Adams Miller LLP

Sometimes an elderly person who gets ill would rather not be saved, but the decision not to save someone can be difficult for families and doctors to make.

An 87-year-old man named Herb Lee went out to eat and may have gotten something bad. He became extremely ill and had to be rushed to the hospital.

Lee had previously watched his wife suffer from cancer. He was determined that he did not want to suffer like she did.

Lee had made it clear to his family that should he ever become seriously ill, he did not want any efforts made to prolong his life. He did not want respirators or feeding tubes. He did not want to be resuscitated.

However, that put the medical staff in a bad situation,  since they could only give Lee half treatments that left him suffering in great pain.

The doctor who eventually had to make the decision about what to do, was Lee's grandson-in-law. He wrote about the experience in the Washington Post article titled "I saved an old man's life. He didn't want it."

Ultimately, the grandson-in-law decided to do what was necessary to save Lee's life, so he would not linger in great pain. Lee lived a normal life for several years after that and was able to enjoy many family events.

The grandson-in-law eventually asked Lee if, in hindsight, he would want his life saved if he had to do it all over again.

Lee said that he would not.  An advanced directive for healthcare is designed to prevent these very dilemmas when they occur.

There are no right answers about what should be done in these types of situations. Families and doctors should take into consideration the wishes of elderly patients.  However, that does not always settle the matter.

Reference: Washington Post (July 29, 2017) "I saved an old man's life. He didn't want it."

Understanding Alzheimer's Disease - Pell City Elder Law and Estate Planning Law Firm

Alzheimer's disease is a frightening thing to think about getting for anyone. Understanding what we know about the disease can help lessen that fear, but one of the most important things to understand about Alzheimer's is what we still do not know about it.

Everyone knows what the end stage of Alzheimer's disease is like. Thinking about getting it can give anyone the chills. What are not as well known are the early stages of the disease and the current state of scientific understanding about them.

Recently, the New York Times attempted to explain that in "What Is Alzheimer's Disease?"

Anyone who has ever lost her car keys and wondered if she was getting Alzheimer's can rest easy. Minor lapses of memory are common and often increase with age. They are not necessarily a sign Alzheimer's is present.

Alzheimer's is diagnosed by assessing memory loss that regularly impedes basic life functions. Beyond that, however, the current scientific knowledge about the disease is somewhat lacking. It is uncertain what causes the disease in the majority of cases.

A genetic marker that has been shown to increase the likelihood of Alzheimer's is only present in a minority of patients. Medications are available to treat Alzheimer's, but they only slow its rate of progress for a little while. There is currently no cure.

Even though there is still a lot to learn about Alzheimer's disease there is something that everyone can do about it. Everyone should get a health care power of attorney and a durable general power of attorney so that if they are unfortunate enough to get Alzheimer's a trusted person can have legal authority to handle their affairs.  There are other strategies that you can put into place as part of a comprehensive estate plan in Alabama to deal with the potentially devastating effects of Alzheimer's disease.  

Reference: New York Times (April 30, 2016) "What Is Alzheimer's Disease?"

If you have an aging parent or loved one, click the link to get a free copy of our Caregivers Guide which lays out the questions to ask and steps to take if you will become a caregiver.  You can also register for one of our free estate planning workshops by calling us at 256 251-2137 or visiting events.adamsmillerlaw.com/Workshops.html.

3 Estate Planning Documents Everyone Should Have

Estate Planning is not just for the wealthy.  Everyone should have these three documents no matter how much they have.  Without having these 3 documents in place as part of a plan, you leave a heavy burden on your family when something happens to you.  Watch the video to learn more.

3 Estate Planning Documents Everyone Should Have

 For more information, order a free copy of our report The 7 Biggest Mistakes People Make in Their Estate Plan by clicking the link.  You can also register for a free estate planning workshop by calling us at 256-237-3339 or visiting www.AnnistonEstatePlanning.com.

Former NBA Star Could have Future Ex-Wife Making Medical Decisions

Lamar Odom and Khloe Kardashian may appear to be split on reality TV, but on paper, their divorce is not final. That could leave the former NBA player's estranged wife with the role of making medical decisions for him. Odom, who has an address in Henderson, and Kardashian both signed off on their divorce in July, but the case has not even been assigned to a judge in the backlogged Los Angeles court system. A court spokeswoman said that a final resolution can take months. The judgment packet has been received and awaits a review by a judicial officer, and there are no hearings scheduled at this time, said Mary Eckhardt Hearn, director of public information for Los Angeles Superior Court. Former L.A. Lakers forward Odom was found unconscious at a brothel in Nye County. He remains at Sunrise Hospital and Medical Center in Las Vegas, according to several people who have visited him and spoken to the media afterward. But officially, Odom was not registered as a patient at Sunrise — a status that was his right through federal laws designed to shield patient information from the public. Anyone who called asking about Odom was told his information did not appear on the hospital registry, the same answer someone would get if he wasn't a patient there at all. "Only information that comes from a hospital spokesperson is considered legitimate information," said Stacy Acquista, a marketing executive with the Far West Division of HCA, the company that owns Sunrise.

A story in the Las Vegas Review-Journal, "With open divorce case, Khloe Kardashian could be making Lamar Odom's medical decisions,"explains just who is allowed to make medical decisions.

Nevada law spells out who will make medical decisions for patients who become incapacitated, which are sometimes called substituted judgment statutes. In the Silver State, spouses or registered domestic partners are first in line. If Odom does not have advanced directives, legal documents stating his health care choices, Khloe would be the one to make these decisions.

There are several types of advanced directives, including living wills and medical powers of attorney. These estate planning documents let individuals make their wishes known to family, friends, and health care professionals to avoid confusion in cases like Odom's.

Odom may have an advanced directive which would apply. By signing an advanced directive, you select the individual you want making your decisions for you.

The Nye County Sheriff's Office stated that Odom had been using cocaine and sexual performance enhancers in the days prior to being discovered unconscious at Love Ranch brothel in Crystal, about 90 minutes outside of Las Vegas. (Nevada is the only state with legalized prostitution, and county regulations say that business licenses can be revoked if brothels have drug issues).

In addition to his 2009 and 2010 NBA Championships with the LA Lakers, Odom is known for being part of the Kardashian family. Khloe filed for divorce in 2013 after four years of marriage.

Reference: Las Vegas Review-Journal (October 18, 2015) "With open divorce case, Khloe Kardashian could be making Lamar Odom's medical decisions"

Come on, Kids! Start Estate Planning!

If you think estate planning is for only the elderly or wealthy individuals, think again. Everyone has collected some stuff, what professionals like to call assets, possessions, investments — and don’t forget the liabilities (debt), like student loans, car or credit card balances. Even if you do not think you have much, it’s important to have a plan for what you do have, and what you want to do with the stuff after you pass away. There are some basic documents everyone should consider having. If you do not complete the appropriate documents, the state you reside in has its own statutory regulations and procedures to dispose of your property. If you do not plan right, you not only surrender your control over your things, but your things may not go to the party you want — such as a partner, life partner, friend or charity. So what can you do?

The website credit.com addresses important tasks that everyone needs to address, in “Why Everyone Needs a Will (I'm Talking to You, Millennials).”

Designate Your Beneficiaries. You can list your beneficiaries on your retirement accounts (401(k), 403(b), IRA, etc.) when you complete the application. Likewise, you can designate your beneficiaries on bank and investment accounts by setting up a TOD (Transfer on Death) designation. It’s easy to do and costs nothing. Remember that beneficiary designations supersede any wish you make in a will.

Draft Your Will. A will is a legal document and is a written statement of your intentions, including where you want your possessions to go and how you want the orderly disposition to happen. See an attorney, as each state has different laws.

State Your Health Care Wishes. Use a Health Care Proxy to let someone you trust make health care decisions and carry out your health care wishes in the event that you are incapacitated.

Sign a Durable Power of Attorney. This form allows someone you trust to make financial decisions in the event you are unable to do so. There is a huge difference between a limited power and durable power of attorney. Talk to your estate planning attorney about these documents.

An experienced estate planning attorney can spend time with you and review your estate issues, complete a will, health care proxy, durable power of attorney, and check beneficiaries, as well as any tax issues. Use an attorney who specializes in this area to ensure your wishes are properly documented and you achieve what you are trying to accomplish, now and in the future.

Reference:  credit.com (September 11, 2015) “Why Everyone Needs a Will (I'm Talking to You, Millennials)”

Talk About End-of-Life Planning Now!

When you dare to think ahead to the last days of your life (if you dare to think about that), what do you imagine? If you are like 70 percent of Americans, you dream of spending your final days at home, in peace and comfort, surrounded by loved ones who care for you compassionately until your last breath. But in reality, the CDC reports that 70 percent of Americans actually die in a hospital, nursing home or long-term care facility. Why are so few people able to realize their end of life dream?

The two biggest reasons that many people do not have the death they wish: many do not plan ahead, nor do they make their wishes known, according to The Huffington Post’s “5 Reasons to Plan Ahead for the End-of-Life.” No one likes to talk about death, so we put off conversations that would let others know of our desires. And most of us don't take the time to work on required documents to establish a legal basis for our wishes.

There are some very compelling reasons to overcome your fears and get going on this. And it's never too early to start planning: remember there are no guarantees for the future.

Five reasons to start planning for the end-of-life now:

1. Preserve Your Financial Legacy. According to a recent survey, roughly 41% of Baby Boomers don't have a will—and 50% of all Americans die without a legal will in place. If you fall into either of these groups, it means that the probate court will decide how and to whom your assets may be distributed among your heirs, according to the state law. If you have no estate plan and don’t discuss a strategy with an experienced estate planning attorney, you may give a significant portion of your estate to taxes. Protect your assets and distribute them to your heirs by creating an estate plan.

2. Provide for Your Minor Children. That same survey found that 55% of Americans with children don't have a will and have failed to designate a legal guardian for their children under 18. Here again, the court may decide who will receive custody of the children if both parents die—a traumatic event for everyone. Take the necessary steps now to name a guardian and protect the welfare of your children.

3. Get the Care You Want at End-Of-Life. Another survey continues the bad news: less than a third of Americans have completed advance Directives—instructions to health care professionals on the type and extent of care to be delivered in a life-threatening situation. Without this, you stand to receive aggressive, full treatment in a crisis, which may not be what you really want. Complete a Health Care directive with instructions for your health care at the end-of-life. This will save energy, resources, and create less stress for your loved ones. Make sure the documents are in your home and easily accessible, should an emergency arise.

4. Be Remembered as You’d Like. If you would like to be memorialized in a certain way, you need to make your wishes known to your family in order to have them executed. Yes, you should stage-manage your own funeral! Write down the arrangements in advance for your own funeral and leave detailed instructions.

5. Alleviate stress for your family. There’s plenty of grief with the loss of a loved one without adding conflicts about handling financial, health care, or after-death arrangements. Communicate your wishes clearly now with detailed instructions and draft the required legal documents to ensure your desires are met.

Talk with a qualified estate planning attorney and make those plans now.

Reference: Huffington Post (September 4, 2015) “5 Reasons to Plan Ahead for the End-of-Life”

Special-Purpose Trusts for the Mentally Ill and Those Suffering from Addiction

It was the summer between her sophomore and junior year at the University of Wisconsin-Madison when Patti Sacher’s daughter Keisha had a breakdown. She had taken LSD at a Grateful Dead concert one weekend in 1989. When Mrs. Sacher called to check on her that Monday, Keisha wasn’t making sense. “She was hearing voices after the weekend, and her thoughts were disjointed,” Mrs. Sacher said of her daughter, who was then 19. “We couldn’t understand what she was talking about.” Keisha became more involved with drugs during the fall. By January, her parents were receiving alarming phone calls from their daughter’s friends. Keisha ended up being hospitalized that winter, but she wouldn’t come home. She was an adult, and her parents had no legal power over her. After a year, she acquiesced and returned to New York City.

The New York Times recently published “For Parents With Troubled Adult Children, Financial Hurdles Abound,”which talks about what can be done to help a loved one stricken with mental illness. It noted that there are many painful and emotional issues in situations of mental illness and addiction that affect children, but also there are financial plans that parents can use, such as a Special-Purpose Trust, that provides care for the suffering child and peace of mind for the parent.

A special-purpose trust is different from a special-needs trust, which is frequently implemented to pay for additional needs of those receiving government benefits where the government has strict restrictions on the recipient’s assets. A special-purpose trust can be used to provide children more of the life they might have enjoyed without mental illness or addiction, and it allows the parents the flexibility to make changes with the distributions.

Special-purpose trusts are more complicated to establish than regular trusts because of the powers they give to the trustees and the restrictions they place on distributions. However, the toughest part of creating a special-purpose trust is getting parents to accept them as necessary: parents must first acknowledge that their children will never fully recover.

Parents are advised to set out some very specific criteria for distributions into trust documents, for example, staying on medication or staying sober for a certain period of time. In addition, those with a family history of mental illness and addiction issues should get a power of attorney and health care proxy for children over 18 who are away at college. In the event that something happens to their child, the parents will have access to medical records and will be able to help.

Work through these issues with an experienced estate planning attorney to make sure that you are doing your best to help your child.

Reference: New York Times (August 28, 2015) “For Parents With Troubled Adult Children, Financial Hurdles Abound”

Estate Planning Lessons in the Death of Whitney Houston’s Daughter

Bobbi Kristina Brown’s tragic death offers a number of poignant end-of-life lessons for parents, young adults, and seniors alike. First and foremost, health and legal experts say Brown’s death spotlights the need for establishing written advance medical directives as early as age 18. These include the designation of a healthcare proxy, a living will, and a “HIPAA Release,” clearing the way for a healthcare agent to communicate with providers about the care of a patient who is in a coma or otherwise incapacitated. Such planning is typically viewed as a concern for older Americans, but younger people — like Brown — can also find themselves unable to communicate their end-of-life wishes as a result of accidents, brain injuries, infections, or other illnesses.

Last week’s NewsMax article, titled “End-of-Life Lessons of Bobbi Kristina's Tragic Death,” suggests that parents of college-bound freshman (18 and older) should think about having a healthcare designation, a living will, HIPPA release, and durable power of attorney prepared for the ‘new’ adult so that parents can act on behalf of their kids if the unforeseen occurs.

Bobbi Kristina was only 22 and the only child of the late Whitney Houston and Bobby Brown. She passed away after a very public six-month family fight over how to treat the comatose Brown, after she was found face-down in a bathtub in the Atlanta townhome she shared with her boyfriend Nick Gordon.

This story illustrates the difficulties families deal with when confronted with complex healthcare decisions. The article emphasizes the need to create advance medical directives to help family members of patients. These end-of-life instructions should be in a legal document, prepared by an estate planning attorney so that it satisfies the requirements of state law. The directives should include:

• A Healthcare Designation. This is a very critical part of an advance directive, as a “healthcare designation” or “healthcare proxy” names an individual you authorized to make medical decisions for you, if you are unable to do so on your own. This friend or relative is given what is also called “durable healthcare power of attorney (POA).” This allows them to speak on your behalf.
• A HIPPA Release. This allows your proxy to communicate with your healthcare providers about your care.
• A Living Will. This formal statement communicates your wishes for medical care should you end up in a “persistent vegetative state” with little or no chance of recovery, and you can’t communicate your wishes. Talk to an estate planning attorney as every state has its own regulations for living wills.
• Treatment Restrictions. You should spell out exactly the circumstances under which you would want to have life-sustaining care or when you want to pass, many times with only medication for pain. Distribute copies to your doctor, family members, and (if appropriate) close friends. The article lists several specific treatments you might want to address:

• A Do Not Resuscitate (DNR) Order. This states that you do not want providers to perform extraordinary measures (like CPR) if your heart or breathing stops.
• Mechanical Ventilation. State when and for how long you would want a mechanical respirator to take over your breathing.
• Nutritional Assistance. Discuss your feelings about nutrition if you could only be fed through an intravenous or stomach tube.
• Dialysis. Kidney failure can be the first step toward death in terminal patients. State parameters around which you would want this treatment.
• Brain Death. State what you would want if your brain function was deemed minimal or immeasurable.
• Organ Donation. Make your wishes known if you want to donate your organs and tissues for transplantation.

It’s no shock that end-of-life planning is a difficult topic to discuss. Just 26.3% of Americans have completed advance directives, according to a 2013 study. But as the Bobbi Kristina Brown case shows, it’s important and never too early to discuss this topic with spouses, family members, partners, adult children, and parents.

Reference: NewsMax (July 31, 2015)“End-of-Life Lessons of Bobbi Kristina's Tragic Death”

What is an Advanced Directive for Healthcare?

Last week I talked about the 3 legal documents that everyone needs to have, regardless of income or assets.  This week I have told you about 2 of those documents in more detail  This video tells you about the third document that YOU need, an Advanced Directive for Health Care.  

 

I hope that these videos have been informative. If you do not have a plan in place I would encourage you to get one.  For more information on Advanced Directives for Healthcare or other estate planning issues, please visit our website at www.AnnistonEstatePlanning.com.  You can also register for one of our workshops, 3 Simple Steps to Protecting Everything you Have for Everyone You Love by calling us at 256 237-3339 or by clicking here.