Gupta Law Firm
Planning Ahead for Peace of Mind

Powers of Attorney

Financial Powers of Attorney

A Durable Financial Power of Attorney is a written and revocable document that allows you to appoint another individual who is competent and at least 18 years old, called an attorney-in-fact, to act in your place. This document allows for such things as signing checks, making deposits, paying bills, contracting for medical or other professional services, selling property, obtaining insurance, and doing all the things that you could do in managing your own life, even if you become incompetent to handle your own affairs.

Living Wills and Advance Directives for Medical Decisions

Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you're terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life.

Advance directives aren't just for older adults. Unexpected end-of-life situations can happen at any age, so it's important for all adults to prepare these documents.

By planning ahead, you can get the medical care you want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

Health Care Power of Attorney

A health care power of attorney is a type of advance directive in which you name a person to make decisions for you when you are unable to do so.

The person who you choose to make decisions on your behalf is called your health care surrogate.

Choosing a person to act as your health care agent is important. Even if you have other legal documents regarding your care, not all situations can be anticipated and some situations will require someone to make a judgment about your likely care wishes. You should choose a person who meets the following criteria:

  • Is not your doctor or a part of your medical care team (unless related by blood, marriage, or adoption)
  • Is willing and able to discuss medical care and end-of-life issues with you
  • Can be trusted to make decisions that adhere to your wishes and values
  • Can be trusted to be your advocate if there are disagreements about your care

The person you name may be a spouse, other family member, friend, or member of a faith community. You may also choose one or more alternates in case the person you chose is unable to fulfill the role.

Living Will

A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation.

In determining your wishes, think about your values. Consider how important it is to you to be independent and self-sufficient, and identify what circumstances might make you feel like your life is not worth living. Would you want treatment to extend your life in any situation? All situations? Would you want treatment only if a cure is possible?

You should address a number of possible end-of-life care decisions in your living will. Talk to your doctor if you have questions about any of the following medical decisions:

  • Cardiopulmonary Resuscitation (CPR) restarts the heart when it has stopped beating. Determine if and when you would want to be resuscitated by CPR or by a device that delivers an electric shock to stimulate the heart.
  • Mechanical Ventilation takes over your breathing if you're unable to breathe on your own. Consider if, when and for how long you would want to be placed on a mechanical ventilator.
  • Tube Feeding supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Decide if, when and for how long you would want to be fed in this manner.
  • Dialysis removes waste from your blood and manages fluid levels if your kidneys no longer function. Determine if, when and for how long you would want to receive this treatment.
  • Antibiotics or Antiviral Medications can be used to treat many infections. If you were near the end of life, would you want infections to be treated aggressively or would you rather let infections run their course?
  • Comfort Care (Palliative Care) includes any number of interventions that may be used to keep you comfortable and manage pain while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe mouth dryness, and avoiding invasive tests or treatments.
  • Organ and Tissue Donations for transplantation can be specified in your living will. If your organs are removed for donation, you will be kept on life-sustaining treatment temporarily until the procedure is complete. To help your health care surrogate avoid any confusion, you may want to state in your living will that you understand the need for this temporary intervention.
  • Donating your body for scientific study also can be specified. Contact a local medical school, university or donation program for information on how to register for a planned donation for research.

Do Not Resuscitate and Do Not Intubate Orders

You don't need to have an advance directive or living will to have do not resuscitate (DNR) and do not intubate (DNI) orders. To establish DNR or DNI orders, tell your doctor about your preferences. He or she will write the orders and put them in your medical record.

Even if you already have a living will that includes your preferences regarding resuscitation and intubation, it is still a good idea to establish DNR or DNI orders each time you are admitted to a new hospital or health care facility.

Creating Advance Directives

Advance directives need to be in writing and signed by two witness.

Review your Advance Directive with your lawyer, your doctor, and your health care surrogate to be sure you have filled out forms correctly. When you have completed your documents, you should consider doing the following:

  • Keep the originals in a safe but easily accessible place.
  • Give a copy to your doctor.
  • Give a copy to your health care surrogate and any alternate surrogates.
  • Keep a record of who has your advance directives.
  • Talk to family members and other important people in your life about your advance directive and your health care wishes. By having these conversations now, you help ensure that your family members clearly understand your wishes. Having a clear understanding of your preferences can help your family members avoid conflict and feelings of guilt.
  • Carry a wallet-sized card that indicates you have advance directives, identifies your health care surrogate and states where a copy of your directive can be found.
  • Keep a copy with you when you are traveling.

Reviewing and Changing Advance Directives

You can change your directive at any time. If you want to make changes, you should create a new form, distribute new copies, and destroy all old copies.  Your lawyer will ensure that you are properly revoking your past form.

You should discuss changes with your primary care doctor and make sure a new directive replaces an old directive in your medical file. New directives must also be added to medical charts in a hospital or nursing home. Also, talk to your lawyer, health care surrogate, family and friends about changes you have made.

Consider reviewing your directives and creating new ones in the following situations:

  • New diagnosis. A diagnosis of a disease that is terminal or that significantly alters your life may lead you to make changes in your living will. Discuss with your doctor the kind of treatment and care decisions that might be made during the expected course of the disease.
  • Change of marital status. When you marry, divorce, become separated or are widowed, you may need to select a new health care agent.
  • About every 6-8 years. Over time your thoughts about end-of-life care may change. Review your directives from time to time to be sure they reflect your current values and wishes.

Special Needs Planning

At the Gupta Law Firm, we can evaluate available benefits, help maintain or obtain benefit eligibility, and design a plan that promotes independence and increases quality of life for you or your loved one. We may also be able to identify additional untapped resources that are available to meet your needs. We can help to ensure that you or your loved one is protected from unintended consequences after in the future.

Advising on Public Benefits

When coordinating care for an individual with disabilities, many public benefits questions arise. Should you seek Social Security Disability Insurance benefits for her so she will become Medicare-eligible? What about creating a Medicare set-aside? What if the individual with disabilities receives needs-based benefits such as Medicaid and Supplemental Security Income (SSI)? Is coverage under the Patient Protection and Affordable Care Act (ACA) a better or even an available option? How should her funds be managed from a financial perspective? Is a trust appropriate? There are no easy answers to these questions. At the Gupta Law Firm, we can help you navigate the terrain and advise you on your options.