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Advanced Directives – My Personal Experience When Planning for the Unexpected

My Story

Like many of you reading this article, I never think a major medical disaster could happen to me or, if something did happen, that I would be competent enough to make decisions for myself. Well, as a ‘relatively young’ guy, this was not the case recently when I needed emergency surgery to prevent permanent paralysis.   Two years ago, I was practicing my golf swing on a late Thursday afternoon at Sleepy Hollow in Brecksville, Ohio.  I’m a terrible golfer and I wanted to ensure I wouldn’t embarrass myself the next day while playing with a client.  Near the end of my practice, I decided I wanted to see how hard I could hit the ball.  I hit the ball with maximum effort that ended up landing on the fairway outside of the nets.  During my swing I felt a ‘pop’ in my back and my leg went numb.  I decided to call it quits and go home to rest.

That night, while resting I leaned over to grab the TV remote.  Without warning I had excruciating pain suddenly occur in my back and my legs went limp.  I was on the floor unable to move or reach my phone. Luckily, my friend was visiting and he called EMS.   When EMS arrived, I was crying from the pain, unable to move my legs, laying on the floor.  I have never experienced anything more painful in my life. The paramedics gave me a shot of fentanyl for pain – it did nothing. Upon arriving at the hospital, the nurses gave me a shot of morphine – it did nothing. Then the doctor ordered a dilaudid.  After an hour of being on a combination of fentanyl, morphine, and dilaudid, I was finally relieved of pain and in addition, also relieved of my mental abilities.

After an MRI was performed, the doctor came to give me the news.  She said that I had a severe lateral herniated disc. The disc exploded and was piercing the nerves that control my legs.  I would need emergency surgery within the very immediate future, or I would have permanent paralysis in my right leg for life.  She explained that because the herniation was lateral, it required a more complicated approach.  It was one that she could handle, but she felt her colleague (who was on vacation) was more adept due to his experience. The doctor suggested that I wait three days, in severe pain and on multiple pain meds, to have her collegial surgeon perform the surgery. She needed to know what I wanted to do.   However, because of the effect the medications I was taking for pain, I did not have the mental competency to make this decision myself. Instead, those who I named in my advanced directives would need to make these decisions for me.

What are advance Directives?

Simply put, advance directives are legal documents that provide detailed instructions about who should oversee your medical treatment and what your end-of-life or life-sustaining wishes are. In the event you are unable to speak for yourself, like in my case of mental incapacity, the medical professionals can contact someone else who has authority to make those decisions for you. Though there are many advance directive documents out there, the three most common are Healthcare Powers of Attorney, HIPAA Authorization and a Living Will.

Healthcare Power of Attorney – A healthcare power of attorney allows you to appoint a trusted person to make all healthcare decisions in the event that you are unable to make them for yourself.

Living Will – A living will eases the burden on your healthcare POA to ‘pull the plug’ when you are in a permanent vegetative mental state.

HIPAA (Health Insurance Portability and Accountability Act) – Medical records are private and are covered under the HIPAA laws. You Healthcare POA must have the authority to obtain your medical records through a properly executed HIPAA authorization.

My Healthcare POA

By this time, I was admitted in the hospital and the surgeon needed an answer regarding when I wanted the surgery to take place.  The doctor asked to contact my healthcare POA. I said, no problem her name is Kathy and I will provide her number.  I reached for my phone and it was then I realized that I had forgotten it when EMS brought me in.  Like many of us, I did not memorize Kathy’s number so without my phone, I was stuck.  Additionally, since this was during the outbreak of COVID my friend who called EMS was not able to come into the hospital either.

The nurse taking care of me looked through my cart and noticed I already had my healthcare POA on file, naming Kathy as my Agent. I wasn’t thinking clearly so I hadn’t thought to ask the nurse to check.  It was then that I remembered, in a slight daze, that I practice what I preach.   Three years earlier I completed all of my advanced directives and made sure to upload them with all three major hospitals: Cleveland Clinic, University Hospital, and Metro.

The hospital called my Healthcare POA and she came to my rescue.  As a nurse herself, she knew exactly what medications I was on and how to interpret the medical situation.  Moreover, and critically important, she knew how to handle the insurance barriers that come with getting medical treatment.  Had I not completed my Healthcare POA, Living Will and HIPAA several years prior, I may have had a surgery from an inexperienced surgeon or worse yet, may have been paralyzed for life.  Additionally, had I not uploaded these precious documents with my local hospitals, I would not have had my healthcare agent’s phone number.

When I preach to clients about maintaining updated advanced directives I am preaching from experience.  I didn’t need them, until I needed them! Advanced directives are easy to obtain and require minimal effort to have them uploaded to local hospitals.  I implore you to have them drafted by an attorney or at the very least, complete them the next time you’re at your family care physician. For more information or to learn how Baron Law can help you complete your advanced directives, contact us at 216-573-3723.

 

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Advantages of Establishing a Trust

There are many estate planning tools out there.  But simply put, a trust is an estate planning tool that allows you to plan in advance.  A trust allows you to control your assets even after your death and may allow for certain tax advantages as well as privacy and the avoidance of probate.

There are many different types of trusts and each is used under specific circumstances.    For example, a charitable trust is a unique tool used to establish your legacy with a charity while saving on your income taxes.  Revocable and irrevocable trusts are another form that might help provide protection against creditors, Medicaid, and law suits.  And finally, special needs trusts might help protect your special needs child or family member.

The main difference between a will and trust is that only a will passes through probate.  However, through a trust, your assets will pass to your loved ones privately and does not involve the probate court.  Through a will the probate court oversees the administration of the will and ensures the will is valid. The court will then also administer the property making sure it gets distributed the way you intended.   One disadvantage of a will is that all information and transfers through a will are public, and are reported with the state.

If the court authenticates your will, it will pass through probate reaching your intended beneficiaries.  If the will is not authenticated, your money might end up with the state, instead of your loved ones.  Comparatively, courts do not need to oversee the distribution of a trust, which can sometimes save time and money.

Another benefit of having a trust is that a trust takes effect as soon as it is created.  Comparatively, a will takes effect only after you die.   Through probate, a will determines who will receive your property at your death and it appoints a legal representative to carry out your wishes.  This person is called the Executor.   In comparison, a trust may be used to distribute property before death, at death or afterwards.  A will covers any property that is only in your name when you die. It does not cover property held in joint tenancy or in a trust.

In sum, if you want to effectively save time, money, and headache for your loved ones then you might consider establishing a trust.  A trust avoids the probate process and protects your assets against creditors and lawsuits.  Most importantly, a trust ensures the right people inherit your estate, and that nothing is left with the State.  Contact Cleveland, Ohio estate planning attorney Dan A. Baron for a free consultation.    Contact our Cleveland, Ohio office today at 216-573-3723.