Estate planning documents, including advanced medical directives, only do what you want them to do if your loved ones know they exist and can locate them.

For example, if you don’t want to be hooked up to machines or be subjected to other medical heroics when you are in an end-stage medical condition, you need a legally valid living will.

However, just having the living will is not enough.  Your attending physician must have a copy of the living will in hand in order for it to be honored.

If no copy is available, either because your loved ones don’t know it exists or they know it exists, but can’t find it, it’s as if you don’t have a living will at all.

Then what happens is the burden is on your loved ones to decide whether or not to begin or continue life support.  It will be harder for your loved ones to sleep at night if they have to make the decision whether or not to “pull the plug,” so to speak.

In addition, your loved ones may not agree as to what is the best course to take.  What happens if some loved ones what no life support and no medical heroics and others want life support and all the medical treatment that is available?

Families are torn apart and lawsuits can continue for years.  After all, Terri Schiavo was kept alive for 15 years because her loved ones disagreed as to the discontinuation of life support.

Each adult needs a comprehensive estate plan, including advanced medical directives.  Be sure to tell your loved ones whether you have a living will and, if so, where they can find it, if the need arises.  Any questions?  Consult with a qualified estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Hospice provides end-of-live palliative care for those who are in the last year of their lives.  Hospice services are paid by Medicare and the goal is to provide palliative (not curative) care and support for the family.

Palliative Care

The goal of hospice is to keep the ill person comfortable.  There is no reason for anyone to die in pain.

There are no attempts to cure any illness.  Hospice services are available when no curative path is available or no curative path is chosen.

For example, a patient with advanced pancreatic cancer may choose hospice.  All attempts are made to provide medicine and care to eliminate pain.  No chemotherapy or radiation would be provided.

Stay at Home

Often, it’s a goal to keep an ill loved one at home as long as possible; so, hospice provides care at home.

If more support is required, many hospices have facilities where the ill person can stay 24/7, receive palliative care, and family can visit and receive support services such as counseling and social work support.

Examples of Care Provided

Hospice provides nurse evaluation and visits; pain control; wound care; caretakers to provide assistance with bathing, dressing, toileting, and shaving; and social worker sessions.

If you are ill and the doctor has provided a prognosis of one year or less, either the doctor or you can call a hospice for an evaluation to determine what services are appropriate for you and your family.  Most families who use hospice services rave about their experience.

If you have any questions about hospice or other elder care support services consult with a qualified estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Were your power of attorney documents signed in another state?  Are your documents more than three to five years old?  Has an agent named in your power of attorneys moved, died, become disabled, or is no longer appropriate?  Have your children grown into adults and are qualified to help you?  Have your views changed?  If any of these questions are answered in the positive, you need new powers of attorney.

Two Types of Powers of Attorney

Although there are specific powers of attorney for many situations (i.e. real estate closing or a business transaction), there are two main types of powers of attorney.

They are the financial power of attorney and the health care power of attorney.

Financial Power of Attorney

The financial power of attorney is also known as a “general durable power of attorney.”  It is usually effective immediately and authorizes a trusted loved one or corporate entity to pay bills, file taxes, manage assets, and deal with financial institutions.

Health Care Power of Attorney

A health care power of attorney is effective only if you cannot provide informed consent for medical care.  If needed, a loved one will step into your shoes and make health care decisions on your behalf.

Examples of decisions your health care agent would make are which treatment you receive, hiring and firing medical staff, and deciding whether you get a specific operation, or not.

Updating Your Power of Attorney

It’s definitely in your best interest to update your financial and health care powers of attorney.  Consult with a qualified estate planning attorney to do so.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

Nearly all of our clients want to have a living will, once they understand what a living will provides.  A living will provides peace of mind that you will be protected from medical heroics such as life support machines, if you are in an end-stage medical condition.

End-Stage Medical Condition

If you are in a persistent vegetative state or irreversible coma, you’re in an end-stage medical condition and that’s when your living will is effective.

Ensure Your Living Will is Available

Be sure your living will is available when needed.  Let your loved ones know that you have a living will and where you keep it (and your other important documents.)  Consider a virtual service such as Docubank that makes sure your living will (and other documents) are always available when you need them 24/7/365.  www.docubank.com.

Relieve a Burden and Staying in Control

When you have a living will, you are making a medical decision in advance.  That’s why it’s called an advanced “medical directive.“  This keeps you in control as you are the one to make this health care decision.

In addition, having a living will greatly relieves the burden on your loved ones’ shoulders.  They don’t have to make the decision to have life support removed or not started in the first place.

Avoid Family Disputes

Having a living will also may avoid family disputes if your loved ones have different views.  For example, Terri Schiavo’s parents conflicted with her husband; thus, she was kept alive for 15 years, while totally brain dead.  While Terri had told her husband she didn’t want to be kept alive, she never put it in writing.

Your wishes must be in writing and the treating doctor must have a copy.

If you have questions or concerns about the living will or any other health care estate planning documents, consult with a qualified estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

The key to power of attorney effectiveness is to have the legal document in place BEFORE you need it.  The answer to, “When Should I Get a Power of Attorney?” is right now, because once you’re incapacitated (and, actually, need the power of attorney) it’s too late.  You can’t sign a power of attorney if you’re incapacitated.

If you don’t have a power of attorney in place, your loved ones will have to petition the court to have someone appointed a conservator of your estate and of your person.  A conservator of your estate pays your bills, files your taxes, and manages and invests your assets.  A conservator of your person makes health care decisions on your behalf.

The conservatorship process is a loss of control, very expensive, time consuming, stressful, and public.  The court may appoint someone as conservator that you would not appoint for yourself.  Conservatorship is to be avoided.   You can avoid conservatorship by having a financial (i.e. general durable power of attorney) and a medical power of attorney in place.

In addition, if you have minor children, you need a stand-by guardian authorization that works like a power of attorney.  If you are incapacitated and cannot care for your children, the stand-by guardian will step into your shoes, making health care, general welfare, lifestyle, and educational decisions for your minor children.

Any guardian that you name in your will doesn’t have authority to act, without court intervention, because your will is only effective if you’re dead.  If you’re alive, but incapacitated, your will has no affect.

If your powers of attorney are more than three to five years old or if you don’t have them, consult with a qualified estate planning attorney to get them in place now.  The best time to get a power of attorney is before you need it.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.

A living will is an advanced medical directive; this means that you make a medical decision in advance.  You give or withhold informed consent for a particular potential future medical situation.  A living will is effective if your doctor has a copy and you are in an end-state medical condition such as an irreversible coma or persistent vegetative state.

The benefits of a living will are that you stay in control of your health care decisions in an end of life medical situation; you take a huge burden off the shoulders of your health care power of attorney agent; you don’t run up medical bills for medical procedures that won’t help; and, you prevent family discord by making the decision yourself.

To ensure that your living will is effective, have it drafted by a qualified estate planning attorney, tell your health care power of attorney agents that you have a living will, tell your other loved ones as wekk, and show them all where you keep the living will and other important documents.

In addition to the living will, you need a health care power of attorney which appoints an agent to make health care decisions for you if you are unable to make those decisions yourself.  Your agent steps into your shoes for medical decisions when you cannot provide informed consent.  Your doctor decides when you cannot give informed consent.

You also need a HIPAA release which may be included in your health care power of attorney or may be a separate document.  The HIPAA release is required by federal medical privacy laws and authorizes medical personnel to disclose your medical information to your health care agent.

In addition, consider an organ donation authorization so your death in not in vain.  You can vastly improve the lives of burn and trauma victims and you can save up to 8 lives by being an organ and tissue donor.

If you don’t have an up-to-date living will and other advanced medical directives, consult with a qualified estate planning attorney.

Legacy APC, A Trusts & Estates Law Firm is a member of the American Academy of Estate Planning Attorneys.