Category Archives: Health Care Power of Attorney

Health Care Power of Attorney. A form appointing someone to make choices about your health care when you can’t.

Who decides whether to terminate end of life care?

featimg_2_11The answer may seem obvious.  You, or your designated agent make this decision.  You have prepared a living will and left instructions for your agent to follow or, if you are still able to speak for yourself, you tell the doctors what you want.

In Texas, this is not true.  Because of the Texas Advance Directives Act, a hospital ethics panel – not you or your family – decide whether to end care!

Last October, Evelyn Kelly learned this the hard way.  Her son, David Chris Dunn, a 46 year old former county sheriff had entered Houston Methodist Hospital, transferred from Bayshore Medical Center in Pasadena.  He had a mass on his pancreas and was in renal failure.

He’d been intubated for a month and the doctors had kept him sedated so he wouldn’t disturb the tube in his throat.  Dunn couldn’t verbally respond to questions but he followed his mother’s movements with his eyes and he could nod in response to his mother’s questions.

One day, the chairman of the hospital’s Bioethics Committee told Ms. Kelly that the doctors had met and decided it was time to end David’s medical care.  The hospital ethics committee was going to meet in 48 hours to make its final decision.  Ms. Kelly had made it clear that, as a born-again Christian, she wasn’t going to take her son off of life support.

“From Kelly’s standpoint, every second her son lived was a reason for hope, but for the doctors, it had meant weeks of treating a man who wasn’t showing any signs of improvement beyond simply having a pulse.”

Chris Dunn died in December 2015.

“In Texas, it doesn’t matter what instructions you’ve previously given or what your relatives say:  If you’re in critical condition, you’re dependent on machines to survive and hospital officials decide it’s time to pull the plug, you will die.  And it’s completely legal.”

It’s rare for a patient’s case to end up before a hospital ethics committee only because most patients die before the process is completed.    However, when it does, it’s very difficult to stop the process based on a law signed by George Bush in 1999.

There are several other cases that have been reported.  Here’s one that happened in 2005 when Zee Klein’s 91 year old mother, Edith Pereira, was taken to the Texas Medical Center with a urinary tract infection.  She had brittle diabetes and had gone blind from the disease but her heart and lungs were in good shape, she could still feed herself and she was fairly lucid most of the time.

The family was focused on getting the infection under control so didn’t argue when a doctor put Pereira on a dose of morphine that would keep her unconscious, and thus unable to eat and regulate her blood sugar.  When the medical team told Klein they wouldn’t install a feeding tube for her mother, Klein had a problem.  One of the doctors told her “ We feel that your mother’s spirit is telling us she wants to die!”

Klein was dumbfounded.  She managed to have her mother transferred to another hospital where she lived for about six months before dying.

Be sure you know what’s legal in your state and be prepared.  For more information about advance healthcare directives and living wills, go to www.diesmart.com.

 

Who has your healthcare power of attorney?

A healthcare power of attorney is the document where you name the person who will make medical decisions on your behalf when you are unable to do so.  Equally as important as having this document is telling your family who it is and why.

A legal battle started a short while ago disputing whether Sumner Redstone,  the 92 year old titular leader of both CBS and Viacom (who earned a combined $24 million in compensation from the companies in fiscal 2014), still has the mental capacity to make informed decisions.

The suit was brought by Manuela Herzer, a former companion to Mr. Redstone.  The two dated between 1999 and 2001 and, according to her, still maintain a close relationship.  She was legally designated as the person to make Mr. Redstone’s medical decisions.  However, in October, new documents were executed that stripped her of this power and named, instead, Phillippe Dauman, Redstone’s longtime lawyer and CEO of Viacom.  In court filings, Ms. Herzer claims that Mr. Redstone does not have adequate mental capacity to replace her and has asked the court to make him undergo a medical evaluation to prove her point.

Most of us don’t earn $24 million dollars in one year and don’t have the kind of net worth of Sumner Redstone.  However, the point is still as valid for you and me as it is for him.  If you make changes in your healthcare power of attorney or other legal documents that relate to who can make decisions on your behalf, it’s a good idea to tell those involved so they will be aware of what you’ve done and why.

For more information about a healthcare power of attorney and other estate planning documents, go to www.diesmart.com.

Who makes decisions if your divorce is not finalized?

lamar

I came across a blog the other day that made a very important point.  If you are in the process of divorcing and have a medical emergency, who will make decisions on your behalf?

When Lamar Odom was recently found unconscious in a Nevada brothel and was rushed to the hospital, who did the officials call?  They called Khloe Kardashian.  Although they are in the process of finalizing their divorce, in the eyes of the law, they are still married and unless an advance directive for healthcare states otherwise, is the person who can make medical decisions on his behalf.

Unless you just don’t care, when you are getting a divorce, it’s critical that you update your advance directive to name someone other than your soon to be spouse to decide what the doctors should and shouldn’t do if you have an accident or a sudden health emergency.

To find out more about advance care directives and planning for the end of your life, go to www.diesmart.com.

Why you need a living will & healthcare power of attorney

terri schiavo

Most people don’t like to think about what will happen if they’re in an accident or come down with a catastrophic illness.  They don’t decide who they want to speak for them if they are unable to communicate their wishes themselves.  They don’t tell anyone what kind of care they want….or don’t want.  Once they are hurt or incapacitated, it may be too late.

These are three reasons why you need a living will and a healthcare power of attorney:

1) You name the person you want to speak for you when you can’t.  It should be someone  you trust to make decisions on your behalf and to carry out your wishes.

2) You decide whether you want heroic measures performed to prolong your life if there’s no chance of recovery.

3) You outline the type of treatment you want to receive.

If you don’t have these documents, a relative you don’t know very well and don’t trust or possibly the courts will speak for you and decide what will happen.

For example, they may decide to put you on life support and prolong your life even though there is no chance of recovery and you may not have wanted heroic measures.  They may choose to perform a surgical procedure that you don’t want or they may decide to do something that is against your religious beliefs.

A living will enables you to describe the kind of care you want.

A healthcare power of attorney (It may be called something else in your state or it may be combined with a living will) allows you to name the person you want to be your healthcare agent who can speak for you when you can’t.

Unfortunately, a life threatening accident or a catastrophic illness can occur at any time.  There’s no age that is exempt.  Think of Terri Schiavo.  She was a 26 year-old that had a tragic fall, went into a coma and remained alive, hooked up to a feeding tube, in a vegetative state for more than 15 years because her husband and her parents couldn’t agree on her treatment and she hadn’t legally stated her wishes.

Don’t let others decide for you.  If you don’t have a living will and a healthcare power of attorney, get them drawn up right away so your wishes will be carried out and you will be able to speak for yourself….even when you really can’t.

For more information on this important subject, go to www.diesmart.com.

Medicare to pay for end-of-life care counseling

Effective January 1, 2016, Medicare plans to pay doctors to speak to patients about their end-of-life care. The doctors will provide counseling and discuss options that range from care that’s more focused on comfort than extending life to doing whatever is possible to resuscitate a dying patient. Some doctors are already having conversations about this topic with their patients but are not billing for it.

Medicare payment will ensure that more doctors will have these conversations which many feel are critical to high-quality care.

The Institute of Medicine issued a report last year which found that few people make their wishes known so many deaths “are filled with breathing machines, feeding tubes, powerful drugs and other treatments that fail to extend life and make its final chapter more painful and unpleasant.” The report, “Dying in America” is free as a PDF or can be paid for and ordered as a bound volume.

While most people have given thought to how they would like to die, many have found it difficult to communicate those views and choices to family and loved ones and, in many cases, family and loved ones have their own perceptions and views about death that can influence discussions about dying.  Most people envision their own death as a peaceful and an ideally rapid transition. However, with the exception of accidents or trauma or of a few illnesses that almost invariably result in death weeks or months after diagnosis, death usually comes at the end of a chronic illness or the frailty accompanying old age. Even though death is very much part of the cycle of life, thinking and talking about one’s own death usually remains in the background, at least until its prospect become more probable or imminent.

Thru the new Medicare offering doctors will be able to discuss with their patients how they would like to die, and to encourage them to put their wishes on paper and share those wishes with their family.