Planning in Advance Directives

Our children are growing up fast.  We are getting older.  Our parents are getting even older.  It may be difficult but is important to talk about your plans if you were to become incapacitated or to pass away or if something were to happen with your parents.

Our guest speaker, one of our own gals, JJ Nadicksbernd, talked to us about Advance Finance Directives, Advance Health Directives, and the new California POLST (Physician Orders for Life Sustaining Treatment.   An Advance Directive is the legal definition of your health  or financial care if you can not handle it yourself.  Advance Directives are (a) completely voluntary (b) for people 18 years or older and (c) legal forms can be found online.  Be sure to name two different people as your agent, the second being a backup in case the first is not available, and do not use the word “and.”  It makes it difficult for health care providers if more than one person is names.  First, we took a quick look at a Financial Power of Attorney (POA).

Financial POA can be temporary or longterm.  The forms can be obtained online and have to notarized.  Check with your bank because some banks require their own form.   

Don’t keep your POA forms in a safety deposit box because it becomes difficult for someone to find if you are unable to get it yourself.  Tell someone where it is and make a copy for that person.  Have a copy easily accessible so that someone can bring it to the hospital.  It is advisable to give a copy of your health directive to your primary doctor and to talk about it with the doctor.  That way, someone in your medical group knows your wishes in advance. 

Law 1990 requires that a hospital has to ask if you have a health directive but keep in mind the hospital can not force you to have one.  It is voluntary but the hospital has to ask you.

A Living Will is pretty much the same as a POA but it gives power to the doctor.  The POA gives power to whomever you state in the form. A living will only takes affect if you are terminally ill or completely incapacitated.  JJ recommends a POA instead of a living will. If you do not have a living will or POA, the doctor makes the decision.  Within our society, the doctor will do what it takes to cure the patient.  Only about 5% of patients actually survive resuscitation and only 2% of elderly. 

Within your health directive, you can put exceptions such as feeding tube or blood transfusion.  Be specific as you can.  You can also state that you would like to donate body parts as part of your POA.  JJ recommends you talk to your primary physician about choices; especially for younger healthier people.  Each person is different and each situation is different.  It is better to talk about it in advance.  A health directive requires two witnesses, does not need to be notarized.  If you get separated or divorced, void the POA and do another. 

Whomever you wan to name as your agent, be sure you trust them and talk about your wishes.  Heather recommends choosing someone who can be rational during an emotional situation.  Talk to your agent and ask, “What do you think?” so that you can be sure they understand your wishes and are able to carry them out.  JJ handed out a list of “tough questions” for you to discuss with your doctor, agent, lawyer, loved one, etc.  The handout came from Caring Connections at www.caringinfo.org. 

For health directives, there is a lot of gray area.  Talk to your physician and be medically aware.  Make decisions based on your health at the time. 

Finally, JJ brought us up-to-date regarding the new California Law implemented in January 2009:  Physicians Orders for Life Sustaining Treatment (POLST).  POLST is for the terminally ill.  By law, any medical system must follow such as hospital, ambulance, hospice, etc.  You can find detailed information at www.finalchoices.org.  The patient has to be terminally ill and the form has to be signed by a physician.  The patient can be as specific as he/she wants on the form. 

I hope this information is helpful.  I know I wrote alot, but its a big important topic.  Thanks to JJ for spending her time teaching us.  Remember, this info applies to you or to your parents.  Talk about these topics in advance so that it is easier for everyone if such an emotional situation arises.

Your gal,
Jules

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