The short answer is no, they are not the same. A DNR stands for a DO NOT RESUSCITATE order. A Living Will is a completely different document that is used during a very different time.A DNR should be entered into at your doctors office or in the hospital, not at your local estate planning and elder law attorneys office.Typical estate planning documents that an attorney will assist you with would include a financial and medical power of attorney as well as a Last Will and Testament and maybe a Trust of some type. The confusion often lies in the fact that in a medical power of attorney, you will often see a Living Will as a part of the document.This is collectively known as an Advance Healthcare Directive if medical power of attorney and living will are together in one document. The Living Will does not kick in until the individual is end-stage medical. While there is a very long medical definition for this term, I simply like to state it as when two qualified physicians put in writing that there is no realistic hope of recovery and that you will always remain vegetative, comatose, permanently unconscious, and terminally ill. A medical power of attorney, living will, or advanced health care directive are often documents that are obtained from your estate planning and elder law attorney and not from your health care provider.On the other hand, a DNR or DO NOT RESUSCITATE order is intended to let emergency and other medical professionals know whether or not they should resuscitate you. Methods often used for resuscitation would be things such as defibrillators, breathing tubes, ventilators, CPR, and other invasive techniques.The DO NOT RESUSCITATE order comes into play when the heart has stopped beating or the person has stopped breathing. The medical power of attorney, on the other hand, comes into play when the person simply cannot answer questions for themselves. That could be for numerous other reasons, such as being under sedation or incapacitated, unconscious due to an accident, or unable to speak.Certainly, it does not necessarily mean that the heart has stopped beating or that you have stopped breathing. The Living Will does not kick in until the end of life, but the heart is often beating, sometimes due to heroic and lifesaving measures, but the DNR will prevent those heroics if that is your wish.We truly believe that it is imperative for you to talk to your estate planning and elder law attorney about the estate planning documents as outlined above as well as discuss with your doctor about a DNR order. While you are discussing the DNR order, we would also recommend that you have a conversation with your healthcare professional about a POLST (Physicians Order of Life-Sustaining Treatment). These are documents that will be obtained directly from your doctor and they will be able to assist you with the nuances of how they work.We hope this article provided insight into the definition of a DO NOT RESUSCITATE order and the difference between a medical power of attorney and a Living Will. If you would like further information about these items, contact our office. Wed be more than happy to assist you. Call us at (717) 845-5390.
With stores putting out holiday decorations well before Halloween, it is hard to avoid the hype surrounding the holiday season.For most people, it is an anticipated time of year with traditions, memories and family gatherings. But for older residents, these same reasons may result in the blues, making the holidays a challenging time. Sometimes beloved traditions and family gatherings become out of reach as we age and may be isolated from friends and families. Holidays may remind us of the passing of time, who is missing in our lives and who is not nearby. The loss of holiday traditions and gatherings often changes the way we feel about the holidays. Sometimes reminiscing on traditions that have gone can fuel feelings of loneliness.An AARP study found that 31% of respondents felt lonely during the holiday season. Additionally, another 41% worried about a family member or friend feeling lonesome. Whats more, more than 12 million Americans over age 65 live alone, according to the American Psychological Association. As children grow up and move away, neighborhoods change, and friends pass, the opportunities for close connections sometimes become limited. Financial constraints and loss of independence and mobility can change looking forward to the holidays to dreading them. To help avoid the holiday blues, here are some steps you can take to restore holiday joy. Find new ways to connect, such as video chat and email. Write letters, cards and call. You do not have to wait for family members to reach out. Take initiative. Connecting with others is one of the best ways to relieve loneliness. It is heathy to feel sadness about missing family and friends. It is important to acknowledge your feelings. Volunteer and help others. If you are able, you can help with daily tasks that may seem overwhelming or share a meal. If you are feeling lonely, maybe your neighbor is, too. Being available for someone else is good medicine. Be kind to yourself. Continue your wellness routines and healthy habits. Rethink how you do things this season. Joy is not limited to the last two months of the year! Every day can be treated as a holiday! Consider trying a new activity or hobby or teach someone something you are good at. Limit screen time. A constant diet of bad news creates anxiety. Resolve to make the best of the holidays but adjust your expectations and adopt realistic goals. While the holidays may look different over time, they can still be meaningful. The most important thing to make someone feel special this season is to simply spend time with them. If you cannot participate in person, FaceTime or Zoom also work.Here are other ways you can help others (and yourself) find joy in the holidays and help banish the holiday blues: Share your traditions with others and enjoy theirs. Reflect about past holidays as you unpack cherished decorations. Listen to the stories of others and ask about special pieces. Make a conscious effort to be available for those who might be feeling isolated. Plan a regular call or visit or reach out with a video call or old-fashioned letter. For anyone who might be struggling with holiday loneliness, provide a comfortable space for them to talk. Save judgments or problem solving and simply have a genuine conversation. As you plan your celebrations, look for ways to be inclusive. Extending an invitation may not be enough to make others feel included. Being with a crowd of strangers who have little in common can still feel very lonely. Being recognized and honored goes a long way in combating loneliness. Be open to asking about and including favorite memories such as treasured decorations, traditional treats and meaningful music. Religious organizations often offer extra social and/or spiritual support. Just talking with someone can go a long way. Bring or send familiar treats that represent holiday customs for elders to enjoy and share. Often, holiday blues are temporary. However, if symptoms last for more than two weeks, they can indicate clinical anxiety or depression. According to the National Institute of Mental Health (NIMH), socially isolated older adults are at higher risk for depression.It may be time to seek help if you or someone you love is experiencing any of these common symptoms of depression: Feeling so down you cannot shake it off Too little or too much sleep, or interruptions through the night Changes in appetite; eating more or less than usual Difficulty concentrating Lack of interest in the things that typically make you happy Irritability Lack of interest in socializing or engaging with others. Plan to look for and spread cheer this season, but if the holiday blues linger well beyond the season, discuss your symptoms with your primary care provider.ABOUT THE AUTHOR Courtney L. Whitt, Ph.D. is Director of Behavioral Health at Healthcare Network, which offers behavioral health services as a routine part of comprehensive care and traditional counseling services. Healthcare Network provides quality primary care services for children and adults in locations throughout Collier County. To learn more or make an appointment, please call 239.658.3000 or visit HealthcareSWFL.org.
Many people believe that having a Will is all they need, and they dont need an estate plan. Over the years we have worked with many families who only had a Will, and no provisions for needing care in a nursing home. As a result, the healthy spouses financial security was neglected and the family went broke.Many of my clients who want to protect assets from long term care costs, own their houses in an asset protection trust. These are the top 6 reasons why our clients decide to use this trustWhile Your Parents Or Grandparents Didnt Have An Asset Protection Trust, They Didnt Often Need Long Term Care. They likely had family members nearby caring for them.Statistically speaking, your odds of needing long term care are increasing. Estimates point to two out of three people who will need long term care in nursing homes in their 80s. Nursing homes currently cost $15,000 a month, and they will cost even more 20 years from now. Asset protection is important, to avoid losing everything to long term care costs.Estate Planning Is Not Just About Answering The Question Of Who Gets Your Stuff When You Pass Away. Its also about planning for what happens if you get really sick. Weve all been paying into this government system with the promise that when we turn 65, we will have healthcare. Unfortunately Medicare doesnt pay for the single biggest health care expense that seniors face, which is custodial long term care in a nursing home.If your health issue is acute, such as a heart attack, or you need surgery, or have cancer, and require acute care in hospital, Medicare will cover the costs of treatment. Whether my spouse and I are financially secure in our retirement years, depends on the healthcare issue either of us will have. This is often beyond our control, but what we can do is to prepare for all eventualities, by protecting our house with a trust. Medicaid Is The Only Government Payment Source For Long Term Care, But The Rules Are Broken. If youre a single person going to a nursing home, youre allowed to own up to $8,000 of assets, a house and car. A couple with $100,000 in a retirement account, must spend that money on care in the nursing home. Once the money is gone you can apply for Medicaid benefits. However, your monthly income is used to pay for care, and you are only allowed to keep $45 a month for all your personal needs. We have a situation where seniors are going broke before they get Medicaid benefits. Theyre allowed to own a house but if they have no money, they cannot pay property taxes, utility bills or maintenance costs.Assuming your child is a power of attorney, they may sell your house to avoid paying the taxes and bills. However, this means you will now have cash which will result in you losing your Medicaid benefits. Not only do you lose your house, but you will need to spend the money on care. When you are broke, you are eligible for Medicaid benefits again. It is not obvious in the Medicaid rules that you will lose the house. The problem is that it becomes financially impossible to keep the house. Putting your house in a trust will protect it from being lost to Nursing home costs.If The House Is Left To Your Child In Your Will, By Paying The Taxes And Keeping The House, Does Not Guarantee That They Wont Lose The House. When somebody who passes away was on Medicaid, the executor is forced to sell the house. The proceeds are used to pay the state for the care the senior received in the nursing home. This is known as the Estate Recovery Program, and the claim in Pennsylvania is limited to someones probate estate. This means that if the assets go through the Will, it will be a probate case, and the state will have a claim against the house.If your house is in the asset protection trust when you pass away, the state cant get your house while its in the trust. Your kids will inherit the house if you go to a nursing home, or you pass away.Your Kids Will Receive Their Inheritance Faster If Your House In An Asset Protection Trust.We dont have to wait 12 months to make the distribution of the inheritance to the children. The distribution process usually happens after four to five months. This is because we dont have to pay creditors. Usually, in probate cases, creditors can make a claim a year after the person has passed away. Once the creditors are paid, distributions are made to the heirs.When Your House Is In An Asset Protection Trust, The Only Thing You Would Have To Give Up Is Having Access To The Home Equity. However, if you have money in the bank, you wont need home equity. Giving up access to the equity, means the nursing home cant access it either. You have protected your house, so you wont lose it. If you or your spouse need long term care, the healthy spouse can still live at home.There are opportunities to protect yourself, and thats what we teach you at our Three Secrets Workshop. If you want to protect your assets, and you want the best plan for your family, we can help you! After attending our Three Secrets Workshop, most of our clients have participated in our Blueprint Workshop. As a result, many of our clients chose to work with us and put their houses into a trust.Register to attend one of our upcoming free workshops. Our workshops are offered various dates/times and locations throughout the Greater Pittsburgh Area, call 724-564-6615 to learn of upcoming Workshops and to register. We will teach you about the estate planning tools you can use to do some good planning.