New Thoughts about Living Wills
(Summary of Wall Street Journal Article “A New Look at Living Wills,” by Laura Johannes, June 8, 2012)
Just when you thought you had the answer to how to handle a loved one’s health emergencies, experience is telling us that end-of-life care planning may not be so simple. Even if one has a Living Will, situations can arise that were not anticipated. Some advisers are even recommending abandoning the Living Will in favor of appointing a family member or friend as your health-care agent. What state you live in can also complicate the matter.
What are the some of the problems with Living Wills? The number one problem is that they are too vague. For instance, a Living Will may specify that life support will be withdrawn when there is “no reasonable expectation of regaining a ‘meaningful quality of life.’ ” What does that mean? Does that mean you can no longer walk, can no longer feed yourself, that you are only semi-conscious for long periods of the day? The medical condition that results after a health crisis sometimes is severe initially, but can improve with time or it may not change much at all over the long-term. One can see where problems can arise.
Another problem is that it is very difficult for doctors to accurately diagnose the outcome of a health care crisis. Lee H. Schwamm, vice chairman of the neurology department at Massachusetts General Hospital in Boston, readily admits this fact. He says that when predicting how a patient will fare after a stroke, “he is wrong 15% to 20% of the time on major outcome measures, such as whether a patient will be able to walk again.”
So what should you do? In addition, to the Living Will, make sure you appoint a family member to act when situations arise which are not covered by the Living Will. Also, make sure you have communicated to that family member under which conditions you want to be kept alive, and under what conditions you would find continued living intolerable. Family members, it turns out, are extremely accurate in predicting a designee’s wishes. In a 400-patient study published in 2001, the University of Michigan’s Center for Bioethics and Social Sciences in Medicine found that, “family members who were presented with nine hypothetical scenarios correctly predicted patient wishes about 70% of the time, whether or not the patient had filled out a living will.”
Finally, read and keep up-to-date on trends on the subject of end-of-life care. New developments are happening constantly. A new type of living will which offers more specificity is called the “Five Wishes” living will. It is available from agingwithdignity.org. And it is easy to understand. It is written at a 6th-7th grade reading level, according to Paul Malley,president of Aging with Dignity, a nonprofit organization that disseminates the document.
You will do the best for your loved one if you are well-prepared for the end-of-life event that awaits all of us.
Hook Law Center: What do most states consider the legal status of pets?
KitKat: Most states consider companion animals or pets as tangible property. So with regard to estate planning, provisions can be made in a will as to whom will take title to the pet after the owner’s death.
Lately, many states, including Virginia, have allowed for the creation of pet trusts. This occurred because, without them, provisions for the pet after one’s death was unclear. Were they property or could they be treated as children? Pet trusts provide instructions and funds for the care of one’s pet(s) after death of the owner. The Hook Law Center has prepared many of these trusts.
If a pet should die before its owner, the ASPCA maintains a Pet Loss hotline for people grieving the loss of their pet. The hotline can provide personalized support from a trained counselor. The # is (877) GRIEF-10.
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