Topic: Advance Planning: wills, trusts, powers of attorney etc.

On April 23, 2014, I attended a webinar on advance planning sponsored by the Cancer Legal Resource Center and thought some of you might find the information provided helpful.

Many people avoid the subject of advance planning but it is necessary to ensure that your property is protected and your health care directives are carried out if you are incapacitated, and that your estate is distributed in accordance with your wishes after your death.  The Cancer Legal Resource Center strongly recommends you consult with an attorney regarding advance planning. 

Estate Planning
Your estate includes your bank accounts, safe deposit boxes, stocks, and other assets that are maintained in your name alone.  Assets that are jointly owned (which pass directly to the surviving owner) and assets with a designated beneficiary (life insurance, IRAs) are not included in your estate.

A will is a written document specifying how you want your estate distributed after your death.  To be valid a will must comply with the requirements of your state.  Most states require that it be in writing and that it be witnessed by disinterested parties.  If you have a valid will in place, it is important to review it periodically to make sure it still reflects your wishes.  If you die intestate (i.e., without a will), the laws of your state will determine how your estate is distributed.  In general, an estate covered by a will or the estate of a person who died without a will must go through probate.  Some states have simplified procedures for small estates.

A trust is a fiduciary relationship in which one party (the trustor) gives another party (the trustee) the right to hold title to property or assets for the benefit of a third party (the beneficiary).  Property covered by a trust does not go through the probate process and information about it is not public.   Although a trust generally covers only that property that has been transferred to the trust, it is possible to prepare a “pour over” will that will transfer property to the trust upon your death.  Generally it costs more to establish a trust than it does to prepare a will but a trust may save money later as probate costs will be avoided.

Protecting your property if you are incapacitated
A Power of Attorney for financial affairs is a document designating an agent to act for you in the event you become incapacitated. It must be signed and witnessed in accordance with the laws of your state.  A springing Power of Attorney (the most common type) becomes effective only when you become incapacitated while a durable Power of Attorney becomes effective immediately.  A Power of Attorney ends upon your death.

Health Care Directives

Power of Attorney for Health Care.  This is a document designating a person to make decisions regarding your care in the event you are unable to do so.  You can include specific instructions or provide only general guidance.)  In general you have the following rights regarding end-of-life care: the right to palliative care, the right to refuse food, the right to refuse medical treatment, the right to palliative sedation, and the right to have your wishes upheld.

Physician’s Order for Life Sustaining Treatment (POLST).  Forty states have a procedure whereby a patient and physician can agree on life sustaining treatment and sign a form that has the effect of a medical order.   

Death with Dignity/Aid in Dying.  A few states permit assisted suicide under certain circumstances. 

Resources
Cancer Legal Resource Center – 866-999-3752 (toll-free) or www.cancerlegalresourcecenter.org
Caring Connections: www.caringinfo.org
Compassion and Choices (end of life issues): www.compassionandchoices.org

Re: Advance Planning: wills, trusts, powers of attorney etc.

Linda R. this is so helpful as I don't think a lot of people are prepared and this is great. Hope we can save it somewhere. Little did I know I would be suing a Hospice Company and would win. It cost me 5,000K to set up an estate. I might add that it doesn't ever hurt to start setting these things up in the beginning as it will save so much stress later. ThanX

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Advance Planning: wills, trusts, powers of attorney etc.

Thanks LindaR. I just completed all of that and feel much better about how things will be handled. It was a big relief honestly.
Jenny

A thousand words will not leave so deep of an impression as one deed.

Re: Advance Planning: wills, trusts, powers of attorney etc.

Linda I too have completed all of this and thank you for this info.  At 34 this task at the time felt very wrong and difficult for me to do, but cancer or no cancer...I am glad that I did this and it is important and vital info for me and to those around me.  I agree it is a big relief but also a difficult task to complete while you are going through it.  It wasn't easy. 
Porter

Hope, love, strength...2013 and for the years to come, Porter.

Re: Advance Planning: wills, trusts, powers of attorney etc.

This is really important info for everyone!  Taking off my lawyer hat, I speak from personal experience after losing a brother unexpectedly that everyone needs to think about planning for the inevitable. Whether it's this cancer or getting hit by a bus, everyone reaches the point of needing some or all of these documents and plans.

I'd also add that if you have specific wishes about what you want done after you die that you make it clearly known. I had a friend whose parents were killed in a plane crash years ago. They had lived all over, due to many corporate moves and the family was very divided over where they wanted to be buried. Caused a lot of disruption and upset at the time.

Impatient patient.

Re: Advance Planning: wills, trusts, powers of attorney etc.

I agree with Lisa ....it isn't just for having CC that we need to have these documents in place.  There wouldn't be much argument in our family over where we would be buried, as we have a burial plot among other family members already.  Still, it's good to have things in writing.  Shortly after we were married, we wrote up wills , which at the time were pretty simple, but they covered any future children, just in case we didn't get around to revising as our family dynamics changed.  Since then, we've changed our wills, etc several times to reflect the changing situations, the most recently about 4 years ago.  They are still up to date, so we shouldn't have to deal with any of that right now  However, there are some personal, family items that my husband wouldn't have a clue of the importance....family heirlooms passed down several generations, valuable paintings, jewelery, quilts, etc.  I found my self on the bed in pre-op for my liver biopsy, ...telling my husband while I was in tears....several of the special items which weren't marked....a special quilt....pieces of jewelery....who I wanted them to go to in case something happened.  Normally, those aren't covered in a will, but should be written down and at least marked with a note as well.  We only have one child, age 34, so this shouldn't be a problem, in any case, but you never know. 

Great info, Linda,

Thank you...Julie T.

Just for today, I can get through anything.  "Never let fear decide your fate."  (from the band, Awoination.)

Re: Advance Planning: wills, trusts, powers of attorney etc.

Linda -
Very good. I am actually going to print out your post so I can give it to my patients so they can understand it all better. I run into these questions all the time.
The first thing we did when Mark was diagnosed was get all of our ducks in a row. We did it all but the POLST and he chose not to make that decision yet....leaving it in my hands if the time came.

Good post.
KrisV

Any advice given is based on my experiences and should not be substituted for any medical recommendations. Please speak with your provider before making any changes.

Re: Advance Planning: wills, trusts, powers of attorney etc.

Everyone, this reminds me of Teddy's last visit to the Lake House in Milwaukee. All our kids mine AND his came out and spent 2 days with us. Teddy had sat for 2 weeks in our house before we went and he made bags for EVERYONE. There were I think 24 of us. He put in Jewelry, special caps, T shirts what ever meant something to him from the Shrine and etc. One by one they met with him in a room and he said what ever he needed to say, I know not what he said to anyone. Had his little chat and gave each one a bag. This was good for him and good for them as everyone got some time with Gandpa.
And Grandpa got to say his personal goodbye to all. AND it was anything but sad.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Advance Planning: wills, trusts, powers of attorney etc.

I'm glad you found this helpful.  As some of you may know, my husband Terry died of cholangiocarcinoma on February 15.  He was the most optimistic person I have ever known but he did realize the importance of advance planning.  The steps we took to make sure all of our affairs were in order have made my life much easier during the past 2 1/2 months.  I am also fortunate to know that the decisions I made about his care at the end of his life were in accordance with his wishes.  This gives me a great deal of peace.

Re: Advance Planning: wills, trusts, powers of attorney etc.

Many many thanks indeed for posting this Linda. I know it will be of great help and interest to so many people.

Thanks again.

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.