idaho's new and existing end-of-life planning tools
TRANSCRIPT
Idaho’s New and Idaho’s New and Existing End-of-Life Existing End-of-Life
Planning ToolsPlanning ToolsState of IdahoState of Idaho
Office of Attorney General Lawrence WasdenOffice of Attorney General Lawrence WasdenIntergovernmental and Fiscal Law DivisionIntergovernmental and Fiscal Law Division
William A. von Tagen, Deputy Attorney GeneralWilliam A. von Tagen, Deputy Attorney General(208) 334-4140(208) 334-4140
[email protected]@ag.idaho.gov
MSNBC.com
Woman dies next to her own graveNewspaper says 65-year-old likely died of a heart attack, was carrying will
ReutersUpdated: 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.
Areas of ConsiderationAreas of Consideration
Estate Planning (Will)Estate Planning (Will)– Directing how property is to be Directing how property is to be
distributeddistributed Health Care DecisionsHealth Care Decisions
– Living WillLiving WillExpressing wishes for health careExpressing wishes for health careHealth Care Power of AttorneyHealth Care Power of AttorneyWho will speak for me?Who will speak for me?
Areas of ConsiderationAreas of Consideration
Physician Orders for Scope of Treatment Physician Orders for Scope of Treatment (“POST”)(“POST”)– A doctor’s orderA doctor’s order
Idaho’s Health Care RegistryIdaho’s Health Care Registry– Making sure doctors and hospitals know my Making sure doctors and hospitals know my
wisheswishes Idaho’s DNR (Do Not Resuscitate) JewelryIdaho’s DNR (Do Not Resuscitate) Jewelry
– Making sure emergency medical personnel Making sure emergency medical personnel know my wishes to know my wishes to notnot have CPR administered have CPR administered
Relevant StatutesRelevant Statutes Uniform Probate Code: Title 15, Idaho CodeUniform Probate Code: Title 15, Idaho Code
– Covers intestate succession, wills and probateCovers intestate succession, wills and probate Medical Consent and Natural Death Act: Chapter Medical Consent and Natural Death Act: Chapter
45 of Title 39, Idaho Code45 of Title 39, Idaho Code– Medical consent: Idaho Code §§ 39-4501 – 39-4508Medical consent: Idaho Code §§ 39-4501 – 39-4508– Living Will and Durable Power of Attorney For Health Care: Living Will and Durable Power of Attorney For Health Care:
Idaho Code §§ 39-4509 – 39-4512Idaho Code §§ 39-4509 – 39-4512– POST: Idaho Code §§ 39-4512A – 39-4512CPOST: Idaho Code §§ 39-4512A – 39-4512C– Idaho Health Care Directive Registry: Idaho Code § 39-Idaho Health Care Directive Registry: Idaho Code § 39-
45154515
Available ResourcesAvailable Resources Additional information about advanced Additional information about advanced
directives is available on the Attorney General’s directives is available on the Attorney General’s and Secretary of State’s websites:and Secretary of State’s websites:– www.ag.idaho.gov (click on “Living Wills”)www.ag.idaho.gov (click on “Living Wills”)– www.sos.idaho.gov (click on “Health Care Directive www.sos.idaho.gov (click on “Health Care Directive
Registry”)Registry”)
Also visit the Idaho EMS Bureau website and Also visit the Idaho EMS Bureau website and the A Better Way Coalition website for further the A Better Way Coalition website for further information:information:
– www.healthandwelfare.idaho.gov (click on www.healthandwelfare.idaho.gov (click on “Emergency Medical Services”)“Emergency Medical Services”)
– www.abetterwaycoalition.orgwww.abetterwaycoalition.org
www.ag.idaho.gov
www.sos.idaho.gov
““The Card”The Card”Don’t leave home without it!Don’t leave home without it!
Available ResourcesAvailable Resources(continued)(continued)
Talk with your PhysicianTalk with your Physician– Your physician is a great resource to answer your Your physician is a great resource to answer your
questions concerning advance directives or if you are questions concerning advance directives or if you are interested in completing a POST. interested in completing a POST.
Other ResourcesOther Resources– Family and FriendsFamily and Friends– Your health care attorney-in-factYour health care attorney-in-fact– ClergyClergy
Estate Planning (Will)Estate Planning (Will)
Basic legal requirementsBasic legal requirements– 18 years old and of sound mind (Idaho Code § 18 years old and of sound mind (Idaho Code §
15-2-501)15-2-501)– Signed and in writing (Idaho Code § 15-2-502)Signed and in writing (Idaho Code § 15-2-502)– Witnessed (Idaho Code § 15-2-502)Witnessed (Idaho Code § 15-2-502)– Holographic wills (Idaho Code § 15-2-503)Holographic wills (Idaho Code § 15-2-503)
Need for professional assistanceNeed for professional assistance Choice of personal representativeChoice of personal representative Discussions with othersDiscussions with others
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. "I may look like just an ordinary man," he said to her, "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...
Medical ConsentMedical Consent
Who can give consent for your medical Who can give consent for your medical care? (Idaho Code § 39-4504)care? (Idaho Code § 39-4504)– Your guardianYour guardian– Person you name in your Living Will and Person you name in your Living Will and
Durable Power of Attorney for Health CareDurable Power of Attorney for Health Care– Your spouseYour spouse– An appropriate relativeAn appropriate relative– Other interested personsOther interested persons
US cat ‘predicts patient deaths’
A US cat that is reportedly able to sense whena nursing home's residents are about to dieis 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. "He doesn't make many mistakes. He seems to understand when patients are about to die," 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: "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." A doctor who treats patients at the home said she believed there was probably a biochemical explanation, rather than the cat being psychic.
Living Will and Durable Power of Living Will and Durable Power of Attorney for Health CareAttorney for Health Care
Idaho Code § 39-4510Idaho Code § 39-4510– Form is in code sectionForm is in code section– May be one (1) documentMay be one (1) document– Can be obtained from the Attorney General’s Can be obtained from the Attorney General’s
websitewebsite– Can be completed by any competent adult to Can be completed by any competent adult to
supplement, or instead of, the POST formsupplement, or instead of, the POST form– Becomes applicable when patient is unable to Becomes applicable when patient is unable to
communicate and is near death or in a communicate and is near death or in a persistent vegetative statepersistent vegetative state
Formalities / RequirementsFormalities / Requirements– Any authentic expression of a person’s Any authentic expression of a person’s
wisheswishes– Forms and formalities are a good idea, Forms and formalities are a good idea,
and it is best to use the form found in and it is best to use the form found in statutestatute
– Need not be witnessed or notarized, but Need not be witnessed or notarized, but it is a good ideait is a good idea
Living Will and Durable Power of Living Will and Durable Power of Attorney for Health CareAttorney for Health Care
Living WillLiving Will
Your instructions for life sustaining Your instructions for life sustaining medical treatmentmedical treatment– Directions to othersDirections to others
Importance of speaking with othersImportance of speaking with others
Durable Power of AttorneyDurable Power of Attorneyfor Health Carefor Health Care
You appoint another to make health care You appoint another to make health care decisions for you when you are unable to decisions for you when you are unable to do sodo so
Most often combined into one form with Most often combined into one form with Living WillLiving Will
Talk to the person you wish to be your Talk to the person you wish to be your health care Attorney in Fact before you health care Attorney in Fact before you complete the formcomplete the form
Who can be appointed?Who can be appointed?– Not health care provider or operator of nursing Not health care provider or operator of nursing
homehome
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
POST FormPOST Form Available from a qualified physician or Available from a qualified physician or
his/her representativehis/her representative Physician completes form with patientPhysician completes form with patient Form acts as a physician’s standing ordersForm acts as a physician’s standing orders Goal of POST is to provide Idahoans with Goal of POST is to provide Idahoans with
increased control over End of Life increased control over End of Life decisionsdecisions
Universally recognized form will facilitate Universally recognized form will facilitate respect for the fundamental right of every respect for the fundamental right of every person to control decisions relating to their person to control decisions relating to their own health careown health care
POST FormPOST Form(continued)(continued)
Clarity Clarity – POST assures patient that comfort care POST assures patient that comfort care
and pain management are always and pain management are always providedprovided
– Decisions are made in advance of a Decisions are made in advance of a terminal condition while patient is still terminal condition while patient is still capable of making informed choicescapable of making informed choices
– Form is completed with the assistance of Form is completed with the assistance of the patient’s attending physicianthe patient’s attending physician
POST FormPOST Form(continued)(continued)
Clarity = ConfidenceClarity = Confidence– With POST, patients can feel With POST, patients can feel
comfortable that they are making comfortable that they are making informed decisions and that their wishes informed decisions and that their wishes will be understood and respectedwill be understood and respected
– Discussion with attending physician Discussion with attending physician provides an opportunity to voice provides an opportunity to voice concerns and clarify areas of confusionconcerns and clarify areas of confusion
POST FormPOST Form(continued)(continued)
Clarity = Assurance for Patient’s Clarity = Assurance for Patient’s FamilyFamily– POST takes the burden of making POST takes the burden of making
treatment decisions off of the patient’s treatment decisions off of the patient’s familyfamily
– POST allows the patient to indicate POST allows the patient to indicate specific care preferences for specific specific care preferences for specific situations, so the family can be situations, so the family can be confident the patient’s wishes are being confident the patient’s wishes are being respected without requiring guessworkrespected without requiring guesswork
POST FormPOST Form(continued)(continued)
UniversalityUniversality– Prior to POST, patients were generally Prior to POST, patients were generally
required to complete new DNR (“do not required to complete new DNR (“do not resuscitate”) directives in each new resuscitate”) directives in each new health care settinghealth care setting
– For example, one DNR for in-hospital For example, one DNR for in-hospital care and one for nursing home carecare and one for nursing home care
– POST transfers between care settings, POST transfers between care settings, and no new DNR order is required in and no new DNR order is required in each settingeach setting
Idaho Advance Directive RegistryIdaho Advance Directive Registry
Advance directives may be Advance directives may be registered with the Idaho Secretary registered with the Idaho Secretary of Stateof State
Registration provides online access Registration provides online access to the directives by health care to the directives by health care providersproviders
POST, Living Will, and Durable Power POST, Living Will, and Durable Power of Attorney for Health Care may be of Attorney for Health Care may be registeredregistered
Idaho Advance Directive RegistryIdaho Advance Directive Registry(continued)(continued)
Registration = Confidence Registration = Confidence – Registration provides patients who have Registration provides patients who have
completed advance directives completed advance directives confidence that those directives are confidence that those directives are easily accessible by health care easily accessible by health care providersproviders
www.sos.idaho.govwww.sos.idaho.gov
Idaho DNR JewelryIdaho DNR Jewelry
Healthcare workers will use CPR Healthcare workers will use CPR (cardio-pulmonary resuscitation) to (cardio-pulmonary resuscitation) to maintain life in a medical emergencymaintain life in a medical emergency
Terminally ill and other people have Terminally ill and other people have the right to refuse CPR the right to refuse CPR
DNR (Do Not Resuscitate) Jewelry DNR (Do Not Resuscitate) Jewelry tells emergency medical personnel tells emergency medical personnel that a person does not wish to have that a person does not wish to have CPR in a medical emergencyCPR in a medical emergency
Idaho DNR JewelryIdaho DNR Jewelry Must complete POST; on receipt of Must complete POST; on receipt of
POST, Secretary of State sends order POST, Secretary of State sends order form (online form pending)form (online form pending)
$30 for gold bracelet or necklace; $20 $30 for gold bracelet or necklace; $20 for nylon braceletfor nylon bracelet
Can request order form at 343-9735Can request order form at 343-9735
Available ResourcesAvailable Resources Additional information about advanced directives is available Additional information about advanced directives is available
on the Office of the Attorney General and Secretary of State on the Office of the Attorney General and Secretary of State websites:websites:– www.ag.idaho.gov (click on “Living Wills”)www.ag.idaho.gov (click on “Living Wills”)– www.sos.idaho.gov (click on “Health Care Directive Registry”)www.sos.idaho.gov (click on “Health Care Directive Registry”)
Also visit the Idaho EMS Bureau website and the A Better Also visit the Idaho EMS Bureau website and the A Better Way Coalition website for further information:Way Coalition website for further information:
– www.healthandwelfare.idaho.gov (click on “Emergency Medical www.healthandwelfare.idaho.gov (click on “Emergency Medical Services”)Services”)
– www.abetterwaycoalition.orgwww.abetterwaycoalition.org
Talk with your PhysicianTalk with your Physician– Your physician is a great resource to answer your questions Your physician is a great resource to answer your questions
concerning advance directives or if you are interested in concerning advance directives or if you are interested in completing a POST.completing a POST.
Other ResourcesOther Resources– Family and FriendsFamily and Friends– Your health care attorney-in-factYour health care attorney-in-fact– ClergyClergy
Man lives to 100, wins bet
From correspondents in LondonApril 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.”