Legal Health Planning
This is one of the most vital steps you can take to be prepared for aging. Unless you make your wishes known in writing the people who love you will have to bear the difficult decision. Most people would answer their Advance Directive questions differently at 65 than at 75. Once you realize you've lived a full life you really must consider the quality of life you would be left with if you made the decision to "pull out all the stops" if you went into cardiac arrest. Modern medicine has certainly advanced how long we can live but not necessarily how well we live.
Living Will or Advance Directive - Legal document used to specify whether you would like to be kept on artificial life support if you become permanently unconscious or are otherwise dying and unable to speak for yourself. It also specifies other aspects of health care you would like under those circumstances such as CPR if cardiac arrest occurs, respirator (breathing machine) artificial nutrition (feeding tube) and artificial hydration (IV fluids). It can indicate when medical treatment should stop, or whether you want passive feeding to be withdrawn. The directives are limited only to care which artificially or technologically postpones death - not comfort care. The Living Will must be signed by you, witnessed by a notary or two non-related adults, excluding your physician and nursing home advisor. Living Will form under Checklists.
CPR (Cardiopulmonary Resuscitation) - Combination of rescue breathing (mouth-to-mouth resuscitation) and chest compressions used if someone isn't breathing or circulating blood adequately. CPR can restore circulation of oxygen-rich blood to the brain. Chest compressions on an elderly person often cause broken ribs, which can then puncture a lung and lead to breathing by a respirator. DNR (Do Not Resuscitate) - A DNR stating CPR should not be attempted if a person suffers cardiac or respiratory arrest may be instituted on the basis of an Advance Directive from a person, or from someone entitled to make decisions on their behalf, such as a health care representative. Any person who does not wish to undergo lifesaving treatment in the event of cardiac or respiratory arrest can get a DNR order, although DNR is more commonly done when a person with a fatal illness wishes to die without painful or invasive medical procedures. Emergency medical personal have to obide by their oath to attempt to resuscitate. Most DNR orders are done when people are in the hospital or a nursing home and they have a degenerative condition. Durable Power of Attorney - Legal document that gives someone else the authority to act on your behalf on matters that you specify. The power can be specific to a certain task or broad to cover many financial duties. The power can be given to start immediately or upon mental incapacity. To be valid the document must be signed by you before you become disabled. Health Care Representative - Legal document in which you name someone to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions for yourself. It is recommended to appoint a first and second health care representative but avoid joint in case there are differences in opinions. Psychiatrist Representatives are to cover if you become mentally incapacitated by Alzheimer's or dementia. HIPAA Authorization - Gives premsission to your family or whoever you would like to be able to receive healthcare information if you were unable to personally authorize it. If advance planning has not been made for handling one's legal and health affairs and you were unable to make safe decisions and care for yourself then a family member, friend or appointed individual would have to seek guardianship. Guardianship - A guardian can be appointed by Probate Court after an application for guardianship has been filed and evidence has been submitted that the individual is incompetent and thus unable to manage decisions related to his/her person or finances. The person whose competency is in question is given the opportunity to refute the need for a guardian if he/she chooses. The effect of a finding of in competency is the removal of all the person's rights. There are strict court procedures and recordkeeping for supervision and maintaining conservator ship and guardianship. Representative Payee - The person designated by the Social Security or Veterans Administration to receive a benefit check on behalf of another person. For example, a check for James Smith is paid to Lucy Jones (Lucy Jones must be able to provide a full accounting of her use of the money on behalf of James Smith if requested to do so). If you become a resident of a nursing home often this is more convenient than having to then write them a check. The designation may be altered by requesting a change at the SSA or VA office.
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