Paul O. Dillon, Attorney at Law

What Is Needed for End-of-Life Planning?

Becoming incapacitated or dying without planning isn’t uncommon. Nevertheless, it is harmful to loved ones who are left to address the legal and financial aspects at the same time they are experiencing the grief of loss. What needs to happen is addressed in an article from Twin Cities Pioneer Press, “Your Money: A balanced approach to end-of-life planning.”

End-of-life care is expensive. Costs rise as the person moves through the different stages of illness or age. Medicare doesn’t cover long-term nursing care in a facility or at home, so resources without planned protection will rapidly be exhausted. An estate planning attorney can help the family prepare for these costs, but only when planning takes place in advance.

Once incapacitated, people cannot legally sign and execute legal documents. If the family hasn’t arranged for a Power of Attorney or Medical Proxy to be created while the person is still legally able, the family may be faced with the additional expense of going to court to petition for guardianship and/or conservatorship.

There are five basic estate planning documents to be prepared. While every adult should have these documents, they become more critical when someone is closer to passing.

Last will and testament. A will directs how you want your assets to be distributed upon your passing. It may include personal property, real estate, jewelry, family heirlooms and any other material goods. Note the will becomes a public document when the estate goes through probate, so don’t include any account numbers or information you don’t want to read by others.

Healthcare directives. Privacy laws are strict, and healthcare providers are limited in what they can discuss with spouses and children if the right documents are not in place. A Medical Power of Attorney or Healthcare Proxy is needed for family members to be involved in medical decisions. A HIPAA Release Form should be created to access health care and health insurance records.

Many accounts, including bank and investment accounts, IRAs, SEPs and life insurance policies, have beneficiary designations, where a person or persons are named to receive the asset upon the original owner's death. Make sure these are up to date to reflect the owner’s wishes.

Trusts take assets out of an estate for tax and wealth transfer purposes. The person creating the trust dictates how and when the beneficiaries should receive assets. Distributions can occur over an extended period or when certain conditions are met.

Meet with an experienced estate planning attorney if you or a loved one is ill and may be approaching the end of life. Putting an estate plan in place ensures that wishes are fulfilled and spares the family from having to guess what a loved one would have wanted in their final days.

Reference: Twin Cities Pioneer Press (Oct. 12, 2024) “Your Money: A balanced approach to end-of-life planning”

Your College Student Needs a Power of Attorney for Finance and Healthcare

Once a child reaches the age of legal majority, they are considered an adult with privacy rights.  This means that parents lose access to private information. This can have dire consequences if the student is involved in an accident or gets seriously ill, explains the article “Navigating The Transition To Adulthood: A Legal Guide For Parents” from mondaq. With proactive steps, parents can address these situations before they occur.

Whether or not your insurance covers your child’s healthcare doesn’t matter. Without a Healthcare POA, parents cannot make medical decisions, speak with healthcare providers, or talk with the health insurance company. Parents are strongly urged to have their college-bound student complete a Healthcare Power of Attorney.

If there is no POA and the child is incapacitated, parents will have to go to court to be able to make medical decisions for their child. Hospitals and healthcare providers are extremely strict about following these rules to avoid litigation and fines. No matter how bad the situation is, don’t expect any rules to be bent.

Your adult child should also have a Living Will. This is a document controlling decisions about end-of-life. It only becomes effective when a person is in a state of permanent unconsciousness, like a coma, or if they are terminally ill. The student uses this document to express their wishes concerning care: do they want to be artificially fed, hydrated, or kept alive by extraordinary means? Do they want to become an organ donor? This document conveys their wishes and can save the family an unimaginable amount of added stress during a trying time.

A Durable Power of Attorney is used to name a person, known as an “agent” or “attorney in fact,” to act on their behalf. The agent can take care of legal and financial matters. This is needed in case of incapacity so the parent or trusted person may deal with financial institutions, colleges, courts and any other company or organization on behalf of the student. Without it, parents cannot access account information or act on the student’s behalf.

Does your student need a will? The estate planning attorney who helps create the documents listed above can help you answer this question. Depending on their situation, if the student owns a car, has a bank account, an inheritance, or sizable cryptocurrency accounts, they may need a will.

The documents mentioned above should also be in place for parents. If parents don’t have a will, Power of Attorney, Healthcare Power of Attorney, Living Will and trusts, if appropriate, their newly minted adult will have a lot to deal with if they should both die unexpectedly. A visit to the estate planning attorney for all generations is a good idea.

Reference: mondaq (June 24, 2024) “Navigating The Transition To Adulthood: A Legal Guide For Parents”

How Parents and Adult Children Talk about Money and Aging

If you thought it was hard to talk with your children about sex, try talking with them about money and death. Americans generally steer clear of talking about death and money. Nevertheless, these conversations are necessary, according to a recent article, “Let’s talk about money and death: Why aging parents and their adult children should have ‘the talk,’” from MarketWatch. Sharing information about finances and end-of-life wishes can prevent resentment or stress before a crisis and gives everyone involved peace of mind.

If an estate plan has been created and financial and tax planning accomplished, but the adult children aren’t told a plan exists, there may be general worry over decades as parents age. What will happen when they die? Will the siblings know what to do? Who will be in charge? A family meeting to discuss the plan and the parents’ wishes can address these issues.

This is especially important for members of Generation X (Americans born between 1965 and 1980). This cohort has the most assets, may deal with a significant wealth transfer and often cares for its children and aging parents.

Start by putting together an agenda for the family meeting. Understand that there may need to be more than one meeting, since there is so much ground to cover. Long-term Care planning, the current status of the parent’s living situation and plans for a possible move to a continuing care facility are just the start. Do the parents have an estate plan and documents like a Power of Attorney, Healthcare Proxy, Advanced Care Directive and the like?

Money can be an emotional conversation, especially if there are disparities in the sibling’s financial status. Parents are often extremely reticent to share information about their net worth, sometimes because they don’t want their children to lose incentive to work, and in other situations because they are embarrassed about not having enough money to sustain them through their later elder years.

Having a neutral third party in the meeting, like an estate planning attorney, can be helpful when emotions are running high. Holding a family meeting in a law office may sound formal. However, having a professional on hand who can clarify estate, financial and tax matters may help keep the conversation focused. If the estate planning attorney works with a therapist or geriatric specialist who facilitates family discussions, they may be able to help the family move past the emotions of anticipated grief into productive, concrete planning.

Confronting the realities of mortality and money is difficult even in the best of circumstances. Nevertheless, with the support of skilled professionals, a focus on care and the creation of a no-judgment zone, the family will be able to help each other as they prepare for the future.

Reference: MarketWatch (March 23, 2024) “Let’s talk about money and death: Why aging parents and their adult children should have ‘the talk’”

Should You Talk with Loved Ones about Your Estate Plan?

We think of family time as gatherings for holidays and celebrating joyful occasions. However, there are times when the business side of life needs to be addressed. The best time to share your estate plan information with the family is when you are well, mentally and physically, says the article “Financial Focus: Consider family meeting to discuss estate plans” from Vail Daily.

What should your conversation include?

What are your wishes for your estate plan? Do you hope to leave an inheritance for family members, support a family member in need, or create a legacy with a charitable organization? The family meeting is the time to clarify your thoughts with loved ones, especially if there are concerns within the family, such as a special needs member or economic disparities between siblings.

Be prepared for surprises. Your millennial children may be more concerned about you having a secure retirement than an inheritance.

If you have your estate planning documents in order, this is a time to discuss them. If you do not, make an appointment to meet with an experienced estate planning attorney to create a comprehensive plan. Your documents may include a will, a trust, financial power of attorney, health care power of attorney and end-of-life documents. Give your family members a general idea of your wishes, especially for end-of-life matters. This relieves them from having to guess what you would have wanted in times of incapacity or upon your death.

Talk about the roles you wish them to play. You will need to name an executor to administer your estate. They should be asked to take on this role before the time comes. You will also need a trustee and a successor trustee for any trusts. Choosing the right person for these roles involves acknowledging who is more capable—just because one sibling is older does not mean they are the best candidate to serve as executor.

For some families, the best setting for a family meeting is their estate planning attorney’s office. It is a neutral setting and people are less likely to fall into old behavior patterns (including spats) when they are in a professional office.

Let the family know this is not the final discussion about your estate plan. Encourage questions and, if necessary, offer to meet again. If the initial groundwork is set, you will have begun establishing a legacy for yourself and your family.

Reference: Vail Daily (Jan. 25, 2024) “Financial Focus: Consider family meeting to discuss estate plans”

Estate Planning When a Loved One Needs Hospice Care

Many families discover their loved ones haven’t done any estate planning, only when moving a parent into hospice. Whether or not any last-minute estate planning can be done depends upon the loved one’s condition, explains the article “The Challenge of Last Minute Estate Planning” from HomeCare.

If they cannot speak for themselves and do not have a Power of Attorney prepared, last-minute planning is no longer an option. If they can speak for themselves, there may be time to complete a few tasks to make things easier for surviving family members. The family should immediately seek guidance from an experienced estate planning attorney. Here are the steps to be implemented.

Create or update the will. If there is no will, have one created as soon as possible. If one exists, it needs to be reviewed and updated. Use this opportunity to communicate their wishes with family members and others to prevent misunderstandings.

Designate beneficiaries. Ensure that all accounts (bank, retirement, life insurance policies, trusts) have updated designated beneficiaries.

Consider a Revocable Living Trust. If time permits, a revocable trust could be considered for certain assets to take them out of the probate estate and provide flexibility in managing the estate.

Power of Attorney and Healthcare Proxy. They’ll need to designate someone they trust to make financial and healthcare decisions on their behalf.

Guardianship for minor children. If the person entering hospice has minor children, they can designate a guardian in their will to ensure the children’s care and well-being. Someone who is terminally ill at a young age usually has thought about who they want to care for their children. However, this needs to be put into the will.

Emergency document kit. It’s a good idea to prepare a document kit including important information, including a list of assets, passwords, insurance policies and contact information for the estate planning attorney, CPA and financial advisor. Keep these documents in a secure and accessible location.

Digital assets. Create a list of assets, including user logins, passwords and the nature of the digital asset. Include instructions for managing or transferring digital assets, including social media, email and online accounts. There are ways to create legacy contacts for social media, so the accounts can be memorialized or shut down in the future.

Discuss and finalize important decisions. Wishes about end-of-life care are more important than ever. Do they want to be kept alive by artificial means, or is pain management their primary concern? If possible, have these discussions in a supportive and loving manner. A hospice counselor or death doula may be helpful.

Ideally, estate planning should be done long before hospice becomes necessary to ensure that the estate is handled correctly, and a person’s wishes are followed. When last-minute estate planning is needed, it’s critical to collaborate with an experienced estate planning attorney.

Reference: HomeCare (Jan. 16, 2024) “The Challenge of Last Minute Estate Planning”

Are You Neglecting Your Estate Planning?

Estate planning is about more than ensuring that assets are distributed according to your own wishes after you die. It’s also about what you’d like to have happen to your assets and who you want to be in charge of your health care decisions if you become incapacitated. A recent article from Go Banking Rates, “8 Key Signs You’re Neglecting Essential Estate Planning,” outlines the top signs showing that you need to take care of this critical task.

You don’t have a will? This is the biggest red flag of estate planning mistakes. A will, or last will and testament, is a critical legal document specifying how you want your assets to be distributed after you die. If you don’t have a will, the laws of your state will determine how everything in your estate will be given to heirs. If you have estranged family members, they may end up owning everything. There won’t be anything your beloved family members can do about it. All state’s laws are different, so speak with a local estate planning attorney to address this critical document.

How outdated are your beneficiary designations? Many people open accounts as young adults and forget to update them as the decades pass. If you’ve been married, divorced, had children, experienced loss, or if your beneficiaries are no longer part of your life, you will want to update your beneficiary designations. Your assets could very easily go to people like an ex-spouse or a former friend. Beneficiary information should be updated every few years to be sure that your current wishes are followed.

Do you have a Power of Attorney? Everyone of legal age should have a Power of Attorney. A Power of Attorney is a legal document giving a person of your choice the legal power to make decisions on your behalf if you cannot do so because of illness or an injury. Without a POA, your family will need to go to court to apply for guardianship to take care of various duties, like paying bills, managing investments, or maintaining your home.

Do you have an inventory of digital assets? If you pay bills online, are active on social media accounts, or own any digital assets like cryptocurrency, you need a plan for digital assets. Start by making a complete inventory of your accounts—you’ll be surprised at how much of your life is lived online. Some platforms have an option for naming a “legacy” contact—someone who can access your data and manage it after you pass. Your digital executor will also need usernames and passwords. Otherwise, they won’t be able to access your accounts.

Have you planned for taxes? Estate planning includes understanding the tax implications of assets. There may be estate taxes or state estate taxes due from your estate, and failing to plan could leave heirs with a smaller or no inheritance.

Do you need a trust? Trusts are valuable tools for addressing specific needs, from caring for a disabled family member to managing minor children's assets. Without trusts, these individuals could face unexpected complications that could otherwise be avoided.

If you own a business, do you have a succession plan? Business owners need a succession plan to protect their work and family. Planning for a smooth transition includes naming key employees, creating partnership or shareholder agreements and determining if the business can continue to operate and provide income to family members, including the retiring owner.

What about end-of-life care plans? Estate planning includes end-of-life care, including a living will or healthcare directives. Your family will be less stressed if you have documented your wishes for what kind of health care you want or don’t want if you become incapacitated.

Reference: Go Banking Rates (Nov. 25, 2023) “8 Key Signs You’re Neglecting Essential Estate Planning”

How Important Is a Health Care Power of Attorney?

Health care decisions are often the most personal and private decisions a person can make. Information about your health can be very sensitive and if revealed to the wrong person, cause embarrassment, job loss and harm to your reputation. The HIPAA law (Health Insurance Portability and Accountability Act of 1996) was created to provide restrictive protection of medical care. A recent article from The Sentinel titled “Elder Care: The power of an informed healthcare agent” explains how this law makes it more important than ever to have a Healthcare Power of Attorney (POA) in place.

If you think you’re too young or healthy to need a health care POA, think again. If a sharp decline in health occurs, your dignity and care may fare far better with a POA than without, for several reasons. For one, if done in advance, you are the one who chooses who your health care advocate will be.

You may not think an estate planning lawyer’s office is the place to go to deal with important health care decisions. However, this is an important part of your estate plan. Planning for incapacity is as much a part of estate planning as is planning for asset distribution postmortem.

What would happen if you were still alive but not able to understand what is happening around you or unable to speak for yourself? Who would you want making critical medical decisions on your part? Your estate plan includes a Health Care Power of Attorney, which authorizes a person of your choice to be your advocate and authorize or refuse medical treatment, based on the wishes you express in this important document.

Giving someone you trust the power to make health care decisions for you has to be done while you still have capacity. Once you are incapacitated by a medical emergency, even if you have some limited ability to express your wishes, you are not legally permitted to sign this document.

A Health Care Power of Attorney is valuable even without a sudden decline in health or a serious diagnosis. Even in routine medical situations, there are benefits to naming a health care agent. Let’s say you go in for a routine colonoscopy, which is a common procedure for anyone over age 50. Several polyps are discovered and someone has to authorize the doctor’s taking them out. If you have a Health Care Power of Attorney and your agent is waiting nearby, they can authorize the removal. If not, and if the doctor has not asked for prior consent to remove the polyps, then you’d have to wait for a post-procedure meeting with the doctor and then undergo the entire procedure all over again.

Ideally, more than one person should be named as your health care agent. If the primary person is not reachable and an emergency occurs, someone else will be able to step up and help as needed.

Your estate planning attorney should also prepare a Living Will to provide guidance on end-of-life medical decisions. This includes whether you want to be resuscitated, how much medical treatment you would want in case of severe and irreversible brain damage and what life-extending procedures you’d want if you are dying from an end-stage medical condition.

Your estate planning attorney will help guide you through these decisions, since they are ultimately yours to make. However, the idea of having them in place before they are needed puts you in charge of what will happen when you can’t speak for yourself. It’s not easy to consider, but better done than left undone.

Reference: The Sentinel (Sep. 23, 2022) “Elder Care: The power of an informed healthcare agent”

Is a Living Will the Same as an Advance Directive?

A comprehensive estate plan contains far more than a last will and testament. It also contains a number of documents to communicate wishes for decisions to be made during life. These include a living will, an advance directive and a healthcare power of attorney, as explained in the article “What Is a Living Will and Do I Need One?” from healthline.

What is a living will? A living will is a document providing instructions for medical care, or in some circumstances, for the termination of medical support. They indicate wishes for the use or discontinuation of life-sustaining medical treatments. The living will is used if the individual becomes incapacitated and cannot communicate normally. Incapacitation is determined and certified by a medical professional. Living wills address such treatments as resuscitation, hydration, a feeding tube and pain management.

Each state has its own rules for creating a legally valid living will. The information required in most states is:

• Legal name and any aliases or nicknames.
• The current day, month and year.
• A statement attesting to being of sound mind and body.
• Healthcare instructions for events with no reasonable expectation for recovery or quality of life, which may include CPR, DNR (do not resuscitate) and do not intubate (DNI).
• The name of your healthcare proxy, the person who you want to communicate and state your wishes and the name of an alternate healthcare proxy, if you have one.
• Witness statements indicating you willingly and rationally signed this document (the number of witnesses varies by state).
• Your legal signature.

An advance directive is not the same thing but can include a living will. The advance directive has two parts: the living will and the healthcare power of attorney. These documents don’t address finances, property distribution, guardianship of children or any non-medical matters. For those, you need a last will and testament.

The healthcare power of attorney is a document identifying the person named to make healthcare decisions for you. It’s sometimes called a durable medical power of attorney. The person you name to make decisions is called your healthcare proxy, healthcare agent, or healthcare surrogate. This document does not address end-of-life care, but instead grants legal permission to the person to make decisions for you.

The living will, advance directive and healthcare power of attorney work together to allow someone else to represent you during a medical crisis. These documents should be created by an experienced estate planning attorney and shared with the people you choose, so they may act on your behalf. Unfortunately, we never know when a medical crisis or accident will occur, so these documents are needed at any age and stage of life.

Reference: healthline (Sep. 1, 2022) “What Is a Living Will and Do I Need One?”

What’s the Difference between a Living Will and a DNR Order?

A living will and a Do Not Resuscitate Order, known as a DNR, are very different documents. However, many people confuse the two. They both address end of life issues and are used in different settings, according to the article “One Senior Place: Know the difference between ‘living will’ and ‘do not resuscitate’” from Florida Today.

What is a Living Will?

A living will is a written statement describing a person’s wishes about receiving life-sustaining medical treatment in case of a terminal illness if they are near death or in a persistent vegetative state. This includes choices such as whether to continue the use of artificial respiration, a feeding tube and other highly intensive means of keeping a person alive.

The living will is used to make your wishes clear to loved ones and to physicians. It is prepared by an estate planning elder care attorney, often when having an estate plan created or updated. To ensure it is valid and the instructions can be carried out, be sure to have this document created properly.

What is a DNR?

A DNR is a medical directive used to convey wishes to not be resuscitated in the event of respiratory or cardiac arrest. This document needs to be signed by both the patient and their treating physician. It’s often printed on brightly colored paper, so it can be easily found in an emergency.

The DNR should be placed in a location where it can be easily and quickly found. In nursing homes, this is typically at the head or foot of the bed. At home, it’s often posted on the refrigerator.

The DNR needs to be immediately available to ensure that the patient’s last wishes are honored.

A key mistake made by well-meaning family members is to have the DNR with someone else, rather than at home or at the bedside of the patient. If the DNR cannot be found and emergency medical responders arrive on scene, they are legally bound to provide CPR or other medical care to revive the patient.

When the DNR is available, the emergency responders will not initiate CPR if they find the patient in cardiopulmonary arrest or respiratory arrest. They may instead provide comfort care, including administering oxygen and pain management.

If a person is admitted to the hospital, their living will is placed on the chart. Depending on the state’s laws, a certain number of physicians must agree the patient is in a persistent vegetative state or has an end-state condition and can no longer communicate. At that point, the terms of the living will are followed.

In addition to having these documents created with your estate plan, make sure that family members know where they can be found.

Reference: Florida Today (July 19, 2022) “One Senior Place: Know the difference between ‘living will’ and ‘do not resuscitate’”

How Do Estate Plans and Trusts Work?

There can be some confusion around terms used in estate planning. Unless you are an estate planning attorney yourself, it’s not likely you know all the terminology used. A recent article from The Dallas Morning News explains further in the article “Clearing up confusion: The difference between a living trust and an estate plan.”

Living trusts, sometimes called “revocable living trusts,” or more formally, “inter-vivos trusts” are documents prepared and implemented when a person is living. They commonly include a distribution plan for assets owned in the trust, in contrast to a last will and testament, which only comes into effect when the person has died.

In most cases, the person who has created the trust (the grantor) is also the person to benefit from the trust (the beneficiary) as well as the person who controls and manages the trusts (the trustee). A living trust also makes provisions for the trust to be controlled and managed by a successor trustee, in case the owner is incapacitated. This also prevents the need for guardianship proceedings to gain control of the trustee.

If the person has no family members to care for them in the event of incapacity, the successor trustee may be a bank or other financial institution.

Living trusts are good tools to use for disposition of assets, especially in blended family situations. Trusts are harder to challenge than wills, and unlike wills, they are private documents. When an estate goes through probate, the will becomes part of the public record. As a result, anyone can see its contents.

An estate plan refers to the larger plan, which may or may not contain a living trust. It also includes an analysis of all of your assets and directions for how each will pass to your beneficiaries. Estate planning also addresses tax planning: federal and state estate taxes and inheritance taxes.

An estate plan also plans for incapacity. Preparing financial and medical powers of attorney, HIPAA releases and advance directives allow designated representatives to take care of your business affairs, talk with doctors about your care and know what your wishes are, if end-of-life decisions need to be made.

To be clear, estate planning is the “process” which creates a course of action for the passage of assets and the preparation of documents to facilitate the plan. A living trust is part of an estate plan, but not the only piece of the estate plan.

Some people are confused by the use of the word “estate.” Your estate includes everything you own at the time of death. Assets owned outside of trusts are divided into probate estate and non-probate estate assets. The non-probate estate consists of assets with beneficiary designations, usually life insurance policies, investment accounts, jointly owned assets and any Transfer on Death or Payable on Death accounts.

The probate estate includes assets distributed under the terms of a will. If you don’t have a will, the court will appoint an administrator to distribute your assets according to the laws of your state. There’s no obligation for the court to name a family member as the administrator. Therefore, a complete stranger might be in charge of everything you’ve ever worked for. The better route: speak with an estate planning attorney to create an estate plan and learn if your situation warrants a living trust.

Reference: The Dallas Morning News (May 24, 2022) “Clearing up confusion: The difference between a living trust and an estate plan”