End of Life Challenges and Planning

Anelderlyyone who has gone through the passing of a loved one, be it close friend or family, knows how much an estate plan, medical directives, and having someone you trust to get you through it really means.  Many times estate planning lawyers have yet to go through the kind of sadness and hard decisions that actually face our clients. From personal experience it is one of the hardest things you have to do.

Terri Schiavo’s family court battles were a learning lesson for the entire country on what can happen when people closest to you do not agree on what should be done with your medical care.  It had people rushing to take care of things like living wills and end of life decisions. The underlying issue from Ms. Schiavo’s situation was not having the right paperwork in place, but the sadness of her family who needed to let go and who could not. That is the sadness and harsh reality for those of us who hold medical directives for friends and family. My own experience is not unique in this.

Shortly after graduating from law school I went to work with my mentor, Marshall, who was an inspiration to me. I had worked with him and his wife since 1993. They were a second family to me.  In 2004, we lost his wife unexpectedly.  Afterwards, Marshall had many thoughts about how and who he wanted to take care of his medical decisions if he could not. Part of his decision, Marshall explained to me, was that he loved his son too much to put him in that position. A fear that his son would second guess himself or harbor regrets was paramount to his decision to ask me to do this for him.  I advise all my clients to sit down and discuss in detail what they want and how they want these things to happen, and that is what we did. It is invaluable to have that discussion in the back of your mind when you are making decisions.  There were many times when I had to think back to the discussion Marshall and I had about what he wanted and what he would want me to do.

Advanced-Health-Care-DirectiveLiving Wills and medical directives can give more guidance than simply “I don’t want to be in a vegetative state.” Yes, they dictate the kind of care you want and, if you reach a persistent vegetative state, it details how long you want those measures to done.  However, a medical directive can be more than that. It can include consulting with trusted doctors and persons, give timelines, direct the kind of care you want B nursing home vs. in-home care, hospice, and many other things. As detailed and in depth a talk as you can have with the person you want to handle your affairs is vital. You have to trust the person you are appointing to be in charge of you to make the decisions you want made regardless of the difficulty of the decision.

thinkingThe decisions for Marshall were not easy. He would be in and out of the hospital in the next couple of years. When he was not able to make decisions, it fell to me.  As much as possible I discussed things with his son before deciding what to do. Inevitably there is a point where what you know your loved one wants is not what the physicians recommend. An emergency room doctor told me once to let Marshall pass.  He did not know what was ailing Marshall, but told me not to have him treated or diagnosed. There was a terrible conflict within me about this advice.

In the end, it was the living will which helped me most. All medical directives are somewhat flexible and you can add in additional information much of the time. The one thing that Marshall added to his was to speak to a certain doctor he trusted.  In the end Marshall was treated and eventually brought home to hospice care. However, that one directive stating to consult his doctor was the saving grace of the evening. It also allowed me to share the burden with someone who was not “in the middle” of things. I encourage all clients to add details such as that to any medical directives they have drawn up.

What I had to do was step back and look at what my heart said and what Marshall had told me he wanted. The biggest question everyone has to face is, “Am I doing this for myself or for my friend/father/mother/etc.”?  The discussion we had years before was helpful in determining what should be done. Marshall did not want to pass in a hospital and he did not want to be kept alive with no hope of regaining his life.  When he did pass he was at home surrounded by his son, family, and me.

hands-medHome hospice and hospice care in general is a blessing to families going through the end of life with loved ones. The care and consideration for the patient and those who love them is phenomenal.  Watching someone go through the end of life is overwhelming. The sadness, loss, grief, anger, and many other emotions crowd in and out of a person minute by minute.  Hospice and hospice nurses are unique in giving the patient comfort and dignity in their last days which also comforts their loved ones. It gives everyone a chance to say good-bye and express their love.

The person you ask to make these decisions for you is someone you have to trust absolutely. Talking to them about your expectations and desires should not be avoided.  If you trust them to make your decisions, you have to communicate to them what you want that to look like. That person is taking on what can sometimes be overwhelming decisions.  They have to be strong enough to make the right decisions for you and follow your directions and desires. Having medical directives in place which detail your desires assists doctors in treating you and in advising your designated agent.

Written by June F. Bourrillion, Esq. for http://www.rkymtnlaw.com

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s