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LIVING WILL & HEALTHCARE TRUSTS

by Dr. Joseph A. Bailey II, MD., FACS on 25th-May-2017

A Living Will Form (also called Advance Health Care Directive, Advance Directive, Advance Medical Directive) is a Trust established and in operation during ones life to essentially spell out ones end of life decisions. This means you (called a Principle) have appointed another as your Agent (to act for you on your behalf) and those acts in writing are binding on you. By the legal instrument of a Power of Attorney, you confer upon the Agent the authority to perform certain specified acts or kinds of acts on your behalf. To elaborate, both a Living Will and a durable Healthcare Power of Attorney allow you to choose someone you trust to make certain medical choices for you. You must be at least 18 years old to create either document and you must be of sound mind. That means no one is allowed to coerce you into making a living will or making them a healthcare power of attorney. But while a Living Will is generally limited to deathbed concerns only, a durable power of attorney for healthcare covers all health care decisions—and it lasts only as long as you are incapable of making decisions for yourself. Since a Living Will generally covers very specific issues like "DNR" (or "do not resuscitate"), it may not deal with other important medical concerns you might have. For example, some people may want to refuse dialysis or blood transfusions. Those sorts of concerns can be directly articulated in a healthcare power of attorney. Make a list of medical procedures you want, do not want, and can compromise on. Write out your conclusions 20 times so as to refine each for Precision, Accuracy, and Plainness in Clear and Simple terms—all essentials for ones intentions and avoid misinterpretations.

Give great attention to limitations and compromises and how to properly state them. This is because there are many ways to interpret your statement—especially if all the details are not laid out—causing you to experience things you are not willing to endure. Do you want your life prolonged if the likely risks and burdens of treatment would out weigh the expected benefits? An example of where Compromise is stated is if you do not want a feeding tube, you may be thinking about only if you are at the end of life. However, after an accident, you may simply require a temporary feeding tube to ensure returning to relatively good health–and to withhold it may mean you could needlessly die. Spell out Limitations: “I do not want to keep living if it is as a “vegetable”—i.e. not knowing who people are that are significant to me”; or “where I cannot take care of personal hygiene.” Either way, Healthcare wishes for ones critical illness or injury (e.g. being comatose) or severe memory loss in old age need to be made known before-hand as to what to do about costs and related to a grim prognosis. Use a Living Will if: you want to specify your wishes so that it is more likely they will be carried out; you are facing the possibility of surgery or a hospitalization; you want to create a complete estate plan; and/or you have been diagnosed with a terminal condition. These directives are valid if signed by a notary public or by two witnesses. This is why it is wise to have both documents in your estate plan.

“If I am unable to communicate my desires (e.g. from being in a coma or medically incapable),” then, at that point, your Agent takes over. So, who do you want to make healthcare decisions for you in case you are unable to do it? A Living Will allows your family and physicians to rest assured that your own personal choices are being respected by your Agent. Get prepared with Online information, as with Caring Connections. From it, a form, doubling as a Living Will, can be printed. Look for where it is best to receive care—including in an extended care or nursing home, a hospital, or outpatient service. There is a Physician Orders for Life-Sustaining Treatment (bright pink) form in which you can indicate whether you want resuscitation, feeding tubes, ventilators, and other life-sustaining procedures. The government keeps silently changing things regarding (among others) Medicare patients. Thus, it is important to periodically see if the same things are in place as a year ago. For example, do Medicare patients still qualify for free in-home hospice care which includes a wide range of Palliative care and services—i.e. those that afford relief but do not cure. Check out stipulations, like if hospice care qualifies only if one has chosen to forego curative intervention and a physician has concluded one is likely to be in the last six months of life. If your situation is complex, it is best to get a legal expert to review—or at least a Paralegal (who charges much less). jabaileymd.com; JABLifeSkills; Theievoice.com

Category: Dr. Joseph A. Bailey II, MD., FACS.
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