the patient advocate designation; photograph every page; ask the doctor about MI-POST if wishes are firm.
2. Review the Medicare plan before December 7, remembering that no plan change is needed for hospice. Call MI Options, 800-803-7174, for free help.
3. Check the Medicaid renewal date and whether Extra Help applies.
4. Enroll in the Winter Protection Plan if your parent is 65 or older or income-eligible; note the Home Heating Credit for January.
5. Tell the utility about any medical equipment and write down the backup plan.
6. Gather medical receipts and mileage for the tax preparer.
7. Ask human resources how FMLA and Michigan earned sick time are requested.
8. Count every prescription and order what will run out before January 2; ask for 90-day supplies.
9. Restock supplies, salt the walk, fix the grab bar.
10. Get your own flu shot, book your own appointments, and plan a break.
11. If something has changed since summer, ask for a hospice evaluation. It costs nothing and commits you to nothing.

Common questions

What should a family caregiver do before the end of the year?

Settle the medical paperwork (Michigan’s patient advocate designation), review the Medicare plan before December 7, check Medicaid and utility programs that reset in winter, order medicines and supplies before the holiday closures, protect your own health and time off, and ask for a hospice evaluation if the person has declined since summer.

Do we have to change Medicare plans before December 7 for hospice to be covered?

No. Hospice is paid by Original Medicare Part A for every Medicare member, including Medicare Advantage members, and the plan’s network does not limit which Medicare-certified hospice you choose. A plan change only affects unrelated care and prescriptions.

What is a patient advocate designation in Michigan?

It is Michigan’s version of a health care power of attorney: a signed document naming the person who makes medical decisions if your parent cannot. It takes effect only after two doctors, or a doctor and a psychologist, determine the person cannot make their own decisions. MI-POST is a separate, portable medical order for people with advanced illness.

Can Michigan utilities shut off a senior’s heat in winter?

Not under the Winter Protection Plan. From November 1 through March 31, regulated utilities cannot disconnect a customer who is 65 or older, receives MDHHS assistance or Medicaid, or has household income at or below 150 percent of the federal poverty level. The customer has to enroll by calling the utility, and the balance is still paid in installments after March.

Can I use paid sick time to care for my mother in Michigan?

Yes. Michigan’s Earned Sick Time Act allows employees to use earned sick time to care for a family member’s illness or medical appointments, up to 72 hours of use a year at most employers and 40 hours at small businesses with ten or fewer employees. The federal FMLA adds up to 12 weeks of unpaid, job-protected leave at eligible employers.

How do I get medicines over the holidays if the pharmacy is closed?

Order refills before the last full week of December and ask the doctor for 90-day supplies of routine medicines. If your parent is on hospice, the hospice nurse arranges comfort medications ahead of the holiday and a nurse is reachable at any hour, including Christmas Day.

Is December too late in the year to start hospice?

No. Hospice can begin on any day, including holidays and weekends, and a nurse can usually evaluate the same day you call. Families who start before the holidays often tell us the days went better than they feared because comfort medications and a plan were already in the house.

General education, not legal, tax or insurance advice. Program rules, dates and income limits change; confirm details with MI Options, your utility, the Michigan Department of Treasury or a tax preparer.

Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day.