June 7, 2017
End of Life Decisions- Advance Directives
No matter how much control we exert over our day-to-day lives, there may come a time in each of our futures when we are no longer able to make decisions for ourselves. When and if that happens, we need to have procedures in place that establish our preferences for certain treatment measures and appoint a trusted individual as a healthcare advocate.
Healthcare Proxy and Advance Directives
Generally, healthcare proxy appointments are taken care of through a legal document called a Durable Power of Attorney (POA) for healthcare. The POA document designates a representative to make healthcare decisions when the patient is either permanently or temporarily unable to make these decisions him- or herself. The decisions the proxy can make include withholding treatment, ending treatment or prolonging treatment of any medical condition that leaves the signor unable to make decisions. Some advance directives may include precise instructions to be followed in the event of specified medical incidents, with decisions for unspecified incidents left up to the healthcare proxy.
Advance Directives, often called a “Living Will”, on the other hand, sets out the patient’s declarations for medical treatment while he or she is in a terminal condition. That is, medical doctors have determined that there is no chance for survival and any measures taken would only prolong life and not ultimately save it. This can include the wish to be kept alive on life support or to not be resuscitated. Often, the living will is incorporated into the Healthcare POA but it can also be a separate document.
Both the POA for healthcare and the Advance Directives are legal documents but are not medical orders.
While the Health Care POA and Advance Directives are legal documents executed through an attorney, you can also fill out medical forms with your doctors called a POLST or MOLST form, depending on in which state you live. These stand for Physician Order for Life Sustaining Treatment (POLST) or Medical Orders for Life Sustaining Treatment (MOLST) form. This form is written by a physician and spells out instructions to medical personnel about the patient’s direct intentions for his or her treatment of a specific condition. It can include orders for end-of-life treatment, medical intervention, and orders to forgo treatment in certain circumstances. Like the living will, POLST/MOLST forms offer instructions for very specified situations and can be used by the whole medical community—including first responders, police and nursing home staff.
It’s important to have both advance directives and a POLST/MOLST form because while advance directives deal with hypothetical situations, POLST/MOLST forms give instructions for actual conditions that the patient has. Covering both ends of the spectrum is vital to ensuring the right treatment is offered.
Keep in mind that emergency medical staff will not wait to conduct CPR while your family member locates your legal or medical documents. If you already have an end-stage condition and know that you don’t want to be resuscitated in the event of an emergency, you may also want to consider a DNR bracelet.
At Kramer Wealth Managers, we can help you work with an attorney to help develop a plan for both financial and healthcare management decisions in the event you are incapacitated. To get started, contact us today.
This material is intended for informational purposes only and should only be relied upon when coordinated with individual professional advice. Neither FSC Securities Corporation, nor its registered representatives, provide tax or legal advice. As with all matters of a tax or legal nature, you should consult with your tax or legal counsel for advice.