Back to School – Three Documents Every College Student Should Have

Going back to school is right around the corner…what!?   How can that be?  However, it is true that as August approaches families will be sending kids back to school.  For those families with children starting college, this time is fraught will all sorts of emotions, checklists, logistics and large bills.  It is also often a time that parents forget that their little one, who has now grown to an adult, is treated as an adult in the eyes of the law.  Furthermore, this is also a time when ‘adult’ children are not fully independent of their parents, but their parents may not be permitted to help because the child is deemed to be an adult.  Age 18 is the age of majority for pretty much every activity, including signing contracts and making healthcare decisions.  To avoid circumstances where parents and their children are separated by legal requirements, here are three key documents every 18-year-old should have. 

General Durable Power of Attorney – This document permits the child to name his or her parents to help make financial decisions.  It allows the parents to deal with financial institutions, housing issues, such as speaking with a landlord, insurance questions, like car insurance or renter’s insurance, and generally stand in the shoes of the child.  It also allows parents to speak with the educational institutional and gain access to their child’s grades, which may be a downside for the child and he or she may hesitate to sign the financial power of attorney.  However, most other sources on the subject argue that if the parents are footing the bill for the education, the parents have a right to make certain demands and receive certain information like the child’s grades.  But, regardless of the motive, the discussion surrounding the need for a financial power of attorney should hopefully generate some thoughtful discourse between parents and children regarding how financial transactions and other legal, contractual transactions will be handled.

HIPAA – The Health Insurance Portability and Accountability Act of 1996 (“HIPAA“) regulates the use and disclosure of protected health information.  HIPAA was intended to add a layer of protection for individuals so that their medical history or health status could not be wrongfully used against them.  However, HIPAA brought with it many more hoops to clear in order to receive medical information.  Having a familial relationship, like parent and child, does not get around the requirement that an adult child has to have given their parents access to their medical records.  Thus, if a child is in a car accident and ends up in the hospital unable to communicate and there is no HIPAA release in place, the parents may be left in the dark regarding their child’s status.  A separate HIPAA release allows the child to nominate individuals who can give and receive medical information.  It does not necessarily mean that those same people have a right to make medical decisions.  It does, however, at a minimum, allow parents to be present.  

Advance Medical Directive – This document permits the child to name his or her parents to make medical decisions.  College is a time when lots of new adventures occur, and sometimes, those adventures go awry.  There are times when accidents do indeed just happen, like car accidents or a slip and fall.  In those circumstances, if a child is at a medical center on campus or off campus, the parents have no right to find out what is going on and to help make decisions unless their child has given them access and authority to do so.  Access can be granted by way of the HIPAA release mentioned above, which could also be a part of the Advance Medical Directive.  But, actual authority to make decisions is only granted by way of an Advance Medical Directive or healthcare power of attorney, if the child is unable to communicate or make decisions for themselves.  Without an Advance Medical Directive, parents may be able to be present, if a HIPAA release is in place, but have no right at the decision-making table.  Thus, similar to the financial power of attorney, the discussions surrounding the need for a healthcare power of attorney should help enlighten parents and children about medical wishes and desires.  It is also a good time to talk about extraordinary measures if a catastrophic event occurs, which may lead to conversations supporting the creation of a Living Will (a fourth document).  Although, for an 18-year-old, it may be too difficult to focus on that specific possibility.

At this back to school time when checklists are aplenty, add these key documents to the checklist.  Having these documents in place will help avoid added stress during emergent situations.  Moreover, both parents and children get to plan their journey during life’s next chapter.  #estateplanning #collegebound #backtoschool #incapacityplanning #powersofattorney @bgnthebgn

National Healthcare Decisions Day – Week Long Event for 2017

Earlier articles have talked about how you can control your final moments and also how you want to be rememberedThis year National Healthcare Decisions Day is a week long event beginning April 16 and ending on April 22.  Such recognition provides a reminder that having an advance medical directive and a living will in which you express your wishes regarding medical care, if you cannot decide, and whether you want life-prolonging procedures, are crucial components in every estate plan.  Several states and the District of Columbia have addressed end of life decision-making through death with dignity statutes.  But, regardless of your position on death with dignity statutes, end of life decision-making and advance healthcare planning is a necessary conversation to have and to share with your loved ones and National Healthcare Decisions Day (or for this year week) helps remind us of the need to begin the dialog on the subject.  @deathwdignity @NHDD #livingwill #estateplanning #endoflife #advancedirective #NHDD

District of Columbia Passes Death with Dignity Act

flowers-4As had been previously discussed, the District of Columbia was considering passing its form of the Death with Dignity Act (the “Act”) that is modeled after the Oregon law.  The D.C. Council, in a 11 to 2 decision, voted in favor of the bill.  A final vote must be held before the end of the year.  Mayor Muriel E. Bowser has the ability to veto the bill, but in recent comments she indicated that she would not veto the bill and it would become law.  Given D.C.’s status of not being a state, Congress will still have the ability to review and overturn the bill should it become law.

The Act allows a terminally ill individual who has received a prognosis of less than six months to request and receive medication that would end life.  The individual must make two oral requests separated by at least 15 days to his or her physician.  A written request must also be made before the second oral request is made and at least 48 hours must pass before the medication is received.  The written request must be witnessed by two individuals who can attest that the decision to end life is voluntary.  One of the witnesses has to be entirely independent, that is, not related or subordinate in some fashion.  The individual has to be able to take the medication on their own without any help from medical professionals, caretakers, home healthcare aides, family or friends.  Finally, the individual must be a resident of the District of Columbia.  If the bill survives the second vote by the D.C. Council and Congressional review, D.C. will join Oregon, Washington, Vermont and California in enacting a death with dignity law.  #endoflife #estateplanning #advancedirective #livingwill @deathwidignity @bgnthebgn

District of Columbia Considers Death with Dignity Act

flowers-3The District of Columbia is considering enacting the Death with Dignity Act (the “Act”) that would allow terminally ill individuals with six months or less to live the ability to receive a lethal dose of medication and end their life.  Several procedural steps lie ahead for the Act now that the D.C. Council has voted to place the Act on the legislative agenda for an upcoming meeting.  However, it is unclear whether there is sufficient support for the Act to be made into law.  Arguments in favor of the Act revolve around giving an individual control over how and when they choose to die, but advocates against the Act are concerned that individuals’ lives will be prematurely terminated. 

The issue once again raises the importance of planning.  Planning for incapacity and planning for death.   Both sides of the death with dignity argument seem to have a common thread involving control, which is exactly what planning gives you.  Planning gives you control over who is in charge of your medical decisions when you are not able to make those decisions. Planning gives you control of whether you want life-prolonging procedures when doctors have certified that nothing more can be done except provide comfort care.  Planning gives you control of how you want to be remembered in those final moments.  Planning gives your family members peace of mind to know that they are truly abiding by your wishes, which in turn may make them feel as if they are in control of the situation.  Planning gives your family time to prepare for a life without you in it and to try to control the emotional turmoil that realization creates.  Ultimately, planning is a gift to yourself to know that that particular item on a lengthy checklist can be crossed off so that you can enjoy life knowing that your end of life is in the best order you can create.  So, regardless of which side of the death with dignity argument you fall, think of the planning that can be done to control your death with dignity. #endoflife #estateplanning #advancedirective #livingwill @deathwdignity @NHDD @bgnthebgn

Facing a Tough Diagnosis – Four Lessons of Gene Wilder

flowers-2With Gene Wilder’s death, the family released a statement that revealed to the world that Gene Wilder had died due to complications from Alzheimer’s disease.  The family also stated that Wilder had not wanted to reveal his diagnosis earlier and risk “one less smile in the world.”  In releasing the statement as they did, the family has provided us with a few valuable lessons about planning. 

  1. What should ‘the public’ know?  From the statement, it seems clear that in receiving an irreversible diagnosis, Wilder’s family talked about how to handle the news both publicly and privately.  Families that have received terrible news of a terminal or debilitating illness are aware of the difficulties surrounding such information.  Questions about who should be notified are common as well as discussion regarding how much information should be disclosed.  In addition, the ‘public’ for each person is different.  This means for some only immediate family members while friends, neighbors and colleagues have a less detailed picture.  Immediate family may include certain close friends and may very specifically exclude others.  What about professional advisors?  How much information should they have?  Each of us has various circles and those circles have to be evaluated to determine who should know and what should be known, which is important to clarify to avoid confusion in the dissemination of information.
  2. What is the care plan?   Certainly from a medical perspective there is a prognosis and then treatment plans that are outlined with various degrees of outcomes and complications.  But what about the plan to care for minor children, if necessary?  Or a caregiver spouse or partner?  Who are or will be the caregivers?  Has respite care been discussed for those caregivers?  Are there modifications to a residence that are needed?  What about access to financial information? Should such access be limited or restricted?  Has there been discussion about involving a care manager?  These are just a few of the questions to consider to determining the plan of action.
  3. Your final moments.  Are friends and family present?  Is music played?  Is a spiritual leader, such as a priest, rabbi or pastor present?  Will the final moments be at home, wherever that may be at the time?  The final moments are not only for the person dying, but the family and friends who are part of that passing.  Discussions such as these are key in determining end of life care
  4. How to be remembered?  An earlier article outlined six questions to ask surrounding the details of how you want to be remembered.  Providing some information about wishes and desires regarding a funeral or service is a relief for family members because decision-making at this difficult is clouded by emotions and shouldn’t be overshadowed with the thought of “Is this really what was wanted?”

Thus, as many of us remember Gene Wilder and the various roles he played in the movies, we can also pause to reflect on how we would face such tough diagnosis with our family, and when the time comes, be prepared to have the important conversations. #GeneWilder #incapacityplanning #estateplanning #advancemedicaldirective #livingwill @bgnthebgn