Without a doubt the most frequent and popular New Year’s Resolutions made each year have to do with health. People resolve to exercise more, to lose weight, to eat better, etc. But far too few people are aware that in addition being healthy in body and mind, there are steps you can (and should) take to protect your medical future and privacy as well.

1. Think about your medical future and put your wishes into writing. How would you like to be cared for in the event that you are incapacitated? How long (and by what measures) would you like to be kept alive if you were to be irrevocably injured or diagnosed with a terminal illness? Who would you like making these decisions for you if you were unable to make them for yourself? These are the issues addressed in an advanced healthcare directive or a living will—documents every adult should have not only for their own peace of mind, but for the peace of mind of their family and loved ones as well.

2. Execute a HIPAA to help protect your medical privacy. A HIPAA Authorization is the document that lets your doctors and other health care providers know who may receive information about your medical status and treatment. Not only does this protect your privacy, but it ensures that the people who should be informed about your medical status will have access to the information they need.

3. Consider your eventual long-term care needs and look into long-term care insurance as a safety net. There is no way to know for sure which of us will need long-term care, but as life-expectancy increases the chances that any of us will need long-term care increase along with it. You can plan for this eventuality and protect yourself and your family from being hit too hard by the expenses of long-term care by investing in long-term care insurance. There are a few options available for long-term care insurance, and our office can help you choose which plan might be best for you.

A recent article in the LA Times reminds us of just how important it is to have some kind of living will or advanced healthcare directive, and that it is absolutely necessary to talk about these things with your loved ones. If you have not done these things it is your loved ones who will be left to make the painful and terrible decisions about your medical treatment and possibly even the heart-wrenching DNR determination.

The author writes of his father—chronically ill, stroke survivor, suffering from mild but advancing dementia—who is currently staying in a nursing home, “where they’ve put him on a diet of pureed foods and thickened liquids, but he often refuses to eat, demanding to be taken home and fed the home cooking he’s always loved. It’s hard to tell him that may never happen, and that his options are increasingly grim. If my dad can’t eat, a feeding tube will be his only choice. Other than giving up the fight.”

The family is now struggling to decide if a feeding tube is the right course of action, what their father would (or does) want, and how involved he should be in the decision considering his current state of mental health. “We worry… that with mild but advancing dementia, my father won’t be able to fully comprehend the implications of being fed through a tube implanted in his gut. And if he declines it, is he competent to make that decision?” These are the heart-breaking decisions that can leave loved ones asking themselves for years after, “Did we do the right thing?”

We often shy away from talking about these issues with our family members and loved ones. We think that they are too sad, too depressing, or too far into the future to worry about yet. The only thing that can make these decisions even the tiniest bit easier, however, is knowing for certain what your loved one would want; and the only way to know for certain is to talk about your feelings with your family, and to put your wishes in writing with a living will or healthcare directive. Our office can help you do this.

More often than not the best that can be hoped for in a situation like the one discussed above is that some measure of peace is attained. We wish this for the author of the article and his family, and we wish this for any of our readers involved in similarly difficult and painful circumstances.

President Obama, in his Presidential Proclamation of National Family Caregivers Month – November 2011 – states;

“Across our country, millions of family members, neighbors, and friends provide care and support for their loved ones during times of need.  With profound compassion and selflessness, these caregivers sustain American men, women, and children at their most vulnerable moments, and through their devoted acts, they exemplify the best of the American spirit.”

Statistics from the Administration On Aging show that the population 65 and older is expected to grow from its current 13%  to 19% of the total population by 2030.  With the older population increasing, the need for elder caregiving will continue to increase.  Family caregivers play a vital role in filling these caregiving needs.  Who better than family can understand the needs and ensure the best care of their loved ones….read the entire article by going to the link below

Please go to the following URL for the entire article and previous articles: Either click on the link   http://www.planforcare.org or copy and paste the following into your browser:      http://www.planforcare.org

The hot and lazy days of summer are almost over; parents are thinking about back-to-school sales, kids are making the most of their final days of freedom, and college freshmen are getting ready to embark on their first year of adult-hood. Most of these college students have a list (whether mental or physical) of all the things they’ll need as they leave the nest for the first time, but most of these lists will be missing two key items: A Healthcare Directive and a HIPAA Form.

You may be wondering why a college student needs estate planning documents—aren’t those just for older, established people? Not at all.

Most incoming college students are now (or will soon be) 18, and considered adults under the law. This means that hospitals and medical personnel are no longer required to ask the parent’s permission before performing medical procedures. In fact, once your child is 18 health care providers are no longer required to share information with the parents at all.

Most college students (and parents) are unaware of this side-effect of turning 18, and parents and children alike can run into frustrating roadblocks should an accident occur. You can avoid these roadblocks by simply having your young adult execute the two simple documents mentioned in this blog post.

A Healthcare Directive (or Living Will) can be an in depth document or a very simple one, but the most important part for your new 18 year old will be the nomination of a healthcare agent. A healthcare agent is the person who will make medical decisions for your child if he or she is unable to make them alone.

A HIPPA Authorization Form addresses the issue of security and privacy of health data. In a HIPAA form your child can list the people who have permission to receive information about his or her medical records and status.

For a fledgling 18 year old these two documents are of the utmost importance, and with the right help, they are very easy to execute. Don’t wait until it’s too late; make sure your young adult has these documents completed before they leave the nest.

Recently, an all too familiar situation arose again. A client called to say he received his first $1,644 monthly check from the Veterans Administration. He told me this was going to make a big difference in his life. Last year he fell and broke his hip and had to move in with his son and daughter-in-law. The client could no longer live on his own without assistance, but his family is happy to help.

This client contacted our office after being told he did not qualify for VA pension (aid and attendance) benefits.  The person who communicated this to the client said that because he “had not been injured in the war, he was not eligible.” They also said that his income was “just too high.”  Even the VA’s own representatives are sometimes unclear about who qualifies for this underused benefit that gives monthly cash payments to qualified vets.  The person who spoke to this client did not know that all World War II, Korean War and Vietnam veterans are entitled up to $1,644 per month ($1,949 a month if the vet is married) if their doctor says that they need daily assistance for their care. There is no requirement that the veteran be injured while on duty, or even to have served in the war theater.

The VA will also pay a relative to provide this daily in home care (when done properly with the assistance of a VA accredited attorney). The VA will also help pay for assisted living facilities. Often, if a senior combines his Social Security benefits, plus these VA benefits, they can pay for a much nicer assisted living facility than they would be able to pay for on their Social Security alone. Or, be able to afford in-home care and stay at home.

Widows of veterans may also be eligible for up to $1,056 per month to cover similar healthcare expenses. This is only if they did not divorce the veteran, or remarry, and if they remarried their second husband was also a qualified veteran.

In regards to the income limits, many people don’t understand that the veteran’s medical expenses (including a caregiver’s cost, insurance premiums, medical supplies, etc..) are deductible from the vet’s stated income on the benefit application.  So once you deduct the medical expenses from the regular income, many vets do actually qualify.

Here is just a partial list of incorrect statements that have been made in connection with the aid and attendance pension benefit offered by the US government:

• You can’t get VA benefits because you were not injured in combat;
• You can’t get VA benefits because you did not serve overseas;
• You can’t get VA benefits because your assets are too high;
• You can’t get VA benefits because your income is too high;
• You can’t get VA benefits because you are only a widow of a veteran;
• You can’t get VA benefits because you only served in the Merchant Marines;
• You can’t get VA benefits because you only served in the Coast Guard.

I am a VA accredited attorney and I can practice before the Veterans Administration. I am a member of the Academy of VA Pension Planners and work closely with Jim Swain, a nationally recognized expert on VA Pension and Estate Planning.  I can give legal advice regarding how to qualify you for benefits, which may also include the use of estate planning tools (living trusts, irrevocable trusts, gifts, etc..) to help qualify you for your VA pension benefit.  It would take hundreds of thousands of dollars in the bank earning interest to equal these cash income payments available to qualified Vets through the VA Pension program. Be sure you have all the facts on this valuable benefit.

If you call our office we can connect you to one of our case managers who will review the benefits and interview you to determine whether you qualify for the pension benefit, and how much you are entitled to receive. This is a free call.  There is no risk and no obligation. Let us see if you have benefits that you are not taking advantage of, after all – you earned them!

Call Shawn McCammon, local attorney and principal of Liberty Law, APC., at the Redding (530.246.1152) or Red Bluff office (530.529.4329) to get your free evaluation started today! Every day you wait could be money lost.

A recent article in the Wall Street Journal shines the light on a new program being instituted by a growing number of states called “Physician-Orders for Life Sustaining Treatment,” or POLST. “A POLST, which is signed by both the patient and the doctor, spells out such choices as whether a patient wants to be on a mechanical breathing machine or feeding tube and receive antibiotics.”

Creating a POLST is an important step toward getting the care and medical treatment you want at a time when you may no longer be able to communicate those wishes to your family or medical staff. As estate planners we know just how important it is to communicate these preferences for health care; in fact, creating an estate plan with our office includes drafting a document called an advance directive, in which you specify which medical treatments or interventions you would or would not like, and more importantly, it is the document in which you nominate a health care agent to serve as your proxy if and when you are unable to speak for yourself.

Keep in mind that although the POLST is an important step in making your wishes known, the POLST is not intended to replace an advance directive. The POLST programs “are meant to complement advance directives, sometimes known as living wills, in which people state in broad terms how much medical intervention they will want when their condition no longer allows them to communicate.”

The WSJ article states that “A study supported by the National Institutes of Health last year found that patients with POLST forms were more likely to have treatment preferences documented than patients who used traditional documents such as living wills and do-not-resuscitate orders.“ This comes as no surprise, considering that executing a POLST includes getting the document signed by your doctor, thus ensuring that you doctor is not only aware that you’ve expressed your wishes for end-of-life care, but has also likely had a part in helping you understand exactly what your options are.

Our office recommends that our clients go one step further—in addition to having your doctor sign your POLST, give your doctor a copy of your advance directive as well. Once you have things squared away with your doctor we also recommend sending a copy of your POLST and your advance directive to the person you’ve named as your healthcare agent.

The more informed you doctors and family are about your wishes for end-of-life care, the more likely it is that you will receive the treatment you prefer.

Apparently the suspicion surrounding end-of-life planning is not as far in the past as we might have hoped. The recent Medicare regulation which would have allowed the government to pay doctors who advise patients on options for end-of-life care was rescinded only days after it was enacted.

Why such an abrupt turnaround? The reason is probably not too difficult to guess. Most people know that Medicare-covered end-of-life planning has a tempestuous history both in politics and in the media. This article in the New York Times stated that “while administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor.”

The alteration of the rule may be disappointing, but it shouldn’t stop you from thinking—or talking to your doctor—about your choices for your own end-of-life care. After all, this administrative change of heart does not alter the fact that having these discussions with your doctor (as well as with your health care agent and loved ones) preserve patient autonomy at a time when events may seem to spiral out of control. As National Public Radio pointed out in their article, “it remains perfectly legal for physicians to talk with patients during annual visits paid for by Medicare about how much or little care they want when facing a terminal illness.”

Media firestorms and political debate notwithstanding, your decisions about your end-of-life care are important. When you have these discussions with your doctor and loved ones, and when you have a living will or healthcare directive in place, you are far more likely to get the care you want at the end of your life, regardless of how invasive or restrained you want that care to be.

If you have reservations about what a health care directive might mean to your future medical care, or if you have any questions about this issue, please don’t hesitate to call our office. Your peace of mind is our first priority.

Advance Health Care Directives (legal documents which include a nomination of your health care agent, and your preferences for end-of-life care) saw a lot of press in 2009 when the Obama administration sought to include end-of-life planning in the new healthcare overhaul. The option was dropped after a media firestorm about “death panels,” but according to this article in the New York Times Medicare-funded end-of-life discussions may be back.

According to the new regulation, Medicare will pay for “voluntary advance care planning” as part of patients’ annual visits with their doctor. “Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.”

The reasoning behind the new regulation is simple, and something estate planning lawyers have known for a long time; “research [has] shown the value of end-of-life planning. ‘Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives.’” Additionally, “end-of-life discussions between doctor and patient help ensure that one gets the care one wants.”

So why does end-of-life planning make so many people uncomfortable when research has shown just how beneficial it can be? Paula Span, author of this post on the New Old Age blog thinks it might simply be a matter of semantics, especially when it involved the term “Do Not Resuscitate.” Ms. Span argues that a more friendly term such as “Allow Natural Death” could make all the difference in the world.

“The phrase “do not resuscitate” signals an intent to withhold or refuse… ‘It says you’re not going to do something.’ To “allow natural death,” on the other hand, connotes permission. ‘It doesn’t sound so overwhelming or scary.’”

Whatever term you use, or however you choose to talk about it, the important thing is that you DO talk about it—with your family and loved ones, with the person you choose as your agent, with your doctor… and even with your lawyer. End-of-life planning is about personal and medical preferences, but the document itself is a legal one; your lawyer can help ensure that your Advance Health Care Directive will hold up in a court of law as well as in the hospital.