Idaho's New and Existing End-of-Life Planning Tools

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Idaho's New and Existing End-of-Life Planning Tools

  1. 1. Idaho’s New and Existing End-of-Life Planning Tools State of Idaho Office of Attorney General Lawrence Wasden Intergovernmental and Fiscal Law Division William A. von Tagen, Deputy Attorney General (208) 334-4140 [email_address]
  2. 2. MSNBC.com    Woman dies next to her own grave Newspaper says 65-year-old likely died of a heart attack, was carrying will Reuters Updated: 3:58 a.m. MT Nov 1, 2006 AMSTERDAM - A Dutch woman, who had meticulously planned her own funeral after the death of her husband last year, died next to the grave in Amsterdam where she wanted to be buried, a newspaper reported. The 65-year-old widow probably died of a heart attack while she was visiting the family grave where her name, but no date, was already inscribed, De Telegraaf daily reported on Wednesday. The woman was carrying a bag with her containing her will when she died and had already organized details of her funeral including the music she wanted played, the paper said.
  3. 3. Areas of Consideration <ul><li>Estate Planning (Will) </li></ul><ul><ul><li>Directing how property is to be distributed </li></ul></ul><ul><li>Health Care Decisions </li></ul><ul><ul><li>Living Will </li></ul></ul><ul><ul><ul><li>Expressing wishes for health care </li></ul></ul></ul><ul><ul><ul><li>Health Care Power of Attorney </li></ul></ul></ul><ul><ul><ul><li>Who will speak for me? </li></ul></ul></ul>
  4. 4. Areas of Consideration <ul><li>Physician Orders for Scope of Treatment (“POST”) </li></ul><ul><ul><li>A doctor’s order </li></ul></ul><ul><li>Idaho’s Health Care Registry </li></ul><ul><ul><li>Making sure doctors and hospitals know my wishes </li></ul></ul><ul><li>Idaho’s DNR (Do Not Resuscitate) Jewelry </li></ul><ul><ul><li>Making sure emergency medical personnel know my wishes to not have CPR administered </li></ul></ul>
  5. 5. Relevant Statutes <ul><li>Uniform Probate Code: Title 15, Idaho Code </li></ul><ul><ul><li>Covers intestate succession, wills and probate </li></ul></ul><ul><li>Medical Consent and Natural Death Act: Chapter 45 of Title 39, Idaho Code </li></ul><ul><ul><li>Medical consent: Idaho Code §§ 39-4501 – 39-4508 </li></ul></ul><ul><ul><li>Living Will and Durable Power of Attorney For Health Care: Idaho Code §§ 39-4509 – 39-4512 </li></ul></ul><ul><ul><li>POST: Idaho Code §§ 39-4512A – 39-4512C </li></ul></ul><ul><ul><li>Idaho Health Care Directive Registry: Idaho Code § 39-4515 </li></ul></ul>
  6. 6. Available Resources <ul><li>Additional information about advanced directives is available on the Attorney General’s and Secretary of State’s websites: </li></ul><ul><ul><li>www.ag.idaho.gov (click on “Living Wills”) </li></ul></ul><ul><ul><li>www.sos.idaho.gov (click on “Health Care Directive Registry”) </li></ul></ul><ul><ul><li>Also visit the Idaho EMS Bureau website and the A Better Way Coalition website for further information: </li></ul></ul><ul><ul><li>www.healthandwelfare.idaho.gov (click on “Emergency Medical Services”) </li></ul></ul><ul><ul><li>www.abetterwaycoalition.org </li></ul></ul>
  7. 7. www.ag.idaho.gov
  8. 8. www.sos.idaho.gov
  9. 9. “ The Card” Don’t leave home without it!
  10. 10. Available Resources (continued) <ul><li>Talk with your Physician </li></ul><ul><ul><li>Your physician is a great resource to answer your questions concerning advance directives or if you are interested in completing a POST. </li></ul></ul><ul><li>Other Resources </li></ul><ul><ul><li>Family and Friends </li></ul></ul><ul><ul><li>Your health care attorney-in-fact </li></ul></ul><ul><ul><li>Clergy </li></ul></ul>
  11. 11. Estate Planning (Will) <ul><li>Basic legal requirements </li></ul><ul><ul><li>18 years old and of sound mind (Idaho Code § 15-2-501) </li></ul></ul><ul><ul><li>Signed and in writing (Idaho Code § 15-2-502) </li></ul></ul><ul><ul><li>Witnessed (Idaho Code § 15-2-502) </li></ul></ul><ul><ul><li>Holographic wills (Idaho Code § 15-2-503) </li></ul></ul><ul><li>Need for professional assistance </li></ul><ul><li>Choice of personal representative </li></ul><ul><li>Discussions with others </li></ul>
  12. 12. Dan was a single guy living at home with his father and working in the family business. When he found out he was going to inherit a fortune when his sickly father died, he decided he needed a wife with which to share his fortune. One evening at an investment meeting, he spotted the most beautiful woman he had ever seen. Her natural beauty took his breath away. &quot;I may look like just an ordinary man,&quot; he said to her, &quot;but in just a few years, my father will die, and I'll inherit 20 million dollars.” Impressed, the woman obtained his business card and, three days later, she became his stepmother. Women are so much better at estate planning than men. Estate Planning...
  13. 13. Medical Consent <ul><li>Who can give consent for your medical care? (Idaho Code § 39-4504) </li></ul><ul><ul><li>Your guardian </li></ul></ul><ul><ul><li>Person you name in your Living Will and Durable Power of Attorney for Health Care </li></ul></ul><ul><ul><li>Your spouse </li></ul></ul><ul><ul><li>An appropriate relative </li></ul></ul><ul><ul><li>Other interested persons </li></ul></ul>
  14. 14. US cat ‘predicts patient deaths’ A US cat that is reportedly able to sense when a nursing home's residents are about to die is baffling doctors. Oscar has a habit of curling up next to patients at the home in Providence, Rhode Island, in their final hours. According to the author of an article in the New England Journal of Medicine, the two-year-old cat has been observed to be correct in 25 cases so far. Staff now alert the families of residents when he sits down next to their ailing loved one. &quot;He doesn't make many mistakes. He seems to understand when patients are about to die,&quot; David Dosa, a professor at Brown University who carried out the research, told the Associated Press news agency. ‘ Premonitions’ Oscar was adopted as a kitten at Steere House Nursing and Rehabilitation Centre. The cat is said to do his own rounds, just like the doctors and nurses at the home, but is not generally friendly to patients. Although most families are grateful for the warning Oscar seems to provide, some relatives ask that the pet be taken away while they say their last goodbyes to their loved ones. When put outside the room, Oscar is said to pace up and down meowing in protest. Thomas Graves, a feline expert from the University of Illinois, told the BBC: &quot;Cats often can sense when their owners are sick or when another animal is sick. They can sense when the weather will change; they're famous for being sensitive to premonitions of earthquakes.&quot; A doctor who treats patients at the home said she believed there was probably a biochemical explanation, rather than the cat being psychic.
  15. 15. Living Will and Durable Power of Attorney for Health Care <ul><li>Idaho Code § 39-4510 </li></ul><ul><ul><li>Form is in code section </li></ul></ul><ul><ul><li>May be one (1) document </li></ul></ul><ul><ul><li>Can be obtained from the Attorney General’s website </li></ul></ul><ul><ul><li>Can be completed by any competent adult to supplement, or instead of, the POST form </li></ul></ul><ul><ul><li>Becomes applicable when patient is unable to communicate and is near death or in a persistent vegetative state </li></ul></ul>
  16. 16. <ul><li>Formalities / Requirements </li></ul><ul><ul><li>Any authentic expression of a person’s wishes </li></ul></ul><ul><ul><li>Forms and formalities are a good idea, and it is best to use the form found in statute </li></ul></ul><ul><ul><li>Need not be witnessed or notarized, but it is a good idea </li></ul></ul>Living Will and Durable Power of Attorney for Health Care
  17. 17. Living Will <ul><li>Your instructions for life sustaining medical treatment </li></ul><ul><ul><li>Directions to others </li></ul></ul><ul><li>Importance of speaking with others </li></ul>
  18. 18. Durable Power of Attorney for Health Care <ul><li>You appoint another to make health care decisions for you when you are unable to do so </li></ul><ul><li>Most often combined into one form with Living Will </li></ul><ul><li>Talk to the person you wish to be your health care Attorney in Fact before you complete the form </li></ul><ul><li>Who can be appointed? </li></ul><ul><ul><li>Not health care provider or operator of nursing home </li></ul></ul>
  19. 19. This is the first page of the Living Will and Durable Power of Attorney for Health Care form, which is available on the Attorney General’s website: www.ag.idaho.gov
  20. 20. POST Form <ul><li>Available from a qualified physician or his/her representative </li></ul><ul><li>Physician completes form with patient </li></ul><ul><li>Form acts as a physician’s standing orders </li></ul><ul><li>Goal of POST is to provide Idahoans with increased control over End of Life decisions </li></ul><ul><li>Universally recognized form will facilitate respect for the fundamental right of every person to control decisions relating to their own health care </li></ul>
  21. 22. POST Form (continued) <ul><li>Clarity </li></ul><ul><ul><li>POST assures patient that comfort care and pain management are always provided </li></ul></ul><ul><ul><li>Decisions are made in advance of a terminal condition while patient is still capable of making informed choices </li></ul></ul><ul><ul><li>Form is completed with the assistance of the patient’s attending physician </li></ul></ul>
  22. 23. POST Form (continued) <ul><li>Clarity = Confidence </li></ul><ul><ul><li>With POST, patients can feel comfortable that they are making informed decisions and that their wishes will be understood and respected </li></ul></ul><ul><ul><li>Discussion with attending physician provides an opportunity to voice concerns and clarify areas of confusion </li></ul></ul>
  23. 24. POST Form (continued) <ul><li>Clarity = Assurance for Patient’s Family </li></ul><ul><ul><li>POST takes the burden of making treatment decisions off of the patient’s family </li></ul></ul><ul><ul><li>POST allows the patient to indicate specific care preferences for specific situations, so the family can be confident the patient’s wishes are being respected without requiring guesswork </li></ul></ul>
  24. 25. POST Form (continued) <ul><li>Universality </li></ul><ul><ul><li>Prior to POST, patients were generally required to complete new DNR (“do not resuscitate”) directives in each new health care setting </li></ul></ul><ul><ul><li>For example, one DNR for in-hospital care and one for nursing home care </li></ul></ul><ul><ul><li>POST transfers between care settings, and no new DNR order is required in each setting </li></ul></ul>
  25. 26. Idaho Advance Directive Registry <ul><li>Advance directives may be registered with the Idaho Secretary of State </li></ul><ul><li>Registration provides online access to the directives by health care providers </li></ul><ul><li>POST, Living Will, and Durable Power of Attorney for Health Care may be registered </li></ul>
  26. 27. Idaho Advance Directive Registry (continued) <ul><li>Registration = Confidence </li></ul><ul><ul><li>Registration provides patients who have completed advance directives confidence that those directives are easily accessible by health care providers </li></ul></ul><ul><li>www.sos.idaho.gov </li></ul>
  27. 28. Idaho DNR Jewelry <ul><li>Healthcare workers will use CPR (cardio-pulmonary resuscitation) to maintain life in a medical emergency </li></ul><ul><li>Terminally ill and other people have the right to refuse CPR </li></ul><ul><li>DNR (Do Not Resuscitate) Jewelry tells emergency medical personnel that a person does not wish to have CPR in a medical emergency </li></ul>
  28. 29. Idaho DNR Jewelry <ul><li>Must complete POST; on receipt of POST, Secretary of State sends order form (online form pending) </li></ul><ul><li>$30 for gold bracelet or necklace; $20 for nylon bracelet </li></ul><ul><li>Can request order form at 343-9735 </li></ul>
  29. 30. Available Resources <ul><li>Additional information about advanced directives is available on the Office of the Attorney General and Secretary of State websites: </li></ul><ul><ul><li>www.ag.idaho.gov (click on “Living Wills”) </li></ul></ul><ul><ul><li>www.sos.idaho.gov (click on “Health Care Directive Registry”) </li></ul></ul><ul><ul><li>Also visit the Idaho EMS Bureau website and the A Better Way Coalition website for further information: </li></ul></ul><ul><ul><li>www.healthandwelfare.idaho.gov (click on “Emergency Medical Services”) </li></ul></ul><ul><ul><li>www.abetterwaycoalition.org </li></ul></ul><ul><li>Talk with your Physician </li></ul><ul><ul><li>Your physician is a great resource to answer your questions concerning advance directives or if you are interested in completing a POST. </li></ul></ul><ul><li>Other Resources </li></ul><ul><ul><li>Family and Friends </li></ul></ul><ul><ul><li>Your health care attorney-in-fact </li></ul></ul><ul><ul><li>Clergy </li></ul></ul>
  30. 31.    Man lives to 100, wins bet From correspondents in London April 23, 2007 11:36pm A MAN who bet £100 ($240) a decade ago that he would live to be 100 is preparing to pick up his £25,000 ($60,000) winnings. So confident was bookmaker William Hill in 1997 that it gladly offered Alec Holden odds of 250/1. But the retired engineer, born April 24, 1907, celebrates his century - to the bookies' dismay. Mr. Holden, from Epsom in Surrey, joked: “I've been very careful about what I've been doing in recent months. If I saw any hooded groups from William Hill standing in the street, I avoided them. Forty birthday cards came for me this morning, including one from the Queen - in fact, I think I saw her delivering it on her bicycle this morning.” The bet was placed on December 10 in 1997 when Mr. Holden was 90. Mr. Holden, who has two sons aged 70 and 60, puts his longevity down to porridge for breakfast and “remembering to keep breathing.” He also plays chess every day, running a local club, he said. Mr. Holden, who also used to work as a teacher and a carpenter, plans to celebrate by taking some friends to a hotel for a few days. Meanwhile the out-of-pocket bookmakers have raised the target age for bets from 100 to 110. Rupert Adams, spokesman for William Hill, said: “When we started taking these bets, 100 years old seemed to be an almost mythical landmark and we were prepared to offer massive odds. But these age wagers are starting to cost us a fortune, and, from now on, we are going to push out the age to 110.” He added: “I am sure that Alec will get more pleasure from our letter than he will from the Queen's.”

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