Will your end-of-life preferences be honored?


The vast majority of people that I speak with regarding end-of-life preferences tell me that they want to pass away in their own bed while they’re sleeping. Unfortunately with the advances in medical science this has become less and less likely, unless you die prematurely. Most of us will lose the ability to make our own health care decisions and therefore not be capable of directing our end-of-life decision making during the dying process. So what can one do?

The good news is that California Law does allow a person to direct a person of their own choosing to make health care decisions including end-of-life decisions for them in an Advance Health Care Directive. An Advance Health Care Directive is a combination of what some would call a living will and a medical power of attorney. So an Advance Health Care Directives not only designates who will make health care decisions for you if you are unable to do so yourself, but it also can provide specific instructions on what type of health care you want in specific scenarios!

The TRAP for most however, is that you must adhere to very specific rules for an Advance Health Care Directive to be valid, otherwise you risk the very real probability that it will NOT be honored by health care providers. The laws pertaining to the creation of Advance Health Care Directives is found in California Probate Code §4600 et seq. These laws are not particularly complex, but failure to strictly follow the requirements could very well result in a health care provider rejecting your Advance Health Care Directive and not following your agent’s directions.

Discussions with Family Members are So Important

Although most of us hesitate to bring the topic up, discussing our end-of-life preferences can be a blessing for everyone in our family. Fortunately, there’s new momentum in America to help everyone find comfortable ways to talk about how they would prefer to spend the remaining years of their lives.

Conversation Project Provides a New Approach to Broach Difficult Discussions

The Conversation Project was first created back in 2010 by the talented writer Ellen Goodman, a few of her friends, and a number of medical professionals. They all decided to share stories about the different ways they had seen many of their family members, friends and others cope with critical issues and lifestyle choices as their lives drew to an end.

As a result of these thoughtful people’s efforts, individuals and families all across America (and elsewhere) can now more openly talk about how they wish to be treated as time winds down. Once you’ve reviewed the Conversation Project’s free online materials, you’ll be in an excellent position to discuss your most important concerns with your family members, doctors, and your California Estate Planning Attorney that practices in the area of Elder Law or as some people refer to it, Elder Care.

Some Useful Tools Provided by The Conversation Project

  • There’s a comprehensive starter kit that explains the project and its offerings. You’ll find key statistics that can help you broach the various discussion topics. For example, 90% of people say talking about end-of-life matters is very important, yet only about 27% of us do so in a timely manner. There are also suggestions for when and where you and others should have your discussions;
  • There is a very comprehensive guide for Families and Loved Ones of People with Alzheimer’s Disease or Other Forms of Dementia;
  • You can also download a free copy of the project’s “How to Talk to Your Doctor Guide.” You’ll learn more about the types of specific topics you should cover with your loved ones or friends, including how you prefer to have end-of-life medications handled when your life is ending. You lawyer is prepared to put all of this information in your estate planning documents;
  • If you’re caring for a terminally ill child or teen, you’ll find special help set forth in the “Pediatric Starter Kit: Having the Conversation with Your Seriously Ill Child.” While it can be upsetting to an adult to talk about impending death with a child, you’ll learn that children are often eager to have this conversation with you. Kids are often well aware of their circumstances. This guide explains the best ways to talk about treatment options and useful ways to comfort your child. Discussing the real possibility of death can actually make a child feel very cared for since they often worry in secret because they don’t want to upset the adults around them by talking about their illness.

Incorporating your Preferences into a Legal Document

Once you’ve looked over the free materials referenced above – or had discussions on your own with family members and friends – it is essential that you create an Advance Health Care Directive to incorporate your health care and end-of-life preferences to make it legal. I have helped hundreds of people create Advance Health Care Directives. As part of this process, I assist my clients in first identifying what is important to them, second I discuss what factors one should consider in choosing the person or persons that will make health care decisions for them, if they become unable to do so themselves, third I suggest language that best communicates their preferences to their loved ones, and lastly I ensure that the Advance Health Care Directive meets all the legal requirements under the California Probate Code to be a valid document. In addition, I suggest language that will encourage health care providers to accept the Advance Health Care Directive.

Benefits both You and Your Loved Ones

The benefits of creating an Advance Health Care Directive are plentiful. First, the probability of your end-of-life preferences being followed are increased substantially. Just as if not more importantly, you remove the indecision and guilt that often accompanies a loved one making end-of-life health care decisions for you because you have made your preferences clear.

Future Articles

In a future article I will discuss what are some of the most frequent health care and end of life decisions that most of us want to address.

Vincent M. Casiano, Esq. is a California Estate Planning Attorney and Elder Lawyer who has spent over 17 years helping seniors and their families’ address the many legal issues that arise as one grows older. Attorney Casiano is a member of numerous professional organizations including the National Academy of Elder Law Attorneys, a charter a charter member of the Academy of Special Needs Planners, and Wealth Counsel Advisors. Attorney Casiano is willing to speak with potential clients over the phone at no charge to see if he can help. (619) 800-6820.


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