Five Steps To Ensure Your End of Life Wishes Are Honored

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Radiant Scoggins, LCSW, psychiatric social worker at Center for Elders’ Independence, a comprehensive health plan for East Bay seniors, counsels CEI participant Jessie Doublin to complete an Advance Healthcare Directive that reflects her values, what life means to her and how she wants to spend her last days.

Most of us avoid thinking about end of life decisions for as long as possible. Yet according to Radiant Scoggins, LCSW, Psychiatric Social Worker at Center for Elders’ Independence, “planning ahead, whether for ourselves or our loved ones, gives us the comfort of knowing that our voice is being heard and our wishes honored.” She recommends five key planning steps:

  1. Have a life care planning conversation with your family. This discussion supports you in deciding how you want to approach the end of your life, and helps your family know and understand your decisions.  “Who will speak for you?”  “What medical interventions do you or do not want?” and “How would you like your assets to be distributed?”  are just a few  questions to consider.
  2. Choose your representatives. Deciding who you trust to carry out your wishes in healthcare and financial matters is a key step in this process. As you go through life, circumstances may change (marriage, divorce, children) and your choice of who will represent you may also change.
  3. Document your decisions. It is essential to complete the necessary legal documents while you are competent to do so. Without signed directives to provide guidance, your next of kin will be in the uncomfortable position of guessing your true preferences, or the medical and legal systems may take over and make decisions for you. Documents to complete include: a Durable Power of Attorney for Finances that enables your representative to manage financial affairs on your behalf, and an Advance Healthcare Directive which gives your designee authority to make healthcare decisions when you can no longer do so and provides instructions about the care you want to receive. Both of these documents are available online for no charge at various sites including The East Bay Conversation Project (eastbayacp.org), which offers Advance Healthcare Directive and Physician Orders for Life Sustaining Treatment (POLST) forms. It is advisable to consult a qualified attorney to safeguard your interests and ensure that the forms are executed properly. In addition, a POLST form  is used for elderly patients and people with a terminal illness, specifying interventions they want in an emergency medical situation. The POLST is completed by the patient with their physician according to the patient’s wishes.\
  4. Protect your assets with a will or living trust. In the absence of a legal document, the state determines how assets are distributed to survivors. A living trust creates a legal entity that holds and distributes assets based on your instructions, so the estate does not have to go through probate. Consult a qualified attorney to determine if a will or a trust is best for you.
  5. Plan funeral arrangements. To ease the burden on your family during a time of loss and grief, and ensure your final wishes are fulfilled, it is helpful to plan the type of service you want and prepare to cover your costs ahead of time. Final arrangements are often more expensive if no advance preparations have been made.

“Planning ahead for the end of your life is an extremely valuable gift to yourself and your loved ones. Today is a good time to begin,” Scoggins added.

For referrals to qualified elder law attorneys, contact California Advocates for Nursing Home Reform (CANHR.org) 415-974-5171. For more information on Center for Elders’ Independence, visit cei.elders.org.

This is Part 1 of a 2 part series.

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