end of life planning

Having the Final Say

Do you remember Terri Schiavo, who at age 27, suffered a cardiac arrest that led to brain damage due to lack of oxygen? Her case went to the Supreme Court because she lacked the end of life legal documents that made her wishes clear. No one wants to believe anything bad could happen to them, but it can and often does. You can avoid some of the pain of this type of situation by executing the proper legal documents.

Legal Matters

Take Inventory–

  • Living Will – specifies that extraordinary efforts not be used to prolong my life should I become terminally ill or unable to regain a meaningful quality of life;
  • Durable Medical Power of Attorney – A Durable Power of Attorney authorizes a designated person [attorney-in-fact] to continue to act for him or her after he or she becomes incapacitated; the legal document must contain the words, “This Power of Attorney shall not be affected by my disability” or “This Power of Attorney shall become effective upon my disability” or something along similar lines.
  • Power of Attorney – specifies the legal right to make non-medical-related decisions for an incapacitated person, are necessary;
  • Advanced Directives – a combination of the above documents;
  • HIPPA Release Form – states that I understand the materials or data I am requesting will be released without protection by Federal Privacy Protection Regulations and includes a “hold harmless” statement.
  • Do you have an executed Durable Medical Power of Attorney?
  • How many copies do you have and where are they stored?
  • Who else has a copy?
  • Are you confident your appointed healthcare agent will act as you wish rather than as they wish?
  • Have you discussed your end-of-life wishes with this individual?
  • Do you have a Living Will?

end of life planning

  • Have you specifically addressed the issue of pain management as we must assume the pain stimulus is still present? (reference Oxford Textbook of Palliative Medicine, 2nd ed. 1999, pages 982-989)
  • How many copies do you have and where are they stored?
  • Who else has a copy?
  • Does your primary care physician know how to reach your appointed healthcare agent?
  • Does your primary care physician have a copy in your file?
  • Have you discussed your end-of-life wishes with your primary care physician?
  • Have you discussed end-of-life wishes with your family and loved ones?
  • Do you have an executed HIPPA Release Form?
    • If you are a DNR (“Do Not Resuscitate”), is your form in order, executed by your doctor and posted in a prominent place in your home? (the refrigerator door is commonly used)
    • How many copies do you have and where are they stored?

Powers of attorney for healthcare decision making are a valuable tool to ensure that your medical wishes are carried out if you become incapacitated and unable to express your desires. Unpleasant decisions, but this document relieves your loved ones from the emotional burden of having to make those decisions by themselves.

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