Advanced Health Care Directive

Advanced Health Care Directive

Included in a complete estate plan is a living will (or Advance Health Care Directive) nominating a health care agent and stating your wishes for end of life decisions and treatment. This document is clear and comprehensive, yet many times health care professionals still have a difficult time withholding life-saving treatments, even if administering them goes expressly against a patient’s clear wishes to the contrary. By considering your options early, you can ensure the quality of life that is important to you and avoid having your family 'guess' your wishes or having to make critical medical care decisions for you under stress or in emotional turmoil.

Recent Answers

Estate Planning Attorney

If you are the agent under the Advance Health Care Directive, you have the ability to make decisions regarding her Heath Care, but if she flat out refuses to work with you on this, it is a difficult situaton.  Have you thought of hiring a geriatric care manager to come up with a care plan? Maybe... (more)

If you are the agent under the Advance Health Care Directive, you have the ability to make decisions regarding her Heath Care, but if she flat out refuses to work with you on this, it is a difficult situaton. 

Have you thought of hiring a geriatric care manager to come up with a care plan? Maybe your mom needs to hear all of this from someone other than you. Perhaps your mom needs to be more involved in the decision making process so that she can visit possible nursing homes. 
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Estate Planning Attorney

Your dad would need to sign a new power of attorney (POA) to transfer the authority to you (or back to you) and revoke the prior POA(s).  It sounds like, however, he may be suseptiable to undue influence. So possibly his girlfriend could get him to sign another POA again and it becomes difficult to... (more)

Your dad would need to sign a new power of attorney (POA) to transfer the authority to you (or back to you) and revoke the prior POA(s). 

It sounds like, however, he may be suseptiable to undue influence. So possibly his girlfriend could get him to sign another POA again and it becomes difficult to stop that, which is when some people turn to the court to get a conservatorship or guardianship. However, you would need to show your dad cannot manage his finances himself and he sounds very active.

You could transfer and ensure all of his assets are in his trust, including the bank accounts, since the POA only controls non-trust assets. 

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Senior Advisor

The first step you should take is to do a lot of research on the subject.  Look at the specific type of cancer he has as well.  That means to search the web, talk to family and friends and maybe a doctor.  Understand everything you can about this and then be understanding to your grandfather... (more)

The first step you should take is to do a lot of research on the subject.  Look at the specific type of cancer he has as well.  That means to search the web, talk to family and friends and maybe a doctor.  Understand everything you can about this and then be understanding to your grandfather.  Things you need to learn about are behavior changes.  You need to understand the changes he might go through when and if he gets a treatment.  Look for national, regional and local resources that could help him out.  The best thing you can do is to be there for him and support him in any way you can.  

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Senior Specialist

I'm sorry to hear about your grandfather's cancer. It's a difficult time for grandfather and your family; but there are things you can do now to be proactive with the progression of this disease. Adding to Vanessa's recommendations on the medical and financial power of attorney; also look into... (more)

I'm sorry to hear about your grandfather's cancer. It's a difficult time for grandfather and your family; but there are things you can do now to be proactive with the progression of this disease. Adding to Vanessa's recommendations on the medical and financial power of attorney; also look into hospice care as this is end of life care that is covered by Medicare benefits. Hospice care is used primarily to help the individual with pain management and help the family prepare with death.

I know this may be difficult, but also sit down with your family and your grandfather and discuss how he would like to live the remaining days of his life (at home or a facility). Also if possible discuss how he would like your family to celebrate his life. What kind of funeral (burial or cremation), getting an estate plan in order if their are assets, and also access to all account information (emails, banks, life insurance, etc.)

Good luck with your journey and remember it is difficult to discuss all these topics but remember you are doing this out of love.

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Estate Planning Attorney

From a legal stand point there a some key documents your grandfather should consider putting in place: A medical power of attorney, which nominates someone to make medical decisions; A financial power of attorney, which appoints an agent to make medical decisions; and  Determine whether, depending... (more)

From a legal stand point there a some key documents your grandfather should consider putting in place:

A medical power of attorney, which nominates someone to make medical decisions;

A financial power of attorney, which appoints an agent to make medical decisions; and 

Determine whether, depending on the types of assets your grandfather has, if he needs to have a Will or a Trust.

Certain accounts and assets can pass at death via a beneficiary designation. I'd encourage your grandfather to check all accounts for this option. 

As difficult it may be, I'd also encourage your grandfather to think about end of life decisions and be as specific as possible regarding health directives. 

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Estate Planning Attorney

You would want to find out if your dad has a Advance Health Care Directive (AHCD), which is a legal document that names an agent to make medical decisions on his behalf. Along with this document, your dad should consider having a Living Will which addresses end of life decisions such as if he were... (more)

You would want to find out if your dad has a Advance Health Care Directive (AHCD), which is a legal document that names an agent to make medical decisions on his behalf. Along with this document, your dad should consider having a Living Will which addresses end of life decisions such as if he were in an irreversible coma, would he want life support to be removed.

There are other health related documents that also deal with end of life decisions -a Do Not Resusitate Order or DNR may state more broadly that your dad does not want to be Resusitated at all no matter what. The DNR order in California is now called a POLST. So you would want to check your specific state forms. 

Your dad's doctors office or local hospital should have some sample forms for you.

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Private Fiduciary, Trustee,Conservator, Financial Advisor

Look at your state's palliative care website for health care directives for your state.  Or contact an elderlaw attorney

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Senior Advisor

I'm so sorry to hear this.  Hospice is usually reserved for the final six months.   Timing is tough to predict these matters.   Since your mom is still under the care of her doctor, they would know when to transition her.   With mom being in the home setting already this transition should be... (more)

I'm so sorry to hear this.  Hospice is usually reserved for the final six months.  Timing is tough to predict these matters.  Since your mom is still under the care of her doctor, they would know when to transition her.  With mom being in the home setting already this transition should be seamless.  This final phase is designed to provide the patient with the comfort, quality of care and dignity one can only ask for in these final times. Hospice care isn’t about healing.  It allows patients to move through the dying process.  Through these tough times, hospice care also offers family members resources for the transition to grief ahead, usually in the form of chaplain visits. 

Most people who are facing their final days want to be surrounded with loved ones.  They prefer to be in a home setting versus a hospital.  The home environment is best for not only the patient, but for the family and friends that visit.  Once under the care of hospice, all the services and doctors will be coming from them.  You may want to consider home care (non-medical) to offset time off needed for loved ones that are involved on a daily basis.  You have to care for yourself as well during these times.  Other things to consider are the legal documents like wills, power of attorney and advance directives are all up-to-date.  

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Senior Specialist

Hospice care is known as end-of-life care, as life expectancy is less than six months. A team of health care professionals and volunteers provides the service. They give medical, psychological, and spiritual support. The goal of the care is to help people who are dying have peace, comfort, and... (more)

Hospice care is known as end-of-life care, as life expectancy is less than six months. A team of health care professionals and volunteers provides the service. They give medical, psychological, and spiritual support. The goal of the care is to help people who are dying have peace, comfort, and dignity. The caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's family.

To qualify for hospice service, two physicians must certify that the patient is terminally ill. These physicians are typically the attending physician and the hospice medical director. Medicare Part A is usually the payor for this type of service.

I hope this helps and sorry that you have to go through this process.

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Private Fiduciary, Trustee,Conservator, Financial Advisor

She needs hospice now to provide palliative care first, and then, if you chooses to stop treating her disease, then hospice begins,  Palliative care is invaluable!

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Private Fiduciary, Trustee,Conservator, Financial Advisor

The same legal documents  YOU and anyone over the age of 18 needs: Wills, Trusts, Powers of Attorney for business matters, Health Care directives.  Do you have yours?

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Estate Planning Attorney

This is a great opportunity to be proactive. There are two essential documents anyone should have that relate to legal and medical issues if one becomes incapacitated: power of attorney for finance: this document names a person or persons to make financial decisions for you in the event you are... (more)

This is a great opportunity to be proactive. There are two essential documents anyone should have that relate to legal and medical issues if one becomes incapacitated:

  • power of attorney for finance: this document names a person or persons to make financial decisions for you in the event you are unable.
  • advance healthcare directive: names a person or agent to make medical decisions for you if you are unable. It can also address what kids of decision you want that person to make. In this way, the agent named has authority to make medical decisions AND knows what decisions to make. Along with the advance healthcare directive, one might consider having a Living Will, which addresses end of life decisions, specifically, if in an irreversible vegetative state, whether you would want to continue to be on live support or have it removed. Finally, there is one other medical document to consider called a Physician Orders for Life Sustaining Treatment or POLST, which used to be called a Do No Resuscitate Order or DNR. This document would address end of life questions as well. Your mom would discuss this particular document with her doctor.
There are two other documents to consider that cover the time period after one passes away and how assets would be distributed and who would be in charge of this. This would be either a Will or a Trust. Depending on the state your mother resides in and the assets she has, either a Will or a Trust might be appropriate. It is a good idea to see a estate planning or elder law attorney to discuss these documents. 

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