How to Decide Who Your Healthcare Proxy Should Be

It’s especially important to name a healthcare proxy, because the chances of having a crisis escalates dramatically as we age. That’s why so many people put off naming a healthcare agent, says Forbes in the article “How to Select A Healthcare Agent” often only addressing this, when they are completing other documents for their overall estate plan.

What usually happens is that people get so stressed out about naming a healthcare agent that they put it off or make a bad selection. Making it even worse, is neglecting to tell the person they have chosen for this important responsibility.

It’s not guaranteed that the person you chose as your healthcare proxy will ever be called on to serve. However, if they are, you’ll want to make sure they meet certain guidelines. For one thing, they’ll need to be at least 18 years old. They cannot be your direct health care provider or any of the direct health care provider’s employees, unless that person is also your spouse. They have to be willing to speak up and adhere to your own wishes, even if those wishes are not the same as their own. You’ll want to have a very candid conversation with the person you think you want to name as your healthcare agent.

You might want to go through this exercise to make sure they are really willing to carry out your wishes. Create a worksheet that describes in detail some of the situations they may face. There are a few sources for this kind of worksheet, including one from a group called Compassion and Choices, a nonprofit centered on helping people get what they want at the end of their lives.

If you are close with your family, it may seem obvious to select your spouse, first-born child, or a sibling for this task. However, be realistic: when push comes to shove, will they be able to stand up for your wishes? Will they be able to deal with the fallout from family members, who may not agree with what you want at the end of your life? They’ll need to be up to the challenge.

Age is a real factor here. You want your agent to be available in both the immediate and distant future. If you have a sibling who is only two years younger than you, she’ll be 84 when you are 86. That may not be the time for her to make hard decisions, or she may not be available—or alive. Select a few backups, and make sure the primary, secondary and even tertiary are listed on your advance directive.

Geography also matters. The person may be called upon in a crisis—if you are on the West Coast and they are in the Midwest, will they be able to get to your bedside in time? Many hospitals and skilled nursing facilities require a live human being to be physically present, if critical care decisions need to be made. Someone who lives within a 50-mile radius of you, might be a better choice.

Once you’ve made the decision, you’re almost done. Have a conversation with the person, whether they are the primary or a backup. You should also have a conversation with your estate planning attorney, to make sure that your healthcare directive and any related documents are all set for your future.

Reference: Forbes (April 10, 2019) “How to Select A Healthcare Proxy”

 

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What Happens When Unmarried Couples Don’t Have Wills?

There can be serious problems when people live together without the benefit of marriage. One is that they don’t have any legal right to make medical decisions for each other. Another is that without any will or estate plan in place, the surviving partner has no legal right to any of the decedent’s property. That’s just for starters, explains the article “Longtime unmarried couple hasn’t planned for future” from the Santa Cruz Sentinel.

The couple may be pleased with their decision to live on their own terms.  However, by refusing to plan for the inevitable, they are creating an unnecessary difficulty for their loved ones. The children and grandchildren of the couple are likely going to end up having to sort out the mess, after one of the couple dies. They may end up in court, battling over the house or other assets.

If the couple wants their property to end up in the hands of both sets of their children when they pass away, having no estate plan is not the way to make that happen. When one partner dies, any assets they own in joint tenancy will go to the surviving partner. When the surviving partner passes, those assets will go to their children, and nothing will be passed to the other family.

The surviving partner will have no legal right to the assets of the deceased partner, other than any that have been titled to joint tenancy. Assets owned by the deceased partner that are titled in his or her name only, belong to the decedent’s probate estate and will pass to their children. If the gentleman dies first, in this example, will his companion be left homeless?

This is a situation that can be easily remedied with an estate plan, creating wills and trusts that clearly spell out how they want their assets to be distributed upon death. There are many different ways to make this happen, but they will need to work with an estate planning attorney. Where the surviving non-homeowner will live after the homeowner dies is a serious issue, unless other plans have been made. One way to do this is to leave a life estate in the home in his will, or by creating a trust that holds the home for her use. When she dies, the home can then pass to his children. In that case, a series of agreements about how the home will be maintained may need to be created.

Taking the time and making the investment in an estate plan, is for the benefit of the individual and the family. An indifferent attitude about the future is hurtful to those who are left behind.

 

 

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Sleep Apnea Can Be Deadly

Many people think of sleep apnea as a mild annoyance, in that the irregular sounds the person with the condition makes while sleeping can disrupt a partner in bed or the sleep apnea can cause the sufferer to wake up gasping for air. The medical profession now realizes that sleep apnea is far more serious than merely something that prevents a good night sleep. Doctors now know that sleep apnea can be deadly.

If left untreated, sleep apnea can lead to such significant conditions as type II diabetes, high blood pressure, liver problems and perhaps even dementia. When an older person has moderate to severe sleep apnea and is extremely sleepy during the day, he is twice as likely to die as someone who is not in that situation.

The vast majority of people who are prime candidates for sleep apnea, have no idea that they are at risk. Sleep specialists say that most people over the age of 65 are at risk for the most common type of sleep apnea, but fewer than 10% of seniors get tested for the condition. People often think that the only ones likely to develop sleep apnea are overweight men who snore, but this is not the case. As we get older, women also develop the risk for the condition.

You Might Have Sleep Apnea If …

It is easier to be aware that you might have sleep apnea, if you have the obvious classic symptoms, like snoring and waking up gasping for air. However, not everyone has these signs. You might want to talk with your primary care doctor if you:

  • Do not feel as alert or clear-headed as you used to
  • Have difficulty focusing
  • Wake up feeling tired
  • Wake up with a headache that goes away as you get into your day

How to Test for Sleep Apnea

A sleep specialist will evaluate your symptoms and determine, if you need to have a sleep study, also called polysomnography, to assess whether you have sleep apnea. There are typically three types of sleep tests, including:

  • The standard sleep test performed overnight at a sleep center. A technician will hook up a computer to sensors on your chest, legs, scalp, temples, and a clip on your finger or ear. The sensors will monitor your heart rate, breathing patterns, blood oxygen levels, brain waves and eye movements, while you sleep.
  • Some people have difficulty falling asleep at traditional sleep centers, so some of the facilities offer an alternative. They perform sleep studies at hotels, rather than in a sterile laboratory environment.
  • It is possible to do a home test, in which you get a portable monitor from the sleep center and attach it to yourself at home. The center will analyze the results after you return the device. The downside of home testing is that it is far less accurate than the other two options.

Treatments for Sleep Apnea

Physicians offer many suggestions for treating sleep apnea, including:

  • Avoid alcohol for several hours before bedtime
  • Quit smoking
  • Lose weight
  • Use a continuous positive airway pressure (CPAP) machine

A CPAP machine works by blowing air into your throat through a mask you wear all night. The machine contains a pump. About one-third of people stop using CPAP devices, because they find the mask uncomfortable or the machine too noisy for them to sleep. Experts urge patients to try different types of masks, since there are several options.

References:

AARP. “Why You Should Take Sleep Apnea Seriously.” (accessed March 21, 2019) https://www.aarp.org/health/conditions-treatments/info-2019/what-is-sleep-apnea.html

 

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