As Cognition Slips, Financial Skills Are Often the First to Go, New York Times
Dear Mom and Dad: Are Your Finances Ready for Retirement?, New York Times
As Cognition Slips, Financial Skills Are Often the First to Go, New York Times
Dear Mom and Dad: Are Your Finances Ready for Retirement?, New York Times
Medical care in the United States is extremely expensive, even for patients with insurance coverage. Here are a few tips that may save you or family members money on medical bills:
For additional tips, read An American Sickness: How Healthcare Became Big Business and How You Can Take it Back by Dr. Elisabeth Rosenthal.
Medical directives are documents in which patients specify their wishes for end of life care. Typically, patients express their desire to decline artificial respiration, nutrition and hydration and other medical procedures where such treatment would only serve to prolong the process of dying and not result in a cure for a terminal illness or where there is a permanent unconscious condition. Having a medical directive helps avoid family disputes about the level of care to give a patient in such a situation.
Perhaps the most recent publicized example of a family dispute involving end of life care was Terri Schiavo, a Florida woman in a persistent vegetative state. Terri had not signed a medical directive before she had a cardiac arrest and resulting brain damage in 1990. Eight years later, having given up hope that Terri’s condition would ever improve and believing that Terri would not want to be kept alive in such a situation, her husband Michael petitioned the court to remove the feeding tube (medically assisted nutrition) keeping Terri alive. Terri’s parents intervened as did government officials and after seven years of extensive litigation Terri’s feeding tube was finally removed and she allowed to die in 2005.
Hospitals and other care facilities affiliated with the Catholic Church are required to follow the Ethical and Religious Directives for Catholic Health Services published by the United States Conference of Catholic Bishops. Unsurprisingly, such facilities will not readily provide information about Washington’s Death with Dignity Act. However, surprisingly to many people, such facilities will also not necessarily follow patients’ medical directives for end of life care.
For example, Directive No. 24 specifically states that medical facilities “will not honor an advance directive that is contrary to Catholic teaching.” Directive No. 58 states that “medically assisted nutrition and hydration should be provided for patients in chronic and presumably irreversible conditions” who can “reasonably be expected to live indefinitely if given such care” [the Terri Schiavo example]. Medically assisted nutrition and hydration become “morally optional” when they cannot “reasonably be expected to prolong life” or when they would be “excessively burdensome for the patient or would cause significant physical discomfort .” Since these issues require subjective judgment on the part of health care providers, family members may find themselves at odds with such providers in such situations.
Patients and their families may not even realize that a hospital is affiliated with the Catholic church as facility names may not appear to be of a religious nature and information is often not readily accessible on the facility’s website. In order to be sure that a patient’s end of life care wishes are followed, patients and their families should double check before admission that their medical directives will be followed. For further information about hospital policies, see endoflifewa.org and links to the policies of specific health care facilities in Washington.
Ron Lieber is one of my favorite columnists in the New York Times. He wrote about saving for retirement a while ago but the advice is timeless: “How to Save Money for Retirement”
Should parents of unvaccinated children be liable for transmission of measles? June offers her legal perspective in a recent piece from the ABA Journal, “Lawyers quarrel over tort liability after the Disneyland measles outbreak.”
Here’s a link to an interesting article in the New York Times about advance directives. Much like birthing plans, it is difficult to know in advance exactly what care you will want to have when the time comes. Better to designate a person you know and trust to make health care decisions for you if you are unable to make such decisions for yourself. Make time to discuss at length your thoughts on quality of life with that person on a regular basis so he or she feels comfortable in the decision making. Be sure your health care providers have the documentation in your medical records with current contact information for your designated agent.
Do you have a will? Have you discussed with family members what your wishes are for end-of-life care? Do you have a power of attorney for someone to handle your affairs if you are unable to do so? If the answer is no, then think about making it a priority for 2018 to get organized, and get the appropriate estate planning documentation in order. For most simple estate plans the cost will be less than $500.
I collaborate with an expert in tax law in estate planning for individuals with estates over two million dollars (the starting point for the Washington State estate tax). And unlike many lawyers, I make house calls!
Contacting me by phone or email will get the process started. There is no fee for an initial consultation. I look forward to hearing from you.