New Advance Directive Provides Peace of Mind if Dementia Strikes

If you have a history of dementia or Alzheimer’s in your family this is a form you may want to consider. In 2019, we started using an Advance Directive form called a “Voluntary Advance Directive for Fluids and Oral Feedings in the Event of Dementia.” It is quite a mouthful to say. The most common question is why is it necessary to have this when you have a Living Will or a completed Medical Order for Scope of Treatment, also know as a MOST form, or Five Wishes form. The short answer is because it is not truly covered in those documents.

Living Wills, a MOST form or Five Wishes form all deal with the type of treatments you want done if you are facing a vegetative state or terminal illness. These are good forms to have and they help guide your medical agent and doctor so you get the type of care you want in the event you are facing a vegetative state or terminal illness. What they do not cover is a situation where you are suffering from dementia.

Dementia is a state where your brain cells have been damaged to the point it is affecting your ability to communicate. It essentially can affect your thinking, behavior, and feelings. Not everyone will suffer from dementia. Alzheimer’s disease is a type of dementia. It is also not a normal part of aging. Having dementia or Alzheimer’s is not the same as having a terminal illness or being in a vegetative state. There are many different causes of dementia. For more information you may wish to check out the Alzheimer’s Association.

Should your loved ones find themselves in a position where you are suffering from dementia and are being cared for either by independent caregivers or in a facility, there may come a time when a doctor asks if your loved ones know what you would want when it comes to oral feedings or fluids. Oral feedings include being fed by another person either a normal meal or foods that have been softened or liquefied/pureed. Fluids generally mean a liquid form of nourishment administered through a feeding tube or intravenously. If you have moderate to advanced dementia you may not be able to communicate your desires. If you have completed this Advance Directive, then your agents will know exactly what your wishes are.

This Advance Directive provides information for when you can no longer feed yourself. The options are simple. They cover two circumstances: 1) if you want to have food and liquids withheld; or 2) if you want to continue to be fed by others when you cannot feed yourself. Option one is self explanatory. Option two basically says you want to be fed until you refuse all forms of nourishment. It also specifies what you want to be fed and for how long.

This document speaks for you and provides guidance to your loved ones and medical staff when you cannot do so yourself. If you have a family history of dementia or Alzheimer’s disease it can be a helpful tool in your estate plan. As always consult with an attorney to determine whether or not this form is right for you.

Written by June F. Bourrillion, Esq. for


How to Stop Exclusion of Loved Ones During Times of Crisis Before It Happens


We hear the stories all the time about loved ones being excluded from hospital or hospice rooms because the family does not want him or her there. These days many people choose to live together rather than getting married. This only poses a problem when their companion is dying or hospitalized and the rest of the family decides the companion should be excluded. If there is nothing to state otherwise, the family can do this causing much pain to the companion and ignoring the desires of the loved one. It is a heartbreaking situation that could be remedied through advanced medical directive planning.

Visitor passIn 2010 a federal rule was instituted giving patients the right to designate who they did and did not want to see while hospitalized. The rule was to promote an equality of sorts by not giving exclusive visiting rights to family only. However, when a patient is not conscious or is unable to voice what visitors they want, it then falls on the person the patient has designated as their agent to speak for them in those circumstances. The agent then decides who will and will not be seeing the patient. If there is no designated agent then the family decides. Sadly, this is how family can sometimes exclude companions.

What is an advanced medical directive? A living will, a medical power of attorney, or a declaration of life. Generally living wills and medical powers of attorney tell doctors, hospitals, family and the world what you want to be done in the event you cannot voice your opinion on your medical care whether because of mental incapacity or medical situation (e.g., coma, persistent vegetative state, etc.). Many different things go into these documents regarding whether or not to use feeding tubes or electronic devices to sustain life or the appearance of life. There are requirements that dictate consultation with more than one doctor. Essentially everything is laid out for your agent and a doctor or doctors to follow as to your care.

hipaaA remedy would be to add to your medical power of attorney and living will that you want your companion to have equal access to you as if he or she were family. A simple paragraph added to both the living will and the medical power of attorney can prevent the exclusion of a companion from your side in the hospital, hospice or care facility. Also adding the companion to a HIPAA release for your medical information gives him or her access to your medical records and allows a doctor or hospital/facility to speak with him or her directly.


Part of what a living will and medical power of attorney are supposed to accomplish is making sure your wishes are followed at times when you cannot participate in your care. Establishing that either: your companion is your agent for health care or is someone you want kept in the loop and allowed access to you when you cannot voice it yourself is important. Directly expressing that lets doctors, facilities, hospitals and courts know what you are expecting and what you want when it comes down to it. It takes the guess work out of what you would want to have happen.

Everyone would like to believe such a situation would never happen to them. However, a medical crisis does not always bring out the best in everyone. It is better to prepare for the worst and hope for the best. Talk to your estate lawyer about options and planning.

Written by June F. Bourrillion, Esq. for

Coffee Cans Full of Money

coffee cansCoffee cans, old trunks, books, drawers and anything else that a person could use to stash some cash should be gone through thoroughly before any estate sale, or disposing of property for any decedent’s or protected persons estate. Why? Because sometimes you can discover thousands of dollars in cash or valuables that even the family did not know existed.

steamer trunkMany years ago, I was appointed by the court as a trustee over a decedent’s testamentary trust. A testamentary trust is a trust that is created by a person’s will to the benefit of one or more beneficiaries. The estate had little money and few assets. By the time I entered the picture the house been sold but a plethora of personal property remained.  The estate had placed the personal property of the decedent in storage and it was time to transfer it to the trust and figure out if any of it could be sold or if it should be given back to the family. That storage unit was a treasure chest in disguise.

The decedent’s spouse had died over 20 years before her. He had had a healthy distrust for banks.  After his death his old steamer trunks sat in the garage untouched gathering dust, spiders, and cobwebs. No keys could be found for them which was probably the reason. Once the locks were drilled I discovered old coffee cans, tins and small boxes full of money rolls – mostly twenties. In the end the trust more than doubled in value from the money hidden in those two old trunks.

Rolls of Money

For whatever reason – a distrust of banks, a need to hide money from others, or just a compulsion – many of the elderly take to hiding cash around their house. There have been other estates where money was found in china cabinets, old shoe boxes, dresser drawers, and the like. So it is always a good idea to check out everything before you sell it, toss it, or give it away. You never know if Aunt Dotty or Uncle Joe liked to hide money and you could be giving away thousands without knowing.

old booksIt is tedious to go through everything, and many times people are still dealing with their own grief which makes the job that much more difficult. Hidden in the piles of seemingly worthless gadgets, suitcases, and more can be treasures which would enhance the value of the estate. Items like hand sewn or homemade quilts, limited edition figurines or books, old dolls or toys, old furniture may have more value than you realize. Not everything you find will be valuable, but you may find items for keepsakes which hold value in more than just money.

old quiltWritten by June F. Bourrillion, Esq. for

Where There’s A Will, There’s A Way

WillA common question is why does a person need a Last Will and Testament. There are many reasons and some of them you may not realize. Whether it is to make sure your property and your remains are taken care of in the manner you would like or to make a record of what your desires are without interference of the courts.

Many people deed their real estate into joint tenancy with rights of survivorship with their children or whomever they wish to inherit the property. They wish to avoid probate court, attorney costs and “hassle”. However, in doing this their heirs may be subject to capital gains taxes that they could possibly have avoided by selling the house or land through an estate. In addition, depending on when the house or land is deeded to others it can affect your qualification for benefits such as Medicaid to help with your long-term care. Other complications can include difficulties obtaining a reverse mortgage, debates about mental competency of the person giving away the property or undue influence on that person by those listed on the deed.


Probate need not cost an arm and a leg, depending on the work needed to be done, the Personal Representative’s willingness to shoulder the majority of the work and how much property, real or personal, you have at the time of your passing. Having a Will gives your heirs direction and takes the guess-work out of what they think “Grandma” or “Dad” would want done. It relieves them of the burden of trying to figure out what you would have wanted done. Another advantage is that your wishes are clear and must be followed.

If you pass without a Will you risk every action taken by you prior to your death being questioned and children or friends who have helped you being grilled about how they have taken advantage of you. It can lead to greater litigation when truly people should be grieving and not fighting. Also depending on who out lives you, you may not want your estate to be divided according to the Colorado Revised Statutes, Title 15. Dying without a Will could mean that the Court will divide up your property according to who the law says gets top priority if that your parents or your spouse or your children. This becomes complicated when you have remarried and your children are not the children of your current spouse.

Divide the Pie

Information needed to make a Will is simple: names, addresses and dates of birth for all heirs; knowing what property and accounts you own, as well as, life insurance policies, annuities, etc.; having one person to handle carrying out your Will and a back up in case the person you choose cannot act as your Personal Representative; and an idea of how you want things to be done. A good lawyer can advise you on if your estate will have to pay taxes or how best to handle leaving funds to persons with disabilities or minors.

Making a Will is painless and, in the long run, cost-effective. Costs of having a Will drafted will depend on how complicated you want your estate plan. In the end, what it saves is guess-work, frustration and a heavier burden for those already grieving your passing.

Written by June F. Bourrillion, Esq. for

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