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Tag: Living Will

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Estate Planning

Navigating End-of-Life Care: Lessons from a Daughter’s Tragic Experience

In an aging society, you might face difficult end-of-life decisions for your loved ones sooner than expected. And when you do, you’ll realize the journey through end-of-life care is rarely straightforward. A recent and heartbreaking story from Maggie Schneider Huston in Newsweek illustrates this. In this article, I’ll highlight key insights from Maggie’s experience and offer practical advice for your situation. 

First, know that an advance directive is a legal document that outlines your wishes for medical care if you cannot decide for yourself. In most states, it also gives authority to a person or people you choose to act on your behalf and ensure your wishes are fulfilled. With that, let’s dive into Maggie’s story. As you read, consider how you might prepare for similar situations in your life or the lives of your aging relatives.

What Happened?

Maggie’s story begins in 2023. Her mom died, and shortly after, Maggie’s father, Terry, revised his will and created an advance directive. He wanted to be entirely prepared for a planned heart surgery he was to have less than three months later. 

His advance directive reflected his desires that he’d been clear about – that he did not want to suffer when his life was coming to an end. He did not want machines to keep him alive. He only wanted to be comfortable. Maggie and her siblings understood and supported their father’s wishes. They gave one of his doctors a copy of his advance directive before the surgery. That doctor later admitted that he hadn’t read it. Terry’s other two doctors did not know he had an advance directive.

After Terry’s heart surgery, his health declined rapidly. As he was lying in the hospital bed, his doctors arguing that he could live with the assistance of machines, he told them that’s not what he wanted. He repeatedly asked for hospice care. Despite Terry’s wishes, his doctors would not order hospice care for him.

Maggie and her siblings quickly got involved and read Terry’s advance directive to the doctors. And after repeated requests, the doctors finally relented. He died shortly after. Even though Terry’s wishes were finally honored, it wasn’t without frustration and heartache for Terry and his family. 

It’s easy to see why the doctors insisted on keeping Terry alive. Their job, after all, isn’t to facilitate death but to promote life (no doubt the fear of being sued for medical malpractice was a factor, too). So it’s not a leap to think that if Terry didn’t have an advance directive, he would still be alive today, subsisting on the assistance of machines at an extreme cost to the family.

So, as Maggie’s story illustrates, having an advance directive is just the first step. You must also ensure that the advance directive is readily available and that your chosen advocates are prepared to fight for your wishes if necessary. It also helps to have a trusted lawyer by your side. 

Advocating for Your Loved Ones

Maggie’s experience with her father shows how important advocacy can be. If you find yourself in Maggie’s situation with a parent or other loved one, here are some strategies you can take to ensure their wishes are honored:

Be prepared to speak up and ask questions. If you need help understanding something, ask for clarification. Don’t be intimidated by medical jargon or embarrassed about asking for explanations.

Ensure that all medical team members have read and understood the advance directive. Don’t assume that because one doctor has seen it, all of them have.

If your loved one’s wishes are ignored, don’t hesitate to escalate the issue to hospital administration or patient advocacy groups. Remember, you’re not just a visitor but an essential part of your loved one’s care team.

Keep a journal or log of all interactions with healthcare providers. Document who you spoke to, what was discussed, and any decisions made. This can be invaluable if there are disagreements or misunderstandings later.

Build relationships with the nursing staff. The nursing staff spends the most time with patients and can be powerful allies in advocating for your loved one’s care.

Consider bringing in outside help if needed. If you feel your loved one’s rights are being violated, this could be a patient advocate, a social worker, or even a lawyer. Read on, and I’ll show you how to get my help and support.

Take care of yourself during this process. Advocating can be exhausting and emotionally draining. Eat well, get enough sleep, and take breaks when needed.

Your role as an advocate can be challenging, but it’s crucial to ensure your loved one’s wishes are respected. You can also prepare for your future so your loved ones have the support they need to advocate for you if the time comes.

How to Help Your Loved Ones Avoid Similar Outcomes

To help your family avoid the challenges faced by Maggie and her siblings, consider the following steps:

Create a comprehensive advance directive and designate a healthcare proxy. This crucial first step involves clearly outlining your wishes for end-of-life care in a thorough Life & Legacy Plan. When you work with me to create your Life & Legacy Plan, I can help you get clear on specific treatments you do or do not want, choose the right people to be your representatives, and ensure they understand and are willing to advocate for your wishes. All these considerations are critically important.

Communicate your wishes openly and distribute your advance directive. Have frank discussions with your family members about your end-of-life preferences. Ensure all relevant family members understand and respect your decisions, proactively addressing concerns or disagreements. Once your wishes are clear, provide copies of your advance directive to your representatives, family members, and primary care physician. I will maintain a copy of your advance directive when you work with me. This wide distribution helps ensure your wishes are known and can be quickly accessed when needed.

Regularly review and update your Life & Legacy Plan. Life circumstances and health conditions can change, potentially affecting end-of-life care preferences. That’s why my Life & Legacy Planning process includes regular reviews of your plan so we can update your plan if needed. This ongoing process of review and update helps ensure that your end-of-life care plans always accurately reflect your current wishes and circumstances and that your plan will work when you and your loved ones need it to.

Finally, remember, end-of-life care isn’t just about how we die – it’s about how we live our final days, weeks, or months. Planning and being prepared to advocate can ensure that this time is as meaningful and comfortable as possible, aligned with your values and wishes. In doing so, you’re providing a final act of love and respect, honoring a life well-lived right up to its very end.

How We Help You Navigate End-of-Life Care

As Maggie’s story clearly illustrates, end-of-life situations can be complex and emotionally challenging. The best time to prepare for these difficult moments is now. We help you create a comprehensive Life & Legacy Plan that ensures your end-of-life wishes are respected, your loved ones are empowered to advocate for you, and your care aligns with your values when needed. Don’t leave your end-of-life care to chance. Let us help you create a plan that works when you and your loved ones need it most.

Schedule a complimentary 15-minute consultation to learn more. Contact us today to get started.

This article is a service of August Law, a Personal Family Lawyer® Firm. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That’s why we offer a Life & Legacy Planning™ Session, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love. 

The content is sourced from Personal Family Lawyer® for use by Personal Family Lawyer® firms, a source believed to be providing accurate information. This material was created for educational and informational purposes only and is not intended as ERISA, tax, legal, or investment advice. If you are seeking legal advice specific to your needs, such advice services must be obtained on your own separate from this educational material.

Categories
Estate Planning

All You Need To Know About Living Wills

When it comes to estate planning, you’ve most likely heard people mention a couple of different types of wills. The most common is a “last will and testament,” which is also known simply as a “will.” But you may have also heard people talk about what’s called a “living will.”

Both terms describe important legal documents used in estate planning, but their purpose and the way in which they work is very different. Here we are going to discuss some of the most critical things you should know about living wills, and explain why having one is an essential part of every adult’s estate plan and how to get yours created or updated.

A living will, often called an “advance health care directive,” is a legal document that tells your loved ones and doctors how you would want decisions related to your medical care handled in the event you become incapacitated and are unable to make such decisions yourself, particularly at the end of life. Specifically, a living will outline the procedures, medications, and treatments you would want—or would not want—to prolong your life if you become unable to discuss such matters with doctors yourself.

Living Will Vs Last Will & Testament

A last will and testament is used to ensure your assets are divided upon your death in the way you choose. Note that your will only deals with your assets, and it only operates upon your death. In contrast, a living will is about you, not your assets, and operates in the event of your incapacity, not your death.

In other words, a last will tells others what you want to happen to your wealth and property after you die, while a living will tells others how you want your medical treatment managed while you are still alive.

What Is An Advance Directive And How Is It The Same Or Different Than A Living Will?

An “advanced directive” or “advance health care directive” are both general terms that describe legal documents that are related to your health care needs. Typically, an advance health care directive will include a living will (with instructions for how you want your medical care handled), and a medical power of attorney (naming the people you want making decisions for you, and giving them authority to talk with your medical team).

Living Will Vs Medical Power Of Attorney

A medical power of attorney is the part of an advance health care directive that allows you to name a person, known as your “agent,” to make health care decisions for you if you’re incapacitated and unable to make those decisions yourself. While medical power of attorney is an advance directive that names who can make health care decisions in the event of your incapacity, a living will explains how your medical care should be handled. Not all living will form documents or templates include a medical power of attorney or the proper legal authorizations to give whoever you want making decisions for you (your agent) the legal authority to access your medical records.

Why Is A Living Will So Important?

A living will is a vital part of every adult’s estate plan, as it can ensure your medical treatment is handled exactly the way you want in the event you become unable to communicate your needs and wishes yourself. Additionally, a living will can prevent your family from undergoing needless stress and conflict during an already trying time.

Without a living will, your family will have to guess what treatments you might want, and your loved ones are likely to experience stress and guilt over the decisions they make on your behalf. In the worst cases, your family members could even end up battling one another in court over how your medical care should be managed.

Even Young People Need A Living Will

Although you may think that a living will is something that only the elderly or older people need, the fact is, you can experience a serious accident or illness at any age, which would leave you incapacitated and unable to communicate your wishes for medical care. For this reason, all adults over age 18 should have both a living will and a medical power of attorney in place.

Decisions And Scenarios Addressed In A Living Will

A few of the most common types of decisions, treatments, and scenarios typically addressed in a living will include the following:

  • Tube Feeding. You can include instructions about if and for how long you would want tube feeding used to supply you with nutrients and fluids needed to prolong your life.
  • Resuscitation (CPR & DNR). Depending on whether or not you would want to be resuscitated in the event your heart stops, you can include what’s known as a Do-Not-Resuscitate (DNR) order in your living will. A DNR can also be a stand-alone document.
  • Intubation & Mechanical Ventilation. You can state if and for how long you would want to be intubated and placed on a mechanical ventilator if you could not breathe on your own.
  • Pain Management & Palliative Care. These are instructions about the types of pain management medications you would—or would not—want to be prescribed to you; if you want to die at home; as well as any other interventions you might want for comfort and pain management at the end of life.
  • Organ/Tissue Donation. You can specify in your living will if you want to donate your organs and/or tissues for transplant following your death. Note that you will likely receive life-sustaining measures until any procedures are completed to remove your organs and tissues.

Should You Try An Online Living Will?

While you’ll find a wide selection of generic living wills, medical power of attorney, and other advance directive documents online, you may not want to trust these do-it-yourself solutions to adequately address such critical decisions. When it comes to your medical treatment and end-of-life care, you have unique needs and wishes that just can’t be anticipated by fill-in-the-blank documents.

To ensure your directives are specifically tailored to suit your unique situation and that you actually get it done instead of just knowing you need to get it handled and never do it, work with experienced planning professionals like us to create—or at the very least, review—your living will, medical power of attorney, and other documents.

Communication Is Vital

Even if you have a well-thought-out living will, it won’t be worth the paper it’s printed on if nobody knows about it. Both living wills and medical power of attorney go into effect the second you sign them, so you should immediately deliver copies to your agent, your alternate agents, your primary care physician, and any other medical specialists you’re seeing.

And don’t forget to give those folks new versions whenever you update the documents and have them shred the old documents. This is a standard part of our practice when serving our clients, so when you work with us to create your legal documents, we’ll ensure that everyone who needs to have your documents always has the latest version.

Don’t Wait Until It’s Too Late

Your living will and medical power of attorney must be created well before you become incapacitated and unable to make your own decisions. You must be able to clearly express your wishes and consent in order for these planning documents to be valid, as even slight levels of dementia or confusion could get them thrown out of court.

Not to mention, an unforeseen illness or injury could strike at any time, at any age, so don’t wait—contact us to get these vital documents put in place.

A Comprehensive Plan For Incapacity

A living will and medical power of attorney are just two of the legal documents you need as part of your overall plan for incapacity. You will also likely need other estate planning tools, such as a durable financial power of attorney and a revocable living trust, in order to have a truly comprehensive incapacity plan. We see estate planning as so much more than planning for death, which is why we call it Life & Legacy Planning—because it’s about your life and the legacy you are creating by the choices you make today.

If you’ve yet to create your incapacity plan, schedule a complimentary 15-minute consultation. We can advise you about the proper planning vehicles to put in place. And if you already have an incapacity plan—even one created by another lawyer—we can review it to make sure it’s been properly set up, maintained, and updated.

This article is a service of August Law, Personal Family Lawyer®. We do not just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That’s why we offer a Family Wealth Planning Session™, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love.
Categories
Estate Planning

Long-Term Care Insurance: What You Need to Know

With the booming aging population, more and more seniors will require long-term healthcare services, whether at home, in an assisted living facility, or in a nursing home. However, such long-term care can be extremely expensive, especially when it’s needed for extended periods.

Moreover, many people mistakenly believe that their health insurance or the government will pay for their long-term care needs. But the fact is, traditional health insurance doesn’t cover long-term care. And though Medicare does pay for some long-term care, it’s typically limited (covering a maximum of 100 days), difficult to qualify for, and requires you to deplete nearly all of your assets before being eligible (unless you use proactive planning to shield your assets).

To address this gap in healthcare coverage, long-term care insurance was created. Since such insurance is fairly new, we’ll answer some of the most frequently asked questions about these policies to help you determine whether you (or your loved ones) could benefit from investing in long-term care insurance coverage as part of your estate plan.

What is long-term care?

Long-term care is a general term that describes the type of care or support you need when you are no longer able to handle activities of daily living (ADLs) on your own. ADLs include things, such as getting dressed, bathing, eating, and using the bathroom.

In some cases, long-term care might simply mean that you have someone assist you in your own home with getting ready in the morning and before bed at night. In other cases, long-term care might mean you move into a nursing home to recover from surgery or manage a chronic medical condition.

What are the different types of long-term care?

Long-term care services typically fall into two categories: personal care and skilled care. Personal care, also known as custodial care, is for people who require assistance with non-medical activities, including the following:

ADLs such as dressing, grooming, bathing, and eating.

  • Instrumental activities of daily living (IADLs), such as grocery shopping, meal prep, and laundry
  • Companionship
  • Supervision
  • Transportation

Skilled care, or skilled nursing care, is for people who require skilled medical care or rehabilitation services, including:

  • Medication management
  • Vital sign monitoring
  • IV treatments or feedings
  • Occupational, physical, and speech therapy
  • Wound care
  • Mobility assistance

What is long-term care insurance?

First introduced as “nursing home insurance” in the 1980s, long-term care insurance is designed to cover the expenses related to your long-term care in the event you are no longer able to handle your own ADLs.

These policies cover the cost of both personal care and skilled care services whenever and wherever you plan to receive care, whether in your own home, an assisted living facility, a nursing home, or a community care facility. Some policies even cover modifications to make your home more accessible, such as adding wheelchair ramps or grab bars to your bathroom.

How does long-term care insurance work?

Before your coverage kicks in, most policies require that you demonstrate you have lost the ability to engage in at least two or three ADLs. Most policies also have a deductible, or “elimination period,” which is a set number of days that must elapse between the time you become disabled (eligible for benefits) and the time your coverage kicks in.

Many policies offer a 90-day elimination period, but others can be longer, shorter, or even have no elimination period at all. Of course, the shorter the elimination period, the more expensive the premium. Additionally, long-term care policies typically come with a predetermined benefit period, which is the number of years of care it will pay for.

For example, a benefit period of three to five years is a quite common duration for such policies. Most policies also come with a cap on the dollar amount of coverage that will be paid for care on a daily basis, known as a Daily Benefit Amount.

When should you purchase long-term care insurance?

Obviously, the younger and healthier you are when you buy the policy, the cheaper the premiums will be, so the sooner you invest in coverage, the better. In fact, most policies exclude certain pre-existing conditions, so if you wait until you become ill, it can be impossible to find coverage.

For example, if you have any of the following conditions, it generally disqualifies you from obtaining coverage:

  • You already need help with ADLs
  • You have AIDS or AIDS-Related Complex (ARC)
  • You have Alzheimer’s Disease or any form of dementia or cognitive dysfunction
  • You have a neurological disease, such as multiple sclerosis or Parkinson’s Disease
  • You had a stroke within the past year to two years or have a history of strokes
  • You have metastatic cancer
  • You have kidney failure

According to the American Association for Long-Term Care Insurance (AALTCI), the best age to apply for coverage is before you reach your mid-50s. Beyond that age, your health is unlikely to improve significantly, so waiting longer will typically increase your premiums, or you may even become ineligible before acquiring a policy.

How do I purchase coverage?

If you are looking to purchase long-term care insurance, you should speak with multiple insurance providers and compare their benefits, care options, and premiums. Different companies may offer the same coverage and benefits, but they can vary dramatically in price. Always ask about the insurance company’s history of rate increases, including the amount of the most recent increase.

For the best chances of success when shopping for a policy, get help from a fee-only planner, who is not compensated based on your choice of coverage. Or, if you are working with a commissioned agent, we can review the policy terms to ensure it’s a good fit for you before you sign on the dotted line.

What are the most important elements in a long-term care policy?

When meeting with an insurance provider, you must get answers to the following three questions about your policy:

  1. How long is the elimination period before the policy begins paying benefits?
  2. What capacities, or ADLs, must you lose before coverage kicks in?
  3. How many years of care are covered?

These are the most important elements in a long-term care policy, and as such, they will make the biggest difference in the quality of coverage and the amount of your premiums.

Can I buy coverage for my parents?

Yes, you can buy long-term care insurance for your parents. You will pay for the policy, and then have your parent(s) listed as the beneficiary. If you know you are going to be the primary caregiver for your aging parents, investing in a policy for them can help offset the expenses related to their long-term care.

Furthermore, buying long-term care insurance should always be a family affair, because you are going to need your family members to advocate for you and file a claim for the policy when you need to use it. Given this, make sure your family knows what kind of policy you have, who your agent is, and how to make a claim.

What’s more, you should pre-authorize the right person to speak to the insurance company on your behalf, and not just rely on a medical power of attorney. That said, you should definitely have a well-drafted, updated, and regularly reviewed medical power of attorney on file as well.

Once I have a policy, how often should I review my coverage?

Once you are in your 50s, your long-term care policy should be reviewed annually to evaluate new insurance products on the market and update your policy based on your changing needs. Whatever you do, once you have a policy in place, make sure you don’t miss a premium payment. If you fail to pay, even for a short period of time, you’ll lose all of the money you invested and will have no access to the benefits when you need them.

A Key Component In Your Estate Plan

Meet with us for guidance and support in finding the right long-term care insurance policy for your particular situation. In addition to life insurance, a long-term care insurance policy is a key component in your estate plan. When combined with the right estate planning strategies, you can rest assured that your loved ones will be protected and provided for no matter what happens to you.

We view estate planning as much more than just planning for death, which is why we call it Life & Legacy Planning. Ultimately, it’s all about your life and the legacy you are creating by the choices you make today. Contact us today to learn more.

This article is a service of August Law, Personal Family Lawyer®. We do not just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That’s why we offer a Life & Legacy Planning Session, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love.

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The August Law PLLC team will work hard to deliver good quality information upon subscription. However, if you decide that you no longer want to receive emails from us, feel free to click the "unsubscribe" button at the bottom of the email received.