Building Legacies that Last Estate Planning and Elder Law

You Never Know When You’ll Need an Advanced Directive

Woman sitting looking out a window

“Advance care planning is making preparations and decisions about the medical care you want to receive, if you become unable to speak for yourself.”

Talking with your family and your physician ahead of time about what you would want if you should become incapacitated, is a difficult but necessary conversation, reports The Herald News in the article “Being Prepared: Advanced Directives.” An Advanced Directive is a key part of your estate plan. If you have reached the age of majority (age 18 in most states), then you need to have this document.

An estate planning attorney can help you ensure that you have an Advanced Directive in place which conveys your wishes to your loved ones. Discuss this ahead of time and let your family members know what you would want to happen in advance.

Select a person you know and trust to be your healthcare agent. Tell them you have selected them to serve in that role. Don’t let this be a surprise to them at the last minute. They will need to fully understand your wishes and be willing to carry them out.

Be as specific as you can about what kind of treatment you would want and which you would not. That includes medical ventilation, a feeding tube, kidney dialysis and other treatments.

Do you want to be resuscitated if you stop breathing, or have CPR performed if your heart stops working? You’ll want to have a DNR—Do Not Resuscitate—if you don’t want extreme measures to be taken to keep you alive.

Once you have made your decisions, meet with an estate planning attorney to complete a written advanced directive.

States have different sets of rules regarding advanced care directives, so an estate planning attorney in your state of residence is necessary.

 You should keep your advanced directive and DNR document, where someone can get them if an emergency occurs. Do not give it to a relative who lives two states away—they will not get to you in time. Be sure that everyone involved with your healthcare has a copy. This includes your primary care physician. Ask that your directive be maintained in your official medical file.

If you are wondering how or when to have this conversation about a loved one’s end-of-life preferences, the answer is now. Start by sharing your own wishes and then ask them to share theirs. Ask if they have made the proper preparations for their wishes to be carried out and discuss what must happen to have their wishes followed.

It’s not the happiest conversation you’ll ever have.  However, if an emergency occurs, your loved ones will have peace of mind knowing they did what you wanted. You’ll also have peace of mind.

Resource: The Herald News (Aug. 10, 2018) “Being Prepared: Advanced Directives”

 

Tell Someone about Your Advanced Medical Directives

MP900448483If you have a health care power of attorney and living will, you should make sure that someone you trust knows where to find them.

It is very easy to get advanced medical directives today. You can often get living wills and health care powers of attorney as part of the process of admission to a hospital. If you tell a doctor about your wishes, it is often good enough for the doctor to make a note of them in his or her notes. However, getting those documents at a hospital or by telling a doctor can be a problem.

The system of medical records used in the U.S. does not make it easy for doctors to know that you have expressed your wishes ahead of time, especially when they actually need the information as The New York Times reports in "You've Detailed Your Last Wishes, but Doctors May Not See Them."

There is a potential way to mitigate the possibility that this problem will happen to you. Get your living will and your health care power of attorney ahead of time, by going to an estate planning attorney. These documents are routinely created as part of the estate planning process.

Once you have created the documents, you should store them in a secure place.  However, do not stop there. Make sure that someone you trust knows where to find the documents. That person can then get them when needed, to the doctors providing care for you.

This is not a perfect plan that will work all of the time, but it is better than relying on the current system of medical records.

Reference: New York Times (March 27, 2018) "You've Detailed Your Last Wishes, but Doctors May Not See Them."

 

Planning for Accident or Illness

MP900314367It is impossible to know whether you will ever have an accident or have an illness that will leave you incapacitated.  However, you can easily plan for dealing with it should it happen.

Most people generally understand that the older they get, the more likely they are to suffer from cognitive decline because of Alzheimer's or some other form of dementia. As people get older, they often begin to prepare for what will happen if their time comes and they become incapacitated.

What people do not think about is that elder dementia is not the only way people can become incapacitated. There are no age requirements for disabling accidents or illnesses. Everyone, no matter their age, should plan for what would happen if they are incapacitated. It is not difficult to do, as TC Palm discusses in "Be as prepared as you can by planning for incapacity."

To get started, schedule an appointment with an estate planning attorney. The attorney can prepare the necessary documents for incapacity.

You will need a general durable power of attorney, so someone else has the authority to handle your day-to-day finances. A health care power of attorney will allow someone else to make your health care decisions. A living will lets you decide ahead of time what medical means can be taken to prolong your life.

Consider taking another step at the attorney’s office and get an estate plan, just in case an accident or illness does more than incapacitate you.  A thorough estate plan prepares you and your loved ones for illness and death.

Reference: TC Palm (Feb. 20, 2018) "Be as prepared as you can by planning for incapacity."

 

Handling Death in the U.S.

Bigstock-Doctor-with-female-patient-21258332[1]Studies continue to show that the how and when Americans would prefer to pass away, is not how they actually pass away. That needs to change.

Most of the time, the medical profession treats its patients in keeping with what the patients want. If someone has a broken leg, for example, then doctors set the leg, put a cast on it and let it heal.

That is what people want.

When we get sick, doctors give us the best known treatment for whatever disease we have and everyone is satisfied. However, this does not necessarily hold true when people are at the end of their lives.

What medical professionals do at the end of their patients' lives, is not what studies suggest patients necessarily want, as The New York Times reports in "We're Bad at Death. Can We Talk?"

The disconnect at the end of life between doctors and patients, stems from the fact that doctors are trained to do everything they can to sustain life. On the other hand, most patients would prefer to be let go with the least amount of pain and discomfort.

This leads to terminally ill patients being placed in intensive care units on artificial life support, when they would prefer to be placed in palliative care or return home so that they can pass away in peace.

This is something that needs to be addressed by the medical community.

There is something you can do about it for yourself. You can get advanced medical directives to let doctors know what you want, when you are terminally ill. At Profit Law Firm, we prepare Advanced Medical Directives as part of basic estate planning.

Reference: New York Times (May 10, 2017) "We're Bad at Death. Can We Talk?"

 

Death Has Changed A Lot

MP900407501[1]How, when and where people pass away has changed in the last 100 years. Evidence suggests that people are not entirely happy about that.

A long time ago, most people passed away in their homes. There were not many hospitals or hospices for people to go to, when they were terminally ill.

There are now many of those places and most people pass away in some sort of facility.

That has been both good and bad.

People generally like that they do not die as young and from as many diseases as people used to, but most people would still rather die in their homes than in a facility, as the Economist reports in "How to have a better death."

In fact, the majority of people are not happy that they cannot choose when and where to die.  People are often given life-saving treatment by doctors that they do not want.

It is important that people take some matters they can control into their own hands.  Maryland, the District of Columbia and Virginia and other states allow people to choose living wills that specify when and what type of treatment, if any, they should receive, under different circumstances.  These states also allow people to designate a person who can make personal healthcare decisions for them, if they are unable to do so, for example if they are in a coma.

Everyone should have advanced medical directives, at a minimum, that dictate what procedures doctors can and cannot use to prolong their lives. Maryland living wills are called advance medical directives and they allow people to control healthcare decisions in catastrophic situations, where they can't communicate.

Reference: Economist (April 29, 2017) "How to have a better death."