How Can I Avoid the Skilled Nursing Facility?

When I ask our younger clients if they would like to complete a Health Care Directive, they often say no, stating that they are too young to need such a thing.  My response is always, What does age have to do with end-of-life decisions?  I can think of at least fifty examples of a young person ending up in the end stage of life and a family member having to make difficult decisions on their behalf.  Please, do not get lulled into complacency by thinking that age is protection.   I was in my doctors office recently when I noticed a large collage talking about the importance of having a Living Will or Health care Directive.  It emphasized the importance of having such a document, regardless of how old you are, reinforcing to me what our office always stresses to our clients and the community.  A Health care Directive is a document in which each of us tells our loved ones how we want the end of our life to be handled.  When we are in a permanent vegetative state, a permanent state of unconsciousness, or in the end-stage of a medical condition, all with no reasonable likelihood of any significant recovery, it provides answers such as Do you or do you not want to be resuscitated, to you want tube feeding, and appoints an agent that can serve to make decisions for you once you are unable to do so yourself.   One of the quotes on the doctors display said, End-of-life decisions should not be made at the end of life. Another said, For human beings, life is meaningful because it is a story, and in stories, endings matter.  Another said, I have an Advanced Directive, not because I have a serious illness, but because I have a family. Most of us know what medical decisions we want at the end of our lives, but have we communicated that to our family and loved ones?  When we meet with clients to help them create estate planning documents, we always point out to them that they have the option in their Health Care Directive of deciding what, if any, extraordinary measures they want to be taken at the end of their lives.  Once they select those options, we then come to perhaps the most difficult question of all: Should these instructions be binding on their families and providers, or do they want their loved ones to be able to override their decisions? Many opt for binding instructions so their loved ones do not have to make any of those difficult decisions in the heat of a devastating crisis. Either way, they have expressed their desire to guide their loved ones. Age is not a factor in creating a Health Care Directive; tragedy can strike unexpectedly at any age. The expense is low, but the peace of mind comes from knowing that when our time comes, we have already made those decisions for ourselves and our loved ones.  So, start the conversation with your family. Communicate your wishes to them and urge them to communicate theirs to you. Then, go to a qualified estate attorney and put those wishes on paper so that when your time comes, all involved, including your medical providers, know how you want the end of your life to be managed.  We offer FREE Workshops each week. You can also call our office at (717) 208-2899.

Durable Power of Attorney Documents: Why They Are IMPORTANT            Adults make decisions every day in life. You make financial choices regarding banking, paying bills and managing assets. You decide with whom to socialize and also where to live. You make health care decisions such as consenting to or refusing treatment, obtaining medical records and choose a course of treatment when ill. But what happens if you are too sick or disabled to manage these decisions? Before it is too late, have you prepared for someone to act on your behalf in the event of a crisis or if you are unable to manage decisions on your own? Adding a person to your bank accounts is not the answer because, among other reasons, it is dangerous and places your accounts at risk. Thankfully, there is a key legal tool for substitute decision making called a Durable Power of Attorney.             A Durable Power of Attorney means one person (the principal) gives legal authority to another (the agent or attorney-in-fact) to act on behalf of the principal. Durable means the agent can act when the principal loses capacity. A General Durable Power of Attorney permits your agent to manage any part or all of your financial affairs and property. A Health Care Durable Power of Attorney enables your agent to make any or all health care decisions if you become incapacitated.  A Living Will allows you to spell out your desired medical treatment regarding life-saving procedures, artificial nutrition and artificial hydration if you become unable to speak for yourself and have a terminal illness, or are in a persistent vegetative state.            Choosing the right person as an agent is a very important decision and should be given careful consideration. It should be someone who is trustworthy, honest, knows how to handle money and accepts the responsibility as an agent. This agent owes a duty to the principal called a fiduciary duty, which means the agent has to act in the principals best interest, in good faith and with care, and keep good records. Abuse by an agent or a breach of fiduciary duty can be punishable civilly and criminally. A principal has the control to revoke a Power of Attorney at any time.             If you become incapacitated and have not executed Power of Attorney documents, court proceedings called Guardianship and Conservatorship may be needed for someone to obtain decision making authority, which is both time consuming and costly. However, this may be avoided by planning in advance the execution of Durable Power of Attorney documents, which give you greater control and freedom of choice in an affordable manner. This article was written by Donna A. Schuyler, Attorney, who practices in the areas of estate planning, elder law, guardianship and probate. Donna Schuyler Law, PLLC; elderlawboise.com; Phone 208-344-1947

Throughout my twenty-year career in Estate Planning and Elder Law, I have always found pride in our team here at Bellomo & Associates. While we strive to do the very best for our clients, and although my pride in our firm has remained strong, I continued to feel as though we needed a key component. For a long time, I could not put my finger on exactly what this missing component may be until I met a friend who had begun to incorporate Life Care Planning into his firm. He explained how they had hired a Client Care Advocate to serve his clients better and after several conversations, I knew that this was exactly what we were missing. Providing our clients and families with clear answers that help them feel confident and knowledgeable about their decisions is a priority. There were few things more frustrating than being unable to provide the answers and support they needed when we got questions such as, How do I make sure that Mom is safe at home, or Is assisted living the right choice, or When should we consider a skilled nursing facility? We would refer to outside organizations to get families the help they needed, but I knew that ultimately, I wanted our firm internally equipped to help in this area. For nearly three years, our firm has been a member of the Life Care Planning Law Firms Association. Meg Motter, a licensed social worker, and our Client Care Advocate, brings thirty-five years of experience to the table. She helps families assess their current needs, answer any questions, help to provide the right course of action for their individual needs and wants, and so much more. Being able to add this piece to our firm has served to benefit both our clients and our staff. We are now able to support and advise in ways we could not have before. It is a gift to be able to care for our community in this way. If you are interested in learning more about Life Care Planning and specifically about how our Client Care Advocate can assist you and your family in putting together a plan, please call our office at (717) 208-2899, where we would love to help you.