Category Archives: Elder Law

Elder Law. Advanced directives. Power of attorney. Living will. Health care power of attorney. HIPPA. DNR. Long Term Care Insurance. Medicaid. Medicaid Penalty Period. Medallion Signature. Social Security Payee Representative.

DNR order – should your pet have one?

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Do you know what a DNR (do not resuscitate) order is?  It is a medical document that alerts doctors and other medical and rescue personnel about whether you want them to do anything they can to revive you if your heart stops.

I have been in the local hospital a few times for various medical procedures and am used to the questions that the staff asks before admitting you.  And I have a DNR (do not resuscitate) document that I  keep on file there.  If my heart stops and reviving me will negatively impact my quality of life, I want my loved ones to let me go.

Information for and against human DNRs is readily available on the web and in books; anyone you ask will have an opinion.

However, for pets it’s a different story.  Last week I had to take my dog, Suzi, to the veterinary hospital for a minor medical procedure and was given several forms to sign.  One of them caught me totally off guard.  I was asked to sign either a DNR or an “administer CPR” form for her.    I had never thought about a DNR in relation to my dog and didn’t know what to do.  I had no idea about how easily a dog’s heart stops beating during surgery and how quickly it’s quality of life will be impacted after that stoppage.

The vet told me that asking for a pet DNR is becoming common practice for many animal hospitals but would give me no recommendation on which form to sign.

When I got home, I got on the web and tried to research a pet DNR to see what the recommended practice is.  I could find very little helpful information.  I called friends with pets and they had no idea what to do either.

Luckily, the procedure went smoothly and Suzi was fine.  But what if there is a next time?  What should I do then?

We at Die Smart would love to hear from you with your opinions on this subject.  To write a comment or to find out more about end of life planning, including human DNRs, go to www.diesmart.com.

Vermont passes doctor-assisted suicide law

Yesterday, the Vermont House of Representatives voted in favor of a bill that will legalize doctor-assisted suicide.  The State Senate had approved the measure previously.  All that remains is for Governor Peter Shumlin to sign the bill and the Patient Choices at the End of Life Act will become the law.

The bill is patterned after the Oregon model, which has several built-in safeguards.  These include a requirement that the patient state three times – once in writing – that they want to die.  Another safeguard is the requirement of a concurring opinion from a second doctor that a patient has less than six months to live and is of sound mind.

Critics of the bill feel that there is potential for abuse of senior citizens, while those in support of it believe that it makes a positive statement about the value of personal freedom.

If the governor signs the bill, Vermont will become only the fourth state in the US to permit doctors to help patients to die by writing a prescription for a lethal dose of medication.  The other three states – all in the west – where this is legal are Oregon, Washington state and Montana.

For information about end of life issues and planning, go to www.diesmart.com.

Whole Body Donation – Another Option

 

The other night, I was at the emergency room of our local hospital and overheard half of a phone conversation.  Evidently, a relative had died of cancer within the last hour and there was no money available for a funeral.  The person I could hear was lamenting that she had no idea what to do.  She wanted to do the “right” thing for the deceased but didn’t know what that was.

Respecting her privacy (even though she was talking on a cell in the middle of the lobby), I said nothing….but I began to think about options she might have.

One that is not talked about much but could have been the solution to her quandary is whole body donation. Study of human bodies can help in the discovery of cures for many diseases and medical conditions and can aid in the development of new medical and surgical procedures as well as new, potentially life-saving, medicines.

If you think this is something you’d like to do, you should make the arrangements prior to your death.  You can preregister with a medical school or research organization by signing a consent form stating your wish to donate your body.  A copy of the consent form should be put with your will and other valuable papers so it can easily be found.

When you die, your family should notify the facility.  They will transport your body transported to the research facility or medical school with which you signed the consent form.

If you did not sign a consent form agreeing to whole body donation, your family can still decide this is what they wish to do after your death.  They will need to contact the medical facility or research center of choice and sign an after death donor form.  Then the process is the same as if you had made arrangements pre death.

When the group to whom the body has been donated is finished with it, they will cremate it and return the ashes to the next of kin or dispose of them in the way you have designated.

Cost to the family – usually zero.

For a list of medical schools which accept whole body donations, check out the list published by the University of Florida State Anatomical Board.

A national organization we found which provides a lot of information about this subject is MedCure.

Finally, for further information about funeral options and body and organ donation, go to www.diesmart.com.

 

 

 

 

 

 

 

 

 

 

 

 

Long term care insurance: If you’re a woman, be prepared to pay more!

Over ten million people have purchased long term care insurance, primarily to cover healthcare expenses that may occur in old age or during catastrophic illness.

Up until now, this insurance usually treated men and women equally.  Policy price depended on health status and age, not gender.

But this year, long term care insurance companies have indicated that they are going to start charging women more for their policies.  One of the first companies to introduce this new type of pricing is Genworth Financial Inc., purported to be the largest seller of insurance in the United States.  Their goal is to reflect statistical realities.  Women live longer than men and prepare more effectively for their futures by buying long term care policies.

According to Genworth, two thirds of its long term care payouts go to women, even though, in 2011, women only bought about 57% of its policies.  Women live longer than men and have higher rates of disability and chronic health problems.

So this spring, if their proposed plan is approved by regulatory agencies, Genworth will introduce gender specific policy pricing.  For women, that will boost the cost of a new policy by 20 to 40%, depending on age and benefit package selected.

A Genworth spokesperson said that the new pricing will only affect women applying on their own.  Lower rates will still be offered to married couples who purchase joint coverage and the changes won’t affect current policy holders.

For more information about long term care, go to www.diesmart.com.

 

Nursing Home: If your parent needs one, will you have to pay the bill?

This is a true and shocking story.  John Pittas was ordered by a Pennsylvania court to pay his mother’s $92,943.41 nursing home bill under a filial support law.  The filial support law states that certain family members are liable for the care, maintenance and financial support of some other indigent members of that family.  It’s a law that’s been around since colonial times in one form or another.  Several states have abolished it but 29 have not.

John’s mother entered the Liberty Nursing Rehabilitation Center in Allentown, PA and spent about six months there after breaking two legs in an auto accident in September 2007. 

In March 2008, his mother, who was born in the United States, relocated to Greece where two other children live.

As the only family member still living in this country, Pittas was sued for payment of the huge bill.  The owners of the nursing home sued him for the money and a 2011 court trial was decided in the nursing home’s favor.

If his mother’s Medicaid application had been approved prior to the accident, this never would have happened.  Medicaid would have paid.  Last year, Pittas appealed but the Superior Court of Pennsylvania once again ruled in favor of the nursing home.

If you have an aging parent who may one day need nursing home care, what can you do to avoid having the same problem as John Pittas?

1) Talk with your parent about his or her financial resources.  If your parent is reluctant to have this discussion, relate John Pittas’ story.  It’s better to have a plan prior to an accident or other health crisis.

2) If your parent has limited resources, find out whether that parent is eligible for Medicaid.   If so, get your parent to apply immediately so that it will be available when needed.

3) If your parent is not eligible, sit down with all the members of your immediate family and talk about which family members can provide care or financial aid in case it is needed.

Don’t delay.  Put a plan in place today so that you won’t suddenly receive an unexpected bill for $93,000 or more.

For more information about planning for long term care and Medicaid, go to www.diesmart.com.