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January 21, 2010
Why Your Parents Need a Living Will
Filed Under (Diabetes (Type 2)) by admin

If your parents become unable to make decisions about their end-of-life care, a living will is one of the documents that can help ensure they receive the treatment they want. But it has benefits for you, too—namely, the peace of mind that comes from knowing you are following their wishes. Indeed, living wills aren’t just for seniors. Sanford J. Mall, a nationally certified elder-law attorney with Mall Malisow & Cooney, in Farmington Hills, Mich., explains why everyone needs one.gt;gt;
gt;Q:gt;
gt;What is a living will?gt;
gt;gt;
gt;A:gt;
gt;A living will, sometimes called an advanced health directive or a medical power of attorney, is a legally enforceable document that identifies a patient's end-of-life wishes. It can specify that you want the cessation of treatment under a specific set of conditions—when you want to "pull the plug," in other words. Most people draw the line in one of three ways.gt;gt;

gt;gt;If they're in a coma or a persistent vegetative state and there's no hope for recovery.gt;gt;gt;gt;If they're not in a coma, but have lost so much cognitive function that the doctor feels there's no hope for recovery.gt;gt;gt;gt;If there's a terminal illness with no hope for recovery.gt;gt;

A living will does not authorize someone else to act on your behalf for medical decisions. You need a health-care proxy for that.gt;
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gt;Q:gt;
gt;Who should have a living will?gt;
gt;gt;
gt;A:gt;
gt;Anybody who is older than 18 and competent. If you are sure you don’t want to be put on artificial support, and don’t want to have extraordinary measures used to sustain your life, then you should sign a living will. Remember the case of Terri Schiavo: Her husband and her parents fought a seven-year legal battle over removing her feeding tube, with some 20 judges ruling on whether there was sufficient evidence that she would want to stop treatment. If it had been in writing, would you need 20 judges, or all the heartache and family strife? No.gt;
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Next Page: gt;What to include in your living willgt;
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gt;Q:gt;
gt;How do you get a living will?gt;
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gt;A:gt;
gt;In many cases, gt;state bar associationsgt; have forms available online. They may not be exactly what you want, but at least they're a starting point. If you work with a lawyer, you won't have to worry about whether the form is good or bad. Plus, you may want something very specific in your document that the form doesn't cover; a lawyer can help you with that. Each state has its own requirements for what you need to do to make the document legally enforceable, such as the number of witnesses and who can sign as a witness. These guidelines, which can affect whether the document is legal or not, should be spelled out on your state's bar association site. You may also be able to find living will resources at local hospice groups. Some hospitals offer the forms for patients or visitors.gt;
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gt;Q:gt;
gt;What should a living will say?gt;
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gt;A:gt;
gt;I recommend that a living will respond broadly to what a person wants—it’s hard to anticipate every possible specific scenario. However, there might be individualized specifics. Take my grandmother, for instance. On the one hand, she believed that "where there's life, there's hope," but on the other, she never wanted to be intubated because she had it done once and found it to be the most excruciating experience. Also, she didn't want a doctor to perform any chest compressions on her, even if she could die without them, because she was weak and her ribs could be easily cracked. So the document we drew up for her had to take all that into account.gt;
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gt;Q:gt;
gt;How do you talk to your parents about getting a living will?gt;
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gt;A:gt;
gt;The best way to have that conversation is proactively. Have it in advance of anyone needing a living will. Even if your parents put off your initial approach, at least you've planted the seed. And even in states where next of kin can legally make an end-of-life decision for someone, a living will can at least let you know what your parents want. I recently had a situation where a man who had a terminal illness came to see me to do his end-of-life planning, including a living will. At his funeral, his daughter came up to me said, "When we got the call from the hospital that a decision needed to be made about Dad, we pulled out all the documents and read what he wanted. It was such a comfort knowing that he thought about these things and was specific about what he wanted."gt;
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January 21, 2010
Special-Needs Trust: How to Ensure the Care of Your Disabled Child
Filed Under (Diabetes (Type 2)) by admin

Caring for special-needs children can be very expensive. Some parents are prepared to spend a small fortune to provide food, shelter, and medical care for their special-needs kids. But what if the care becomes unaffordable? And who will take over when the parents are no longer around?gt;gt; "People with disabilities are now living long lives," says Chris Cooper, a certified financial planner in Toledo. "They're living into old age and getting old-age problems like Alzheimer’s and arthritis, so they're dependent much longer." In conjunction with government assistance, a special-needs trust can ensure that your child is set for life.gt;gt;gt;What is a special-needs trust?gt;gt; A special-needs trust, also known as a supplemental trust, is a safe place to park assets for your disabled child. First of all, the trust is protected; if you are sued, go through a divorce, or have your will contested, the funds cannot be touched and there will never be an interruption in available money for your child. Second, by giving money to the trust rather than directly to your child, he or she will continue to qualify for government assistance programs. "You can give money in such a way that the state doesn't view it as an asset or a resource," Cooper says.gt;gt;gt;How does a special-needs trust interact with government programs?gt;gt; Many children with special needs—a category that comprises a wide array of medical, behavioral, developmental, learning, and mental-health conditions—qualify for government assistance programs such as Medicaid, which covers most medical services and housing, and Supplemental Security Income, which provides a monthly stipend for basic living needs. These programs are administered on the state level; though eligibility requirements vary, in most states your child cannot have more than $2,000 in assets. If you or a relative bequeaths more than that to your child, it should be placed in a special-needs trust; otherwise he or she can be disqualified from government programs.gt;gt;
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Next Page: gt;How do I set up a special-needs trust?gt;
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gt;gt;How do I set up a special-needs trust?gt;gt;Initiate the trust as soon as you determine that your child may not be capable of supporting himself. If your child's development improves and he is able to earn a living, great—the trust can always be dissolved and the funds returned to you or given to the child. Special-needs trusts are complicated animals, however, and rules vary from state to state. You should gt;find a financial plannergt; who deals specifically in this area of the law.gt;gt;gt;How do I fund the trust?gt;gt; Although you can fund the trust with your estate or the proceeds of a life insurance policy, Ron Pearson, a certified financial planner in Virginia Beach, Va., who specializes in families with special-needs children, recommends that you do it throughout your lifetime. Should you die unexpectedly, the trust will already be operational and able to provide your child with money. You should also inform your extended family about the trust so that relatives don't inadvertently disqualify your child. Aunt Edna's thoughtful $10,000 inheritance should be left to the trust, not the individual.gt;gt;gt;How will my child use the trust?gt;gt; The money is doled out by a trustee, either yourself or someone you designate. The funds can be used anytime, not just after your death. For instance, you might make use of government programs to provide basic expenses like medical care and housing, while using a special-needs trust for "enhanced care that improves the quality of life," says Pearson. Pearson, the father of two developmentally disabled sons who live in a group home, says he gives his sons money from their trusts that they mostly spend on country music CDs. You could also use the money for medical equipment or care that Medicaid doesn’t cover.

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