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03-2020 | How Do I Make Decisions about End-of-Life Care?

How Do I Make Decisions about End-of-Life Care? (Published 03-2020)

Making decisions about end-of-life care is tough for everyone.  Young or old, serious illness or injury can strike at any time.  It is not something that we look forward to doing; but it is an essential part of any comprehensive estate plan. Talking through your options with an estate planning attorney can help to determine what steps you can take to plan for these possibilities.

What Is An Advanced Directive?

A healthcare advance directive is a legal document that expresses an adult’s healthcare wishes and is used when he or she is unable to make healthcare decisions. Advance directives help to ensure that you receive the medical care you desire and that decisions are made by those you trust.

There are two types of documents that are used in situations where you are not able to make decisions for yourself.

Living Wills:

The first type of document is a living will.

A living will expresses your thoughts and wishes regarding medical care in the case you are not able to express them for yourself. Your feelings about life prolonging or life curtailing measures can be expressed in this type of document.

The desirability of palliative care (i.e. Hospice) is also something that you can discuss in your living will. Issues concerning your religious views on medical care can also be expressed in this type of document.

The concept is that you will have thought through the different situations and expressed your own opinion, in advance, as to how you think any given medical situation should be dealt with.

In addition to helping secure the type of care you desire, another advantage of having a living will is that it often takes pressure from loved ones who are charged with making life ending decisions on your behalf. Instead of making decisions, they are merely executing our wishes.

Durable Power of Attorney for Health Care:

A durable power of attorney for healthcare (DPA) or health care proxy can be used independently or in conjunction with a living will.

In a living will, the document speaks for you, at least to the extent that the document covers the situation you are in. A DPA for health care is a bit different. In this document, you appoint one or more people who have the ability to make medical decisions for you in the event that you are not able.

The thinking is that the people you appoint are able to digest the medical information given to them by your doctors and decide for you based on what they know at the time.

The advantage is that the document identifies the people you feel are most capable to make decision on your behalf.

The theory is that you have had some discussion with your health care agent about your wishes so they can take in medical information and harmonize if with your wishes. In practice, many people do not enter easily into these types of discussions. In such cases, development of a living will to aid your health care agent is a great idea.

Consulting with an experienced estate planning attorney in your state can help determine the best approach. 

Matthew V. Piwowar is a Grand Rapids estate planning attorney.  Mr. Piwowar is a member of the State Bar of Michigan, and the State Bar Probate & Estate Planning Section, the National Network of Estate Planning Attorneys, and the Michigan Forum of Estate Planners.

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