Planning for disability or incapacity tends to be an abstract process for many people. In our opinion the best disability plans are ones where the person has truly imagined the kind of scenarios that would lead to the plan being used. Understanding that helps them to think through what kids of decisions would need to be made, what qualities would you need in a decision maker, what kind of guidance would they need, and what conflict could arise.
Temporary Incapacity Due to Illness or Accident
When people think of this kind of planning they often focus on the end of life but many of us will need someone to make choices for temporary incapacity due to illness or accident as well. At Phinney Estate Law we got a reminder of just how real that possibility was when Mike came down with a horrible stomach virus. By the time we got childcare for our daughter and got the ER we was so dehydrated that he couldn't give coherent answers to the doctors trying to give him an IV about his medical history or consent for care. Luckily we had his medical power of attorney on file with Group Heath and Jamie was able to take over making care choices for the hour it took for him to get enough fluids in him to be lucid. Similar situations can arise when some has an allergic reaction, is render or is knocked out in an accident. People in these situations usually want full active treatment and are able to resume decision making as soon as their situation is stable. But for that short period, a good disability plan can make treatment more streamlined and effective.
Cancer
Approximately 20% of all Americans will die of cancer and many more will have successful treatment of the disease. Cancer deaths peak at age 65 and diagnosis is usually proceeded by relative good health. Diagnosis is usually followed by intense medical treatment with either recovery or a short terminal phase. Cancer treatment frequently requires surgery and it is not uncommon that doctors will discover additional tumors during an operation. Because the patient is usually under and can't give consent, the frequently need to seek authority from others to address those issues rather than risk further surgery. Chemotherapy and Radiation are also frequently used. Both can cause unexpected side effects that can render the patient temporarily unable to make medical and other life choices. If the cancer cannot be treated, the end of life is often accompanied by intense pain that can be managed by medication but not without making the patient too groggy too make their own choices. This is a period when choices about care can be complicated and when patients often benefit from hospice.
Organ Failure
Deaths from organ failure, generally heart, lung, and kidney disease, peak among patients 75 years old. These deaths account for about one in four deaths in America. Deaths from organ failure often runs a far bumpier course than cancer. These patients’ lives are punctuated by bouts of severe illness alternating with periods of relative stability. At some point rescue attempts fail, and then death is sudden. While the patients are often able to make all the decisions necessary for early interventions and chronic treatment, frequently others must make choices during crisis including how to manage the final emergency.
Dementia & Frailty
For many people death following extended frailty and dementia is their worst nightmare. It can be an long and dignity robbing series of losses for the patient, and an exhausting and potentially bankrupting ordeal for the family. But approximately 40 percent of Americans follow this course, and the majority of those living beyond 85 years of age.
These patients must depend on the care of loved ones, usually adult children, or the kindness of strangers, the aides who care for them at home or in nursing facilities. Those suffering from physical frailty lose the ability to walk, to dress themselves or to move from bed to wheelchair without a lift. These patients require diapers, spoon-feeding and frequent repositioning in bed to avoid bedsores. Those with dementia, most often Alzheimer’s disease, lose short-term memory, fail to recognize loved ones, get lost without constant supervision and eventually forget how to speak and swallow. They typically need custodial care and someone else to make all of their medical choices and take over their financial management. These decision makers face many tough choices about when to seek or decline medical care for patients, especially as their quality of life diminishes, and these choices are made more difficult when the decision making takes place over a long period of time with no meaningful input from the patient.
Each of these scenarios present their own challenges, stresses, and conflicts. In our experience each is made more bearable for all involved if their advanced planning that assigns the right person to make choices and provides them with a guide as to what choices they should make. If you are interested in setting up a free consultation to get started on such a plan, please contact us (206) 459-1908 or info@phinneyestatelaw.com.
Temporary Incapacity Due to Illness or Accident
When people think of this kind of planning they often focus on the end of life but many of us will need someone to make choices for temporary incapacity due to illness or accident as well. At Phinney Estate Law we got a reminder of just how real that possibility was when Mike came down with a horrible stomach virus. By the time we got childcare for our daughter and got the ER we was so dehydrated that he couldn't give coherent answers to the doctors trying to give him an IV about his medical history or consent for care. Luckily we had his medical power of attorney on file with Group Heath and Jamie was able to take over making care choices for the hour it took for him to get enough fluids in him to be lucid. Similar situations can arise when some has an allergic reaction, is render or is knocked out in an accident. People in these situations usually want full active treatment and are able to resume decision making as soon as their situation is stable. But for that short period, a good disability plan can make treatment more streamlined and effective.
Cancer
Approximately 20% of all Americans will die of cancer and many more will have successful treatment of the disease. Cancer deaths peak at age 65 and diagnosis is usually proceeded by relative good health. Diagnosis is usually followed by intense medical treatment with either recovery or a short terminal phase. Cancer treatment frequently requires surgery and it is not uncommon that doctors will discover additional tumors during an operation. Because the patient is usually under and can't give consent, the frequently need to seek authority from others to address those issues rather than risk further surgery. Chemotherapy and Radiation are also frequently used. Both can cause unexpected side effects that can render the patient temporarily unable to make medical and other life choices. If the cancer cannot be treated, the end of life is often accompanied by intense pain that can be managed by medication but not without making the patient too groggy too make their own choices. This is a period when choices about care can be complicated and when patients often benefit from hospice.
Organ Failure
Deaths from organ failure, generally heart, lung, and kidney disease, peak among patients 75 years old. These deaths account for about one in four deaths in America. Deaths from organ failure often runs a far bumpier course than cancer. These patients’ lives are punctuated by bouts of severe illness alternating with periods of relative stability. At some point rescue attempts fail, and then death is sudden. While the patients are often able to make all the decisions necessary for early interventions and chronic treatment, frequently others must make choices during crisis including how to manage the final emergency.
Dementia & Frailty
For many people death following extended frailty and dementia is their worst nightmare. It can be an long and dignity robbing series of losses for the patient, and an exhausting and potentially bankrupting ordeal for the family. But approximately 40 percent of Americans follow this course, and the majority of those living beyond 85 years of age.
These patients must depend on the care of loved ones, usually adult children, or the kindness of strangers, the aides who care for them at home or in nursing facilities. Those suffering from physical frailty lose the ability to walk, to dress themselves or to move from bed to wheelchair without a lift. These patients require diapers, spoon-feeding and frequent repositioning in bed to avoid bedsores. Those with dementia, most often Alzheimer’s disease, lose short-term memory, fail to recognize loved ones, get lost without constant supervision and eventually forget how to speak and swallow. They typically need custodial care and someone else to make all of their medical choices and take over their financial management. These decision makers face many tough choices about when to seek or decline medical care for patients, especially as their quality of life diminishes, and these choices are made more difficult when the decision making takes place over a long period of time with no meaningful input from the patient.
Each of these scenarios present their own challenges, stresses, and conflicts. In our experience each is made more bearable for all involved if their advanced planning that assigns the right person to make choices and provides them with a guide as to what choices they should make. If you are interested in setting up a free consultation to get started on such a plan, please contact us (206) 459-1908 or info@phinneyestatelaw.com.
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