Powers of Attorney & Living Wills
Medical science has made it possible for people to survive illnesses or injuries that used to be fatal. Medicine is able to keep people alive who would be dead except for life sustaining machines or the artificial provision of nutrition and water through tubes or other techniques. Often there is quantity of life, but no quality of life. If you are unable to make and communicate your decisions, who would make those significant medical and financial decisions for you?

Until recently, the decision often rested with the patient's family members acting in consultation with the patient's physicians. But, because of potential legal liability and because of changing relationships between doctor and patient, such informal arrangements are not usually possible anymore. Additional changes to the Federal Healthcare Information privacy provisions in April, 2003, make access to even basic healthcare records for informal decision-making difficult, if not impossible.

The courts, therefore, are often asked to appoint a guardian to make health care decisions for a person unable to do so for himself. This can be an expensive and time-consuming procedure, and can lead to decisions that might not reflect the personal wishes of the patient.

These questions arise not only with regard to life and death matters, but are involved any time there is a patient unable to make or express decisions about medical care, personal matters or possible institutional placement.

If you are concerned about how your personal affairs are conducted, how your personal care is arranged and how your medical decisions are made if you become disabled, there are several choices you can make now to assure that your own preferences are honored.

Health Care Power of Attorney
First, you should consider naming someone as your agent in a Health Care Power of Attorney. This document, now recognized everywhere in the United States, allows you to designate someone (as well as at least one alternate) to have legal authority to grant or refuse any consents needed to obtain or refuse any kind of medical or other health care treatment.

The Health Care Power of Attorney can be very specific as to what the agent may approve or refuse or it can be very general, relying on the agent's discretion. Such a power of attorney is always revocable and amendable at any time. The agent will be able to review your medical records, consult with your caregivers and sign any forms that may be needed to assure care according to your preferences.

The Health Care Power of Attorney establishes an advocate of your choosing to make health care decisions for you during any time that you are unable to make and communicate those decisions yourself, even making decisions about your medical and end-of-life care in the event of a terminal illness.

Living Will (Declaration of a Desire for a Natural Death)
Second, you might sign a Living Will. A Living Will is a statement of your preferences about medical care in the event of a terminal illness. It describes how far you want your physicians to go in providing care when death would otherwise be imminent.

Unlike the Health Care Power of Attorney, the Living Will applies only in a terminal illness or event; the Health Care Power of Attorney is effective anytime you cannot express your own wishes.

Many people will sign both a Durable Health Care Power of Attorney and a Living Will. You should read each document carefully to be certain it reflects your actual desires.

Durable General Power of Attorney
Third, you should consider a Durable General Power of Attorney. A General Power of Attorney appoints one or more persons to help you with your personal business while you are unable to do so yourself. It can set limits about the areas of your business that you authorize the agent to handle for you and can be designed to either have specific time limits or to commence upon or survive your subsequent incapacity. The power of attorney is effective anytime you cannot express your own wishes. As with a Health Care Power of Attorney, a General Power of Attorney is always revocable and amendable at any time.

In dealing regularly with older clients and their families, we have frequently confronted the issues of personal control of health care decision making. Our elder law attorneys are familiar with the issues facing older clients as they make plans for their estates, their health care and their financial well being. And we are able to assist in providing an integrated plan to meet these and other special needs.