• Many of us have heard of or even experienced a family conflict at the bedside of a very sick loved one. Maybe you have read stories in the news about family members disagreeing about whether to continue Mom’s aggressive care or to let her have a natural ending without medical intervention. Neither side of the argument might be wrong, but the big question is: “What would Mom have wanted?”

    Such conflicts may be more easily managed or even minimized with a little planning and conversation ahead of time. In fact, according to a survey conducted by The Conversation Project, more than 90% of 2,073 Americans aged 18+ believe that having a conversation on end-of-life matters with loved ones is important. But only around 30% have actually done so.

    Discussing options, decisions, and wishes about end-of-life care can make a big difference during crises. The benefits to expressing wishes about end-of-life care include:

    • Giving loved ones a chance to understand important end-of-life care wishes for the future whether it is related to a progressive illness or older age
    • Removing the burden from caregivers and loved ones, who might not agree with one another when making certain end-of-life care decisions
    • Helping doctors and family members make vital healthcare decisions if a dying loved one becomes unable to make decisions for him or herself

    By having an end-of-life care conversation, you can establish comfort and trust with those in charge of your care. It may offer you and your loved ones more peace of mind than you might expect.

    Why It’s Important

    In a study published in the Journal of the American Medical Association, 126 participants—including 48 dialysis patients, 40 people with HIV, and 38 patients in long-term care facilities—answered a series of in-depth, open-ended questions about quality end-of-life care.

    Survey answers were analyzed and organized into the following 5 main categories representing what study participants cared about most:

    • Receiving adequate pain and symptom management
    • Avoiding inappropriate prolongation of dying
    • Achieving a sense of control
    • Relieving burden for caregivers, family members, and others
    • Strengthening relationships with loved ones

    How would you answer the question as to what quality end-of-life care is? What would matter most to you? It can help to jot some of your thoughts down.

    Having A Conversation with Loved Ones

    If you or your loved one is advanced in age or is managing a chronic, life-threatening or serious illness that will worsen over time, having on open and honest dialogue with loved ones, caregivers and family members is a good way to ensure that end-of-life wishes are known. Of course it can be difficult to discuss this topic—your loved ones may not want to face the sensitive topic of the uncertain future. Still, it’s important to talk about it.

    There is no right or wrong way to have the discussion—and there is never a wrong time to bring it up, as long as it’s done ahead of a crisis. Here are a few helpful tips to keep in mind:

    • Take the time to think about what’s important to you—don’t assume that loved ones will know exactly what you want. What are your thoughts on the type of medical care you would like to receive and the extent of life-saving efforts you would wish for (e.g., CPR, artificial breathing, artificial feeding, full life-support)?
    • Discuss your end-of-life concerns with the healthcare team to learn more about your options. If you are managing a condition, ask: How long will the end-of-life journey be? How much pain and suffering will there be? How will the condition affect your family?
    • Communicate your wishes to your family. Your loved ones may disagree about certain options but that’s okay. You may need several talks. It’s important to start the discussion before a crisis occurs
    • Ask yourself: What has to be done to get personal affairs in order (e.g., finances, home)? Do the wishes need to be put in writing, is a living will needed?
    • Think about who you would want to help you make decisions about your care, in the case that you are not able to do so yourself

    Remember that making end-of-life care decisions may be easier for you and your family with a little preparation and communication. So take the time now to ensure that your last wishes are known and that your quality of life during those moments will be supported.

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  • August 20, 2013 /  End of Life Issues

    Man and woman planningI was reading Ashlea Ebeling, a Forbes staff writer, the other day by way of a suggestion from Elise Baker, an attorney in Rocklin Ca., on the topic of Payable On Death (POD) accounts.

    POD accounts are set up so that when the owner dies the funds automatically go to the beneficiary (hence; Payable on death). The beneficiary is not able to access the funds while the owner is alive (with or without capacity) and it avoids probate. They can be a great estate planning tool but…

    Like everything, this tool needs to be carefully used. Ashlea shared a couple of scenarios where it was the wrong tools are not used correctly. If you have a question about this please contact your estate planning attorney, they may help make settling your estate go smoother…which is what I do on your behalf.

    I serve Placer, Sacramento, Yolo, Yuba, Sutter, El Dorado, Solano and even Humboldt counties and your first consultation is free.

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  • November 22, 2011 /  End of Life Issues

    have a healthy healthcare directiveDenny Welch is one of the attorneys I work with and actually, he is the very first one I worked with.  His website for more information is after the article. This is not meant to be technical but to get you to think about end of life issues.  

    The trust is just the tip of the iceberg. Equally as important, in my opinion, is the power of attorney for health care, better known as the Advance Healthcare Directive.

    My wife has been an oncology nurse for a long time. We’ve been married for a long time, and we talk. I get the image of the family in the hospital corridor when the doctor walks out of the patient room. “Well, folks, there’s nothing else we can do. What do you want us to do?” It’s like the deer being caught in the headlight. Nobody knows what to do, because they’ve never talked about it. Even if they did, no one has the legal authority to make a decision because there’s nothing in writing.

    The Advance Healthcare Directive allows you to make a decision today on what you want done if you were that person in the hospital bed. You can make that decision today while you are still in good health and have a clear mind and a clear purpose on what’s best for you.  By making that choice today, you are taking the onus away from your loved ones on what you want done.  Your desires can be as specific as you want.

    Most of us feel that “when my time’s up, my time’s up. ” If all the quality of life indicators are gone, and to a medical certainty they aren’t going to come back, then, under those circumstances, “keep me comfortable and keep me pain free, but don’t keep me alive just because science says you can.” But no one would know that, or have the authority to act, if you hadn’t gotten your ducks in a row.
    Donald D. Welch  is an Estate Planning Attorney servicing the Northern California region. To find out more about Estate Planning, please visit www.dennywelch.com.

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