written By John Ferrari
Do you want a secure future? Of course; everyone feels a little better
knowing the future is secure – but sometimes planning for a secure
future can seem like a full-time job. Do you know there’s a way
to help make things easier for your family and ensure your own future
care, comfort and peace of mind? Advance directives can do just that,
with a little time and effort from you.
Advantage spoke with estate planning, trust and probate attorney Beti Tsai
Bergman, a member of Torrance Memorial’s Professional Advisory Council,
about the advantages of advance directives, so keep reading – we
won’t ask you any more questions, promise.
Advantage: Advance directives are sometimes called advance health care directives
because they specify a person’s preferences for medical treatment.
How, legally, do advance directives work?
Beti Tsai Bergman (BTB): An advance directive is a legal power of attorney. In addition to specifying
health care and treatment preferences for the individual, called the principal,
the directive also names and empowers an agent – someone who can
make medical treatment decisions for the principal. People should have
that in place for when they can’t make decisions for themselves.
Advantage: Advance directives are used when the principal is unable to express his
or her preferences for medical treatment, usually because a medical condition
has rendered the person unconscious or otherwise unable to communicate, right?
BTB: There are two types of advance directive. Advance directives may spring
into effect when the principal loses capacity, or they may be effective
immediately. This is useful for people who want help planning their care.
Some people have the capacity to make decisions but physically are limited,
or they don’t want to deal with everything, and they’re comfortable
with someone they trust making decisions for them. For example, an immediately
effective advance directive can allow the principal’s grown son
or daughter to speak with medical caregivers about medication and end-of-life
decisions, or make decisions about care facilities, so the principal doesn’t
have to do it all. Of course, that son or daughter has to be named an
agent in the advance directive.
Advantage: What else can an advance directive do, besides specify the principal’s
preferences regarding medical treatment?
BTB: Some people like to have very detailed instructions, including an assisted
living facility, even their preferred diet. Besides the ability to make
decisions about medical treatment, the health care agent can also be given
a power of organ donation and burial.
Advantage: What are the limitations of advance directives?
BTB: The big one is people need to put it in place when they have capacity
to put it in place. The principal has to prepare the directive. That’s
why it’s important to have an advance directive before you really
need it. The other thing to remember is agents are not required or obligated
to do the job. Advance directives give them the authority, but they’re
not obligated, so it’s important to speak with anyone you’re
thinking of naming as an agent, to make sure they understand what’s
in it and what your preferences are, and they’re OK with being named
your health care agent.
Advantage: What should people consider before completing an advance directive?
BTB: The main things are who you want to name as your agent, and to name as
many successors as possible to back up your primary agent. You should
also consider end-of-life decisions, like whether you want to be put on
life support or not, your burial preferences, whether or not you’d
like to be an organ donor, and what should happen if you need round-the-clock care.
Advantage: Can anyone prepare an advance directive?
BTB: I would highly recommend that anyone who wants to put together an advance
directive, by itself or as part of an estate plan, go to someone who’s
qualified in this field. Even though the documents may be simple, a lot
of law goes into them. It’s not as simple as filling out a form
– there are different options, and it’s easy to miss something.
Advantage: What happens once someone completes an advance directive?
BTB: We have people name their primary physicians, and we send copies to their
doctors. We tell people to take copies to any hospitals they may be admitted
to. The hospital will keep it on file as part of their medica record.
It’s best to make sure their doctors have a copy, and to let their
Beti Tsai Bergman is an estate planning, trust and probate attorney and
member of Torrance Memorial’s
Professional Advisory Council. She practices at Peninsula Law in Torrance and can be reached at 310-694-8703.