Tag Archives: advance directives

5 Legal Documents every caregiver needs

biyExXGATIf you think a relative may be at risk of dementia or some other disease that will affect their reasoning ability, there are 5 legal documents you should get that relative to complete while still able to do so. Otherwise, when you become that person’s caregiver, you will need to go to court to apply for guardianship and the right to make decisions on his behalf. That court application will typically take 6 – weeks and cost you thousands of dollars. If another family member contests your application, it will only take more time and cost even more money. Don’t wait too long or it might be too late. Your relative may no longer be competent to make these critical decisions.

The 5 advance directive documents are:

  1. A durable power of attorney – It gives you the right to make financial decisions for that relative. Those can be things like paying bills, selling property and making investments.
  2. A healthcare proxy – This gives you the right to make medical decisions on the incapacitated relative’s behalf. This can include things like what course of treatment to follow, which physician to choose and where treatment should be performed.
  3. A living will – This states the medical treatment the person wants, or doesn’t want, so the decisions have been made before you take over. They include things like whether medical personnel should try resuscitation if the person’s heart stops, whether heroic measures should be taken, whether pain killers should be administered, etc.
  4. A current will – If the person has an old will, it should be reviewed to make sure that it reflects his or her present wishes and circumstances. Perhaps the will was written several years ago and needs to be changed. The will should state what should happen to all assets after he or she is deceased.
  5. You might want to also consider a living trust.   A living trust can make it easier for your fiduciaries to manage those assets while following the instructions of an incapacitated or deceased person.

State laws vary so you might want to consult an attorney when preparing these documents. And for more information about advance directives and wills versus trusts, go to www.diesmart.com.

 

End Of Life Counseling Stays in Health Care Reform Bill

End of Life counseling just won’t die.   In the proposed health care legislation today, the bill would allow doctors to bill Medicare for spending time with their patients discussing end of life choices.

The full text of the proposed health care reform bill can be found here…http://www.washingtonpost.com/wp-srv/politics/documents/house_bill_102909.pdf?sid=ST2009102902154

 The exact words defining end of life planning can be found starting on page 129 in a section titled “Dissemination of Advance Planning Information.  

 Find out more about health care directives at http://diesmart.com/elder-law/

Plan for Old Age

Planning makes many things possible....

Planning makes many things possible....

WHY IS PLANNING FOR OLD AGE IMPORTANT?

Consider the following facts contained in a government study called “The Dilemma of An Aging Society.”

In 1900, the usual place of death was at home; in 2000, it was in the hospital.

In 1900, most people died in accidents or as a result of acute infections and they rarely endured long periods of disability.  In 2000, people spent, on average, two years severely disabled on the way to death.  Acute causes of death (such as pneumonia, influenza and septicemia) are in decline, whereas deaths from age-related, chronic, degenerative diseases (such as Alzheimer’s, Parkinson’s and emphysema) are on the rise.

A 2006 Rand study funded by the government tried to envision the future needs of elderly people who are terminally ill and classified them into four groups:

  • The first group will die after a short period of sharp decline.  This is the typical course of death from cancer. Roughly 20 percent of all deaths are of this type.  This type of death peaks around the age of 65.
  • The second group will die following several years of increasing physical limitations, punctuated by intermittent acute life-threatening episodes.  This is the typical course of death from chronic cardiac or respiratory failure. Roughly 20 percent of all deaths are of this type.  This type of death peaks around the age of 75.
  • The third – and largest – group will only die after prolonged dwindling, usually lasting many years.  This is the typical course of death from dementia (including Alzheimer’s disease) and disabling stroke.  The trajectory towards death is gradual but unrelenting, with steady decline, enfeeblement and growing dependency, often lasting a decade or longer.  Roughly 40 percent of all deaths are projected to be of this type.  If you live past the age of 75, it is common for someone to die from dementia or a disabling stroke.
  • The other 20 percent will die as a result of some sudden and acute event, like an accident.

These statistics are astonishing.  Eighty percent of us need to make planning for incapacity from both a legal and a financial perspective just as important as planning for death.

Elder Law

Planning for old age is about “Elder Law.”  Elder law is a term describing a set of legal and financial rules and practices we will encounter as we grow old, or as our parents grow old.  In fact, many of the topics considered to be “elder law” relate to anyone who becomes unable to manage their financial affairs or make their own health care choices, no matter whether they are young or old.

Advance Directives

Planning for old age involves the creation of various legal documents referred to as advance directives.   If your mental capacity becomes compromised as you age, or if you suffer an unexpected accident or illness, your spouse or your children may need to help manage your finances or your health care.  Sounds simple.  It’s not.

The fact is incapacity, like dying, is an event in your life where laws decide who has the authority to manage your affairs for you when you can’t.  These are the laws your family, physicians and friends will be required to follow if you become unable to make decisions on your own behalf.   Your family will find they need multiple documents signed by you to act on your behalf, each one serving a different purposes.

Long Term Care

Planning for old age also requires an understanding of what long term care will cost and how your and your family will pay for long term care if it becomes necessary.   According to the Congressional Budget office, the U.S. will spend $393 billion in 2008 for long term care, not including unpaid services provided by famiy and friends.

Many older people and their children are surprised to find they have no personal insurance to cover the cost of long term care.

If the only insurance you have is Medicare and Medigap, the cost of long term care must be paid from your personal assets unless you have Long Term Care Insurance.

These resources are useful when planning for old age:

FACT : Incapacity can happen to any one
Although planning for death is important, planning for mental or physical incapacity is just as important.  A recent government study stated “eighty percent of people over the age of 65 will spend one to ten years under the care of a caregiver”.  In less than two decades it is expected that some 30 million people will suffer from some form of dementia.  If this happens to you, someone must manage your health care and your money.

Planning is not just for the elderly.  Terri Schiavo was 26 years old when she had a heart attack and slipped into a “permanent vegetative” condition.  She then lived for fourteen years until she was allowed to die following enormous expenses to her family while incapacitated.

In Case of Emergency (ICE)

WHO WOULD YOU WANT CALLED IN CASE OF EMERGENCY (ICE)?

ICE is a list of persons you want contacted in case of emergency, stored in your cell phone. 

Here are some common questions and answers about ICE.

What is ICE?

How does ICE work?

Q.  What is ICE?

A.  If you are in a car accident or some other event requiring unexpected medical care, the physicians and emergency personnel must find a way to contact someone regarding your medical emergency.  Time is important.  Some medical procedures require authorization from a spouse or a health care agent before treatment can begin.  A shorthand process has been developed to facilitate this communication process, referred to as ICE.  ICE stands for In Case of Emergency.

Q. How Does ICE Work?

A. ICE reflects the list of persons who you want contacted in case of an emergency.  This list of persons and their telephone numbers (and other information) is stored on your cell phone.  The steps are as follows:

  • Decide whom you want contacted in case of emergency.
  • Enter ICE as the contact name in your cell phone contact list.
  • Add the phone number of the person you want called in case of emergency.
  • If you want to name more than one person, make an ICE1 and ICE2 entry in your contact list.

FACT: If you are injured in an emergency, paramedics and other emergency responders are trained to examine your cell phone and look under “ICE” to see who ought to be contacted to give your whereabouts and condition.

If you own an Apple Iphone, there are several ICE applications available.  These applications allow you to enter emergency contact information and other types of health information. 

HIPPA

WHO DO YOU WANT TO ACCESS YOUR HEALTH CARE RECORDS?

HIPPA is the acronym for the Health Insurance Portability and Accountability Act passed in 2003.  In an effort to protect your privacy, HIPPA restricts the freedom of medical care providers to share medical information about you with anyone, even family members, without your consent.

The provisions of HIPPA give you the right to view information contained in your medical records and to designate other persons with whom your medical information may be shared.

Here are some questions and answers about HIPPA.

Do you need to complete a HIPPA form in order for your spouse or family to see copies of your medical records?

Wht if you have not completed a HIPA form giving someone the legal right to view your medical records?

How can you authorize someone to access your medical records?

 

Q. Why do you need to complete a HIPPA form in order for your health care agent or family members spouse see copies of your medical records?

A. If you want your medical information shared with someone, you must complete a HIPPA Authorization to Release Information form naming and authorizing the people you will allow to see the records maintained by your physician or hospital.  Access to these records will be important for whomever is in charge of making medical decisions for you.

The list should certainly include your health care agent.  Whether you want your medical information shared with your family is up to you.  If you have old and trusted friends to whom you frequently turn for advice, you may want to name them as well.

Once you sign a HIPPA Authorization to Release Information form, you should give a copy to your family physician.

Although you can add a clause to your Health Care Power of Attorney form giving your health care agent and family access to your personal medical records, it is also wise to sign a separate HIPPA form identifying the people whom you want to have access to your records.

Q. What if you have not completed a HIPPA form giving someone the legal right to view your medical records?

A. Without a written authorization from you to share your medical records, medical professionals and medical facilities face stiff penalties for violating HIPPA.

Without advanced authorization by you, your health care agent will not be able to access the information about you to make an informed decision about the best plan of care for you.

Q   How can you authorize someone to access your medical records?

A.