Estate Planning Documents for a Natural Ending

If you want to control your demise, there are a handful of documents that are typically created during the process of developing an estate plan that can be used to achieve this goal, says the article “Choosing a natural end” from The Dallas Morning News.

The four documents are the Medical Power of Attorney, the Directive to Physicians, the Out-of-Hospital Do-Not-Resuscitate, and the In-Hospital Do-Not-Resuscitate. Note that every state has slightly different estate planning laws. Therefore, you will want to speak with an experienced estate planning attorney in your state. If you spend a lot of time in another state, you may need to have a duplicate set of documents created. Your estate planning attorney will be able to help.

For the Medical Power of Attorney, you are appointing an agent to make health care decisions, if you cannot. This may include turning off any life-support systems and refusing life-sustaining treatment. Talk with the person you want to take on this role and make sure they understand your wishes and are willing and able to carry them out.

You have the right to change your agent at any time.

The Directive to Physicians is a way for you to let physicians know what you want for comfort care and any life-sustaining treatment in the event you receive a diagnosis of a terminal or irreversible health condition. You aren’t required to have this, but it is a good way to convey your wishes. The directive does not always have to be the one created by the facility where you are being treated, and it may be customized to your wishes, as long as they are within the bounds of law. Many people will execute a basic directive with their estate planning documents, and then have a more detailed directive created when they have a health crisis.

The Do-Not-Resuscitate (DNR) forms come in two different forms in most states. Unlike the Directive to Physicians, the DNR must be signed by your attending physician. The Out-of-Hospital DNR is a legally binding order that documents your wishes to health care professionals acting outside of a hospital setting not to initiate or continue CPR, advanced airway management, artificial ventilation, defibrillation or transcutaneous cardiac pacing. You need to sign this form, but if you are not competent to do so, a proxy or health care agent can sign it.

The In-Hospital DNR instructs a health care professional not to attempt CPR, if your breathing or heart stops. It is issued in a health care facility or hospital and does not require your signature. However, the physician does have to inform you or make a good faith effort to inform a proxy or agent of the order.

If you would prefer not to spend your final days or hours hooked up to medical machinery, speak with your estate planning attorney about how to legally prepare to protect your wishes.

Reference: The Dallas Morning News (Jan. 12, 2020) “Choosing a natural end”

Planning for Care in Advance

An aging parent’s health can fail suddenly, or they can have a fall that will unexpectedly put them into a precarious state. Therefore, it is vitally important that legal and medical arrangements be made, while they are still well enough to be an active participant in decisions, advises TAP into Roxbury in the article “Putting Together a Plan of Care.” Here are the steps to get you started:

Advance Directive: This document spells out their wishes regarding future medical care and treatment, if they are no longer able to speak or make decisions on their own behalf.

A Living Will is used to state in advance whether or not they want to have medical treatment, like a feeding tube, ventilator, or heart machine to prolong life, when death is inevitable.

A Durable Health Care Power of Attorney appoints another person to make medical decisions, if the person becomes incapacitated.

A Power of Attorney names someone who will be able to make decisions about their finances, pay bills, and manage real estate and other assets.

A Last Will and Testament provides information about what they would like to happen to their assets upon their demise and names an executor who will be in charge of carrying out their wishes.

Copies of medical insurance cards and any other insurance information, if emergency treatment is needed.

A Do Not Resuscitate (DNR), if they do not wish to be brought back to life during a medical emergency.

A list of medications they are currently taking, as well as doctor’s names and contact information.

A list of professionals, including their estate planning attorney, CPA and financial advisor, and all contact information.

Having all these documents prepared in advance of any emergency will be helpful, if they are ever needed. Keeping them in a safe and accessible location where they can be obtained quickly in an emergency is also important. Do not put them in a safe deposit box, which may be sealed upon their death.

Some seniors are reluctant to have these discussions, although they may be more comfortable having them with a person outside the family, like an estate planning attorney.

Reference: TAP Into Roxbury (October 7, 2019) “Putting Together a Plan of Care”

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