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Should Mom Get an MRI?

8/23/2011

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Last Tuesday, I had my first MRI.  The purpose was to positively diagnose a small non-malignant tumor that I will be able to treat with an out patient procedure this fall.  Having never had one before I was struck but the intense noise and the claustrophobic feeling of not being able to move for 40 minutes.  It got me thinking about how much more difficult the test would be if I was in a different state of health. 


For example, my Grandmother has Alzheimer's.  She wouldn't be able to remember the directions to stay still or remember after a few minutes why she was even there or what the loud noises  were about.  How scary!

When we think about the kind of health care choices we may need to make for loved ones who become disabled or the kind of choices we may need someone to make for us, we tend to think of the big choices like life support.  But there are lots of little choices to be made as well and one area that can be challenging is the area of diagnostic testing. 

There are many medical tests that are routinely ordered as people age, like mammograms or colonoscopies.  These tests, while not always pleasant, are wonderful at catching diseases early and allowing treatment.  Other tests - like CT Scans and MRIs - are ordered routinely in response to symptoms and can be helpful in allowing for accurate diagnosis and possible treatment of a variety of problems.  Because these test are routine and rarely involve a life threatening risk, they are often ordered and given with very little thought or deliberation.  However, for people in some medical conditions they may not be appropriate or as routine and safe as they otherwise might be.  For example, people with dementia often need anethesia to remain still and that carries much greater risks than an MRI for a health individual.  The tests may also be more traumatic and destabilizing to individuals who don't understand them and require regular routines. 

If you are acting as a health care agent and are presented with an order for your loved one to undergo one of these tests, in addition to the normal informed consent questions about risk consider asking some of these questions as well.

(1) Why is this test necessary? 
(2) What information would this test give us that we don't have now?
(3) If this test identified a problem, how would that problem be treated?
(4) In what ways might this test be painful or frightening?
(5) Would it require sedation? 
(6) Could symptoms be addressed and comfort provided without this test?

These questions can help you better understand the purpose, benefits, and downsides of testing.  Diagnosis and treatment is the purpose of most modern medicine.  It is part of the medical culture to always want to know the cause of symptoms. But that may not always necessary?  If your loved one has reached a point of ill health or advanced dementia where you would not choose to have them undergo surgery or chemotherapy if they were diagnosed with colon cancer and would instead just choose comfort care measures, then how important is it to have that diagnosis?  If you don't need the diagnosis, why do the colonoscopy?

In my case the test confirmed my doctors' original diagnosis of a hemangioma.  While not a significant problem now, if left untreated in five years it would begin to be painful and impact my facial control.  The treatment will be painful for a few weeks but permanently take care of the process.  Given my age and health it was an easy choice to do the treatment and to do the testing.  If I were making health care choices for my grandmother, I might make a different choice.  It would be helpful in making such a choice that my grandmother was very good about discussing her feelings about treatment options when she was able to make good choices. 

At Phinney Estate Law we work with client to develop estate plans that properly delegate their health care choices if they become disabled AND to provide good direction to their appointed agents.  We also work with clients to make good choices when serving as health care agents or guardians.  Over the next few weeks we will be posting information about these important topics.  

If you want to begin working on your planning or need advice when serving as an agent, contact us to set up a free 1/2 hour consultation at info@phinneyestatelaw.com or (206) 459-1908.

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Jamie Clausen Becomes Communication Director for NW LGBT Senior Care Network

8/22/2011

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Phinney Estate Law attorney Jamie Clausen has been serving as the Chair of Legal Affairs committee of the NW LGBT Senior Care Network.  This month she also took over as Communications Director for the organization.  As communications director she will be in charge of their website and online membership directory.

NW LGBT Senior Care Network is nonprofit that advocates for the need of the LGBT community as it ages and seeks to make sure that services are available that are respectful, aware, and inclusive.  Our website is intended to be a resource for the community and list of service providers who are committed to non-discrimination and inclusion.

Jamie Clausen has been a LGBT rights activist since 1995 when she founding the University of Washington's first straight alliance group for LGBT rights "Friends of Pride Dawgs" and served as media relations director for the successful movement to have the University of Washington become the first major University in the United States to provide domestic partnership rights to students.  She is excited to be working with the Network to advocate for an often ignored portion of the LGBT community in this important way.  Too often LGBT seniors are denied services or forced back into the closet because of a lack of awareness of available resources.  It is a situation that must change.

If you would like information on how to get involved because check out the newly launched website or contact Jamie at (206) 459-1908. 

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Word of the Week: Legacy

8/19/2011

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Legacy
1.  A gift of property, especially personal property, as money, by will; a bequest.
2.  Anything handed down from the past, as from an ancestor or predecessor.

As an estate planning firm we spend a significant part of our practice dealing with the first of these definitions by helping clients to draft wills that makes sure that they leave legacies to the people they most want to receive their property and helping executors honor these wishes at death.

But at Phinney Estate Law we are also committed to helping clients address the second definition of legacy but making wise decisions about how to protect traditions, share values, and make a lasting impact on their families and communities outside of their financial legacies.  To learn more about our work in this area, explore this site, set up an appointment for a free 1/2 hour consultation, or come meet us this eventing at the Phinneywood Seattle Streets event.

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More Than 100 Participants in Our Legacy Wall Project

8/15/2011

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Friday, August 12, 2011 was the third annual Phinneywood Block Party.  Greenwood Ave was shut down from 6pm to 9pm and hundreds of neighbors came out for the event.  Phinney Estate Law hosted a legacy wall where we asked neighbors to tell us what they most wanted to be remembered for.  While many thought the question '"too big" to answer on the spot, more than 100 neighbors filled out cards to share what they wanted their legacy to be. 

Some people named ambitions like writing a best seller.  Others listed relationship like being a good mom or dad.  Others wanted to be remembered for their art or as a great teacher.  But most people listed a quality.  Kindness, compassion, integrity, humor, and joy all got multiple mentions.  My personal favorite was "always leaving the campground better than you found it" which I think works at multiple levels!

The "wall" will be on display at the Greenwood Sip & Ship through the month of August and we are still taking submissions.  Thank you to the City of Seattle for organizing the event and to Tamela Cole (Phinney Estate Law's paralegal) and Becky Clausen (Jamie's mom) for helping us at the event!
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Phinney Estate Law to Host Legacy Project for Phinneywood Seattle Streets this Friday

8/11/2011

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This Friday, August 12th from 6 to 9 pm, the Phinney-Greenwood Neighborhood will be hosting its third annual Summer Streets Block Party and Art Walk.  Greenwood Avenue will be closed and local groups and businesses will be providing free entertainment and events.

Phinney Estate Law will be hosting a neighborhood Legacy Project as part of the event.  We will be asking participants to fill out a card that answers the questions "What do you most want to be remembered for..." or "What do you most want to be remembered as..."  Answers will be posted on a wire display so that residents can see the variety of answers and get inspiration for building their own legacy.   If you are going to be at the event, please come find us and participate.  We will also be handing out materials for more ideas about starting legacy projects of your own.  The project will remain on display at Greenwood Sip & Ship throughout the month of August.

Not going to be at the event?  Participate virtually by posting your response as a comment here!

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Never Too Young for a Legacy (Guest Posting by Tamela Cole)

8/9/2011

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This Guest Posting comes from Tamela Cole, Phinney Estate Law's contract paralegal who does such great work for our clients in the areas of probate and family law.

“Leaving a legacy is about the impact that people make on those they love and their community and the traditions they build that live on beyond them.  Planning for such a legacy isn’t a onetime event it is a lifetime’s work that can start with simple steps.”

Jamie posted this in a blog earlier this month, entitled Legacy Planning.  A few days later I was reminded that “a lifetime” isn’t always as long as we might expect or hope for and that those “simple steps” can be taken by anyone at any time.  On July 20th a member of my church was involved in a terrible auto accident that ultimately took her life.  Rachel Beckwith was only 9 years old, but she had already taken steps to create what has resulted in an amazing legacy.

Having learned about the non-profit organization Charity:Water through Eastlake Community Church, Rachel was inspired to “donate” her 9th birthday to those in desperate need of clean water.  She created a campaign in which friends and family could contribute to the charity in lieu of birthday gifts, and set her goal at $300. When Rachel fell $80 short of meeting her goal, she simply vowed to try harder the next year. 

When the family’s church community learned that Rachel wasn’t going to get the opportunity to try again for her 10th birthday, they contacted Scott Harrison, founder of Charity:Water, and asked to have her birthday campaign reopened. If you visit Rachel’s campaign page you will be amazed at the outpouring of funds given in tribute to a young girl who not only wanted to make a difference —but took steps to make it happen.

Rachel’s legacy is truly incredible. But it not only encompasses the thousands of dollars raised for Charity:Water, it serves as a poignant reminder that you are never too young or too old to take a first step and that no step is too small or insignificant toward creating a legacy in your community.


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Census Data Shows Increase in Same Sex Couple Across Washington State

8/8/2011

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Recently released census data shows an increase in same sex couple throughout Washington State.  The greatest concentration of couples continue to be on Vashon Island and Seattle but the census shows most of the growth has been in neighborhoods other than Capital Hill (West Seattle grew 55%!) and in the suburbs and Eastern Washington. 

Some of this growth may be due to the rights provided to registered domestic partners in this state and its perception as a friendly area to move to.  It is likely that other growth simply reflects that more couples are comfortable sharing their status with the census than they were even 10 years ago.  

The census data also reflects a growth in same couples raising children showing that now 20% of all same sex couples are raising children together.

At Phinney Estate Law we are committed to helping all families create estate plans that are right for them and pride ourselves on our service to same sex couples, who often face special challenges become of a lack of recognition at the federal level.  If you like to set up a free consultation to talk about creating a plan for your family, contact us at info@phinneyestatelaw.com or (206) 459-1908

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Word of the Week: Administrator

8/5/2011

4 Comments

 
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ADMINISTRATOR
:

The person appointed by a court to administer the estate of a decedent and who was not nominated by the decedent as his/her personal representative, usually because the decedent died without a Will.  

At Phinney Estate Law we represent a lot of administrators in their work probating estates.  Often an administrator is appointed because there was no will.  Sometimes there is a will but the named Personal Representative has predeceased the decedent or is unable to serve. 

Whenever we work with an administrator, we work hard to present a case to the court, hopefully with the cooperation of all the family, to allow that person to serve without court intervention so that they can take advantage of that cheaper and simpler probate process.  Sometimes it simply isn't possible under the law, which means that probate will cost an average of ten times as much to administer.  Even when it is possible to get non-intervention powers, the work required to get it approved makes the legal fees at least double what it would have been with a Will that appointed an appropriate personal representative.  Which is why a Will is always a good investment for a family.

There is a statute that lays out who is entitled to serve as administrator, the timeline for their retaining the privilege to serve, and limitations on their serving with non-intervention powers.  If you have lost someone in your life and think you might be entitled to serve as the administrator of their estate, you should contact an attorney as soon as possible to see if you are entitle to serve and what needs to be done to start the process.  At Phinney Estate Law we can answer these questions at a free 1/2 hour consultation. 

Contact us (206) 459-1908  or info@phinneyestatelaw.com.

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Example Legacy Letter

8/4/2011

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One of our clients was nice enough to allow us to share (with the names changed) the legacy letter that he wrote to his daughter as part of his estate plan that we did us.  The letter is to the client's five year old daughter. We hope his example will inspire you to write one of your own.

This particular client had a very hard time putting his thoughts to paper but was really committed to the idea.  He ended up meeting with attorney Jamie Clausen for lunch.  She "interviewed" him about himself and his daughter and his answers became the outline for the letter.  If you are having trouble drafting a letter, scheduling a mock interview with a friend or loved one might help you as well.  For many of us talking about these issues feels more natural than writing them.  It also often brings out more humor and personality.  You could record the conversation or use it to brainstorm ideas for a written statement. 

Dear Lola:

It is very difficult for me to write this letter to you.  You are so young and I hate the idea of not being around to watch you grow up and I hate the idea of my life ending before I have gotten to do so many of the things that I still want to do in life.  But it was important to me to write it because I want you to have something of me if I die while you are still young to remind you of how much I love you and what I wanted for your life.

I want you to know that having you was the best decision of my life.  Raising you has brought your mother and I closer together than we ever were before.  As you know, we are very different people and parenting together really tested us and made us understand and appreciate each more.  I have also learned so much from you.  You have a calm spirit that understands that there is no point in being upset by little mistakes or setbacks.  That is something that I am learning from you.  I also hope that it will be something that you won’t let the pressures of adulthood change in you.  Right now you are such a dare devil and so girly.  I hope you never loose either of those qualities. 

One of the few things that I regret in life is that I didn’t take more adventures when I was younger, particularly that I didn’t travel to more exotic places.  You are a great person to travel with and I loved the trip to London together that we took together just the two of us.  It is my goal to travel with you to some adventurous location like South America when you are old enough.  If I don’t get a chance to do that I really encourage you to take that sort of trip sometime in your life.  I have been glad to have done the traveling that I did during my life.  I think that it is important to see other cultures and other ways of living. 

I also hope that you will travel back to England with some regularity and stay in touch with your family there.  I know that they are far away but you mean a lot to them and I want them to stay a part of your life.  When I left England to come to America it meant moving out of my parent’s house and getting away from them and it felt very freeing.  That is how it feels when you are a young adult and I am sure that there will be times when you will have felt that way about us.  But now that I am older, I really appreciate my family and my parents.  Having you and made me realize how much they mean to me. 

My dad was a hard worker.  I admire him for that but my dad also really cared about his family. He loved my mom and cared about us kids.  My mom was always there for us and always put family first.  When I was growing up, I sometime thought they were too frugal but now I appreciate the value in how they raised us.

I like to think that I am a hard worker like my dad.  I hope that you will be a hard worker too.  But, while work time is important, you need to enjoy your playtime too.  Life isn’t all about work.  And try to make some of that playtime physical.  It is important to your health and to being happy.  Right now you love to dance and bike, I hope you keep those kind of activities.  I also think it is important to get out into nature.  Don’t get stuck in an office your whole life.  The natural beauty in the Northwest is one the things that I love best about living here.  Right now you love to be outside and are so curious about animals and science.  I was never very good at science but I hope you keep up those interests and wonder and continue to appreciate and experience the natural beauty here. 

For my career, I choose to work with the disabled.  While this doesn’t pay that much, I have been happy with my choice. Even as a kid I knew that I wanted to work in a helping profession.  I would encourage you to do the same.  If it isn’t your career, I would encourage you to find ways to volunteer to help the disadvantaged.  I think that it teaches you compassion and empathy.  It will also remind you that, whatever problems you might have, there is always someone who is less fortunate. 

Beyond that I don’t have much in the way of life advice.  I don’t have any destiny in mind for you that I need you fulfill to make me happy.  I want you to be a decent person who is honest and caring and enjoys life.  I think you will be. 

We have had our moments and I know that I can sometimes come off as the strict parent: The one who wants you not to make mistakes and wants you to succeed.  I am trying to learn to be more calm and patient. But I want you to understand that I want you not to make the big mistakes in life because I want you to have the opportunities to do everything you want to do and I don’t want you to close off any of those opportunities that you might want later on.  I want that for you so you can make your own choices and have the life you want.  But you need to know as you go through life that I know that everyone makes mistakes and that there is no mistake you could ever make that would have ever made me not still love you like I do now.

And I do love you very much.  You are my “bug”.  I love counting down the microwave time with you.  I love playing with you and reading to you.  I love dancing with you in the living room, digging in the garden, and biking to errands.  I like sneaking our secret vices like riding in the car together or eating french fries, pizza, and ice cream. 

One of my favorite memories is of teaching you to climb on the monkey bars. I held you up and helped you climb until you got the hang of it and then let you go and watched you play.  And while I was nervous, you climbed across those bars like a pro.  And honestly, that is how I feel about you and your life.  I want to get to help you learn and I will always be a little bit nervous but ultimately, I really think you are going to be ok no matter what.  And that makes me proud to be your dad. 

Hope you never have to read this.

Love,
Dad

PS:  Vegan, Vegetarian, or Meat eater? Its your choice.  Ultimately, everything is.

If you are interested in creating an estate plan that includes legacy planning, contact us at info@phinneyestatelaw.com or (206) 459-1908.

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    PEL Blog

    This Blog is written by Seattle Attorneys Jamie Clausen & Michael Ballnik.
    It is made available for educational purposes only. Its purpose is to give you general information and a general understanding of the law, not to provide specific legal advice. Reading this blog does not create an attorney client relationship between you and Phinney Estate Law. Because each individual and family is unique, the Blog should not be used as a substitute for legal advice from a licensed professional attorney in your state.

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