Figure Out What You Want In Your Health Care Power of Attorney

power of attorney image, estate planning, Figuring out what you want: The following questions are designed to help you know yourself and to form a basis for discussion with the person you choose to execute your health care power of attorney.

  1. The pleasures of health: How essential are these capabilities to your happiness? (i.e. are they, vital, important, mildly important, not important)
    • Walking
    • Enjoying the outdoors
    • Eating, tasting
    • Drinking
    • Reading
    • Attending religious services
    • Listening to music
    • Watching television
    • Avoiding pain and discomfort
    • Being with loved ones
    • Touching
    • Being self-sufficient
  2. Fear factors: What are your biggest concerns about the end of your life?
  3.  

  4. Spirituality: How much of your comfort and support comes from religion? From personal prayer? From interaction with clergy?
  5.  

  6. End of life: If you had the power to decide, what would the last day of your life be like? Where would you be? With whom? What would you be doing? What would your final words be?
  7.  

  8. Assistance preferences worksheet: It is useful to discuss with your health care agent (and family members as well) the types of assistance you might want, should you need help, and to revisit this issue from time to time, because your preferences could very well change. Looking at each of the different scenarios spelled out below, think through what your preferences would be by asking yourself the following questions:
     

    1. Would I still want to live at home?
    2. Would I want caregivers hired to help me out in my home?
    3. Would I want to be taken to a rehab or assisted living center?
    4. Would I want family members to care for me?
    5. Would I want to live with one of my children?
    6. Would I want one of my children or a relative to live with me?
    7. Would I want my health care agent to make these decisions for me?
    8. Would my answers differ if my spouse were still living at home?
  9.  

    • If you were unable to drive a car
    • If you were unable to climb stairs
    • If physical problems prevented you from being able to dress yourself
    • If you had to use a wheelchair because you were no longer able to walk
    • If you were unable to leave your home
    • If your vision were seriously impaired
    • If your hearing were seriously impaired
    • If you needed kidney dialysis
    • If you needed chemotherapy
    • If you were in physical discomfort most of the time
    • If you could no longer control you bladder
    • If you could no longer control your bowels
    • If you could not think clearly

    The more you take the time now not only to think through whom you wish to choose as a Health Care Proxy, but also how that person would address these future scenarios, the more likely your wishes will be honored in the future.

    Make sure (especially if you are in a second marriage) that you have coordinated the person chosen as your Health Care Agent with the person named as your Trustee and/or your Attorney in fact under a Durable Power of Attorney so that the decisions about your medical care and how to pay for it are coordinated.

     

     

    Patricia Annino is a sought after speaker and nationally recognized authority on women and estate planning. She educates and empowers women to value themselves and their contributions in order to ACCOMPLISH GREAT THINGS in the world – and in so doing PROTECT THEMSELVES, those they love, and the organizations they care about. Annino recently released an updated version of her successful book, Women and Money: A Practical Guide to Estate Planning to include recent changes in the laws that govern how we protect our assets during and beyond our lifetime. To download Annino’s FREE eBook, Estate Planning 101 visit, http://www.patriciaannino.com.

New Risk to Family Cohesiveness: Impact to individual goals and life plans

New Risk to Family Cohesiveness: Impact to individual goals and life plans by the increasing lifespan of baby-boomer generation. Take the Steps Now to Put the Oxygen Over Your Own Face First and Decide Who Will Make Your Health and Financial Decisions If You Are Unable To Do So.

Another risk to family cohesiveness is the impact of increased lifespan to individual goals and life plans. Traditional risks included the illness, death or incapacity of a key family figure. In the family business and in the co-ownership of investment and commercial assets, the new risk is the increased work lifespan of the older generation, which results in the delayed succession of the middle generation. In essence, with the older generation in good physical and mental health and working far longer, the middle generation may in effect be knocked out of position and never get its day in the sun. By the time the older generation decides to move along, the individual goals and life plans of the middle generation may have been passed by; and the baton may be passed to the next generation. This new risk can be mitigated by intentional strategic planning and clear communication among all generations as to what the expectations are for the working lifespan and when the baton should/will pass.

Strategies to Mitigate the Risk of Increased Lifespan to the Ability to Control Your Own Health and Affairs and the Risk to Next Generation’s Life Plans:

1. Understand that estate planning is much more than what happens when you die; in an increasingly aging population that is living longer disability or incapacity planning is essential. Make sure you have in place the legal mechanisms so that you can be taken care of in the way you desire. It is important we all remember what the flight attendant says every time you board a plane- if the cabin pressure changes and the oxygen mask falls down put that mask over your own face first –it is only when you do put the mask over your own face that you will have the strength to protect others. In other words, protect yourself first.

2. Make sure the documents that will protect you if you are unable to care for yourself (Health Care Proxy and Durable Power of Attorney) are up to date and the way you want them.

A Health Care Proxy is a document in which you give the authority to an agent to make medical care decisions if he/she becomes unable to make them. The document can authorize everything, including minor and routine medical involvement, and can give the agent access to all your medical records. It can authorize someone to supervise your care if you are incapacitated, to consent to have you undergo certain types of treatment or to have them withdraw from treatment; to make hospital or nursing care arrangements; and to employ or discharge caregivers.   It can also empower the agent to make such major decisions as whether or not to terminate your life.

Under federal law, only one person at a time can be named as health care agent, but a Health Care Proxy can name a succession of people as alternatives.  This is done so that someone else can take over if, for instance, both spouses are in the same car crash, and neither one of them is in a condition to make medical decisions.  A copy of the Health Care Proxy should be given to your primary care physician and becomes part of the medical record.

As with a financial Durable Power of Attorney, in the health care area, couples usually designate each other to make medical care decisions and list their children as successor agents.  The health care agent must be someone they trust, who shares your value system, who is willing to perform the task and who has a clear understanding of what your preferences are.

It is prudent to update this document regularly, and, when it is updated, to make sure that the most recent contact information for those who have been designated to make health care decisions (including all telephone numbers and cell phone numbers) are current. If the Health Care Proxy was executed prior to The Health Insurance Portability and Accountability Act of 1996 (known as HIPPA) then the document must be updated. Under HIPPA, if you do not expressly waive your right to privacy in writing, hospitals and physicians do not have the legal right to speak with the health care agent or to release medical information to that person.

Choose a Health Care Agent. This important person may have different titles in different states (such as “health care agent,” “health proxy,” “patient advocate,”  “attorney-in-fact,” “health care representative,” or “health surrogate”), but the responsibilities are the same.  The official requirements for health care agents also vary from state to state, but most states simply specify that the person must be an adult (over 18) and must be someone who does not work for your health care provider or for an adult care facility in which you are residing.

It is good to designate both a health care agent and a successor agent (choice #1 and choice # 2), in case you need help at a time when the agent you have chosen is not available.  You should decide which child to choose, and if you have  no spouse or children, which friend or relative to choose.

In order for you to choose a health care agent wisely, it is helpful to establish a basis for evaluating potential candidates. That evaluation should include the following criteria:

1) Religious beliefs:  Since the concept of withholding artificial life supports runs contrary to the teachings of several religions – most notably the Catholic Church – it is helpful to find a health care agent who shares your  religious beliefs and your position on right-to-die issues.

2) Willingness to take on this task.

3)  Strength to act on your wishes and speak out on your behalf (even if faced with doctors, institutions, or family members who disagree).

4) Communication:  The agent is comfortable talking to you about sensitive issues and capable of listening to and absorbing what it is that you want.

5)  Separation:  This is a person who can differentiate between his/her feelings and yours and be able to do what you want done.

6)  Proximity: This is someone who either lives close or could travel quickly to be there when needed.

7)  Availability:  This person is likely to be accessible and capable of performing tasks well into the future.

8)  Personal Understanding:  He/she knows you well enough to intuit what is important to your.

9)  Negotiation skills:  He/she can mediate conflicts between family members, friends, and medical personnel.

Figuring Out What You Want: The following questions are designed to help you know yourself and to form a basis for discussion with the person you choose to execute your health care power of attorney.

1)  The Pleasures of Health:  How essential are these capabilities to your happiness?  (I.e. are they, Vital, Important, Mildly Important, Not important)

*Walking

*Enjoying the outdoors

*Eating, tasting

*Drinking

*Reading

*Attending religious services

*Listening to Music

*Watching television

*Avoiding pain and discomfort

*Being with loved ones

*Touching

*Being self-sufficient

2)  Fear Factors:  What are your biggest concerns about the end of your life?

3)  Spirituality:  How much of your comfort and support comes from religion?  From personal prayer?  From interaction with clergy?

4)  End of life: If you had the power to decide, what would the last day of your life be like?  Where would you be?  With whom?  What would you be doing?  What would your final words be?

5) Assistance Preferences Worksheet:  It is useful to discuss with your health care agent (and family members as well) the types of assistance you might want, should you need help, and to revisit this issue from time to time, because your preferences could very well change. Looking at each of the different scenarios spelled out below, think through what your preferences would be by asking yourself the following questions:

a) Would I still want to live at home?

b) Would I want caregivers hired to help me out in my home?

c) Would I want to be taken to a rehab or assisted living center?

d) Would I want family members to care for me?

e)  Would I want to live with one of my children?

f)  Would I want one of my children or a relative to live with me?

g) Would I want my health care agent to make these decisions for me?

h)  Would my answers differ if my spouse were still living at home?

-If you were unable to drive a car ___

-If you were unable to climb stairs ___

-If physical problems prevented you from being able to dress yourself ___

-If you had to use a wheelchair because you were no longer able to walk ___

-If you were unable to leave your home ___

-If your vision were seriously impaired ____

-If your hearing were seriously impaired ___

-If you needed kidney dialysis ___

-If you needed chemotherapy ____

-If you were in physical discomfort most of the time ___

-If you could no longer control you bladder ___

-If you could no longer control your bowels ___

-If you could not think clearly ___

The more you take the time now not only to think through who you wish to choose as a Health Care Proxy, but also how who would want various future scenarios to be addressed by that person, the more likely your wishes will be honored in the future.

Make sure (especially if you are in a second marriage) that you have coordinated the person chosen as your Health Care Agent with the person named as your Trustee and/or your Attorney in fact under a Durable Power of Attorney so that the decisions about your medical care and how to pay for it are coordinated.

What challenges are you facing in your estate individual goals and life plan?  Share your stores in the comment section below.

Patricia Annino is a sought after speaker and nationally recognized authority on women and estate planning.  She educates and empowers women to value themselves and their contributions in order to ACCOMPLISH GREAT THINGS in the world – and in so doing PROTECT THEMSELVES, those they love, and the organizations they care about.  Annino recently released an updated version of her successful book, Women and Money: A Practical Guide to Estate Planning to include recent changes in the laws that govern how we protect our assets during and beyond our lifetime.  To download Annino’s FREE eBook, Estate Planning 101 visit, http://www.patriciaannino.com.

Put the Oxygen Mask Over Your Own Face First! Choosing a Healthcare Proxy!

Why choosing a healthcare proxy is a far more important decision than who will receive assets at the time of your client’s death.

The most important focus of estate planning should not be what happens when your client dies. It should be what happens if that client loses the ability to make their own decisions. Make sure your client has put in place the legal mechanisms so that they can be taken care of in the way the client desires. It is important we all remember what the flight attendant says every time you board a plane — if the cabin pressure changes and the oxygen mask falls down, place the mask over your own face first. Similarly, it is only when your clients place their masks over their own faces, that they will have the strength to protect others. In other words, your clients should protect themselves first.

A Healthcare Proxy is a document in which your client gives the authority to an agent to make medical care decisions if they become unable to make them. The document can authorize everything — including minor and routine medical involvement — and can give the agent access to all the client’s medical records. It can authorize someone to supervise your client’s care if they are incapacitated, to consent to have them undergo certain types of treatment or to have them withdraw from treatment; to make hospital or nursing-care arrangements; and to employ or discharge caregivers. It can also empower the agent to make such major decisions as whether or not to terminate your client’s life.

Under federal law, only one person at a time can be named as healthcare agent, but a Healthcare Proxy can name a succession of people as alternatives. This is done so that someone else can take over if, for instance, both spouses are in the same car crash and neither one of them is in a condition to make medical decisions. A copy of the Healthcare Proxy is given to the primary care physician and becomes part of the medical record.

As with a financial Durable Power of Attorney, in the healthcare area, couples usually designate each other to make medical-care decisions and list their children as successor agents. For clients without spouses or children (or who are looking for alternative possibilities), I stress that their healthcare agent be someone they trust, who shares their value system, who is willing to perform the task and who has a clear understanding of what your clients’ preferences are.

It is prudent to update this document regularly and, when it is updated, to make sure that the most recent contact information for those who have been designated to make healthcare decisions (including all telephone numbers and cell phone numbers) are current. The document must be updated if the Healthcare Proxy was executed prior to The Health Insurance Portability and Accountability Act of 1996 (known as HIPPA). Under HIPPA, if your client does not expressly waive their right to privacy in writing, hospitals and physicians do not have the legal right to speak with the healthcare agent or to release medical information to that person.

Choosing a Healthcare Agent

This important person may have different titles in different states (such as “healthcare agent,” “health proxy,” “patient advocate,” “attorney-in-fact,” “healthcare representative” or “health surrogate”), but the responsibilities are the same. The official requirements for healthcare agents vary from state to state, but most states simply specify that the person be an adult (over 18) and must be someone who does not work for your client’s healthcare provider or for an adult-care facility in which your client is residing.

It is good to designate both a healthcare agent and a successor agent (choice #1 and choice # 2), in case your client needs help at a time when the agent they have chosen is not available. Your client has to decide which of their children to choose and if they have no spouse or children, which friend or relative to choose.

In order for your clients to choose a healthcare agent wisely, it would be helpful for them to establish a basis for evaluating potential candidates. That evaluation should include the following criteria:

  1. Religious beliefs: Since the concept of withholding artificial-life supports runs contrary to the teachings of several religions — most notably the Catholic Church — it is helpful to find a healthcare agent who shares your client’s religious beliefs and their position on right-to-die issues.
  2. Willingness to take on this task.
  3. Strength to act on your client’s wishes and speak out on their behalf (even if faced with doctors, institutions or family members who disagree).
  4. Communication: They are comfortable speaking with your client about sensitive issues and capable of listening to and absorbing what it is that your client wants.
  5. Separation: This is a person who can differentiate between their feelings and your client’s and is able to do what your client wants done.
  6. Proximity: This is someone who either lives close or could travel quickly to be there when needed.
  7. Availability: This person is likely to be accessible and capable of performing tasks well into the future.
  8. Personal Understanding: The person knows your client well enough to intuit what is important to them.
  9. Negotiation skills: The person can mediate conflicts between family members, friends and medical personnel.

Figuring Out What You Want
The following questions, which I suggest you pose to your clients, are designed to help your client know themselves and to form a basis for discussion with the person your client chooses to execute their healthcare power of attorney:

  1. The Pleasures of Health: How essential are these capabilities to your happiness? (i.e. are they vital, important, mildly important or not important):
    1. Walking
    2. Enjoying the outdoors
    3. Eating, tasting
    4. Drinking
    5. Reading
    6. Attending religious services
    7. Listening to music
    8. Watching television
    9. Avoiding pain and discomfort
    10. Being with loved ones
    11. Touching
    12. Being self-sufficient
  1. Fear Factors: What are your biggest concerns about the end of your life?
  2. Spirituality: How much of your comfort and support comes from religion? From personal prayer? From interaction with clergy?
  3. End of life: If you had the power to decide, what would the last day of your life be like? Where would you be? With whom? What would you be doing? What would your final words be?
  4. Assistance Preferences Worksheet: It is useful to discuss with your healthcare agent (and family members as well) the types of assistance you might want, should you need help and to revisit this issue from time to time, because your preferences could very well change. Looking at each of the different scenarios spelled out below, think through what your preferences would be by asking yourself the following questions:
    1. Would I still want to live at home?
    2. Would I want caregivers hired to help me out in my home?
    3. Would I want to be taken to a rehab or assisted-living center?
    4. Would I want family members to care for me?
    5. Would I want to live with one of my children?
    6. Would I want one of my children or a relative to live with me?
    7. Would I want my healthcare agent to make these decisions for me?
    8. Would my answers differ if my spouse were still living at home?
If you were unable to drive a car ___
If you were unable to climb stairs ___
If physical problems prevented you from being able to dress yourself ___
If you had to use a wheelchair because you were no longer able to walk __
If you were unable to leave your home ___
If your vision was seriously impaired ____
If your hearing was seriously impaired ___
If you needed kidney dialysis ___
If you needed chemotherapy ____
If you were in physical discomfort most of the time ___
If you could no longer control your bladder ___
If you could no longer control your bowels ___
If you could not think clearly ___

Conclusion

The more your clients take the time now not only to think through who they wish to choose as a Healthcare Proxy, but also how they would want various future scenarios to be addressed by that person, the more likely their wishes will be honored in the future.

Patricia Annino is a sought after speaker and nationally recognized authority on women and estate planning.  She educates and empowers women to value themselves and their contributions in order to ACCOMPLISH GREAT THINGS in the world – and in so doing PROTECT THEMSELVES, those they love, and the organizations they care about.  Annino recently announced the release of an updated version of her successful book, Women and Money: A Practical Guide to Estate Planning to include recent changes in the laws that govern how we protect our assets during and beyond our lifetime.  Annino’s book is an exhortation, resource and trusted companion for women in all facets of life.  To purchase the book visit:  http://amzn.to/hOHuEV or for more about Annino, visit: www.patriciaannino.com

 

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