The short answer is no, they are not the same. A DNR stands for a DO NOT RESUSCITATE order. A Living Will is a completely different document that is used during a very different time.
A DNR should be entered into at your doctor’s office or in the hospital, not at your local estate planning and elder law attorney’s office.
Typical estate planning documents that an attorney will assist you with would include a financial and medical power of attorney as well as a Last Will and Testament and maybe a Trust of some type. The confusion often lies in the fact that in a medical power of attorney, you will often see a Living Will as a part of the document.
This is collectively known as an Advance Healthcare Directive if medical power of attorney and living will are together in one document. The Living Will does not kick in until the individual is “end-stage medical.” While there is a very long medical definition for this term, I simply like to state it as when two qualified physicians put in writing that there is no realistic hope of recovery and that you will always remain vegetative, comatose, permanently unconscious, and terminally ill. A medical power of attorney, living will, or advanced health care directive are often documents that are obtained from your estate planning and elder law attorney and not from your health care provider.
On the other hand, a DNR or DO NOT RESUSCITATE order is intended to let emergency and other medical professionals know whether or not they should resuscitate you. Methods often used for resuscitation would be things such as defibrillators, breathing tubes, ventilators, CPR, and other invasive techniques.
The DO NOT RESUSCITATE order comes into play when the heart has stopped beating or the person has stopped breathing. The medical power of attorney, on the other hand, comes into play when the person simply cannot answer questions for themselves. That could be for numerous other reasons, such as being under sedation or incapacitated, unconscious due to an accident, or unable to speak.
Certainly, it does not necessarily mean that the heart has stopped beating or that you have stopped breathing. The Living Will does not kick in until the end of life, but the heart is often beating, sometimes due to heroic and lifesaving measures, but the DNR will prevent those “heroics” if that is your wish.
We truly believe that it is imperative for you to talk to your estate planning and elder law attorney about the estate planning documents as outlined above as well as discuss with your doctor about a DNR order. While you are discussing the DNR order, we would also recommend that you have a conversation with your healthcare professional about a POLST (Physician’s Order of Life-Sustaining Treatment). These are documents that will be obtained directly from your doctor and they will be able to assist you with the nuances of how they work.
We hope this article provided insight into the definition of a DO NOT RESUSCITATE order and the difference between a medical power of attorney and a Living Will. If you would like further information about these items, contact our office. We’d be more than happy to assist you. Call us at (717) 845-5390.
It is very easy with everything that is going on in our country and our world right now, to be concerned about the pandemic and start to think about your own mortality and planning. While we recommend planning at all times to always be prepared ahead of time, this certainly provides a reminder for us to stop and take a look at our current situation to make sure that we have at least our basics in place. Powers of AttorneyEach person should have a financial power of attorney that authorizes another individual to make financial decisions on their behalf in case they cannot. They could be unable to because of an illness or an incapacitation or simply just not in town, or maybe they are traveling out of the country. We cannot stress the importance of having a financial power of attorney in place to avoid the necessity for guardianship. We have discussed in detail in other blogs and articles about powers of attorney and guardianships, and we would encourage you to please take a further look at those, and why it would become important to have a financial power of attorney in place.A medical power of attorney is an essential document that authorizes another individual to make medical decisions on your behalf if you are not capable or able to make those medical decisions for yourself. Although there is a healthcare statute in the state of Pennsylvania that will name the next of kin to be able to make those healthcare decisions in case you cannot, we stress the importance enough of having this document in place to ensure that the people that you want making those decisions can make them without unintended people being named as well. When you reach the end-of-life stage it's also important that you have in place a living will. If the living will is coupled in one single document with a medical power of attorney, that is also considered an advanced healthcare directive. We recommend having these documents in place to ease the burden on your family. This will save them from having to make those end-of-life decisions if two qualified physicians put in writing that there is no realistic hope of recovery that you will always remain end-stage medical or vegetative, comatose, permanently unconscious, or terminally ill. There is certainly a lot that goes into the medical definition, but plainly stated, it is imperative to decide for yourself how you would like those decisions to be made rather than to put the burden on a loved one to feel like they have to play God or pull the plug on their family member. Review Your Current Documents, Including Beneficiaries, to Ensure They Meet Your Needs and Desires We encourage anyone who has planning in place to not assume that it is up to date or that it is what their current wishes are, things change over time. It is also important to review all of your beneficiary designations on accounts, such as life insurance policies, annuities, retirement accounts, etc. Often, the most overlooked item is reviewing the beneficiary designations of an account, and it is probably the most critical thing that can screw up an estate plan. Please make it a priority to review your documents to make sure they accurately reflect your wishes. If you have questions or need to make some changes we would be more than happy to see you at one of our workshops to discuss the different documents and how they can assist you and your family. We certainly understand if there is any anxiety or stress that you are experiencing but encourage you to be prepared no matter what, which will give you a sense of comfort and security. If you would like further information about this topic or to learn more about our firm, please visit us at www.bellomoassociates.com or call the office at 717-845-5390.
Oftentimes, the death of a loved one is the hardest thing that any of us will endure. Not only did we lose the individual physically and emotionally, but in certain instances the financial impact can also be great. We are often asked in our firm what needs to occur after death, and we have provided other blogs and articles specific to that situation. This blog generically gives direction on how you can get access to the benefits and assets of your loved one. Jointly owned assets: These are the easiest assets to gain access to because the spouse or child is already a joint owner and simply needs to notify the financial institution or company that they are the surviving spouse or joint owner. You may need to provide a death certificate to take the deceased loved ones name off of the account. Also, be sure to check the taxpayer identification number associated with the account, which may need to be changed to that of the surviving joint owner. Assets that name a beneficiary:These are also fairly straightforward assets for a beneficiary to be able to obtain because they merely need to contact the company if they were named as a beneficiary on an account such as life insurance, an annuity, or other product that has a beneficiary listed. These also include accounts that have individuals named as an in-trust-for-beneficiary, a transfer-on-death beneficiary, or a payable-on-death beneficiary. They are all fancy terms, but ultimately if the beneficiary is named, they will be able to fill out some paperwork and will receive those assets fairly promptly with not a lot of problems or delays. Veterans benefits:If the individual who passed away was a veteran, there may be additional monies and funds that may be payable to the spouse. In some cases, benefits can even transfer to children. The benefits themselves are not difficult to receive, but the Veterans Administration has very particular and specific requirements that must be met for eligibility. An experienced attorney can assist with and provide guidance in this area. Social Security benefits: Social security benefits, including death and monthly survivor benefits, can also be claimed after the death of a loved one and will go to a surviving spouse or potentially to dependent children. The benefits themselves are not difficult to obtain, but it is essential that you meet the strict eligibility requirements. Survivor benefits must be immediately requested because they are not retroactive if they are claimed after a certain amount of time. The Social Security death benefit is only payable to a spouse and not to children. These are simple steps that you can take to be able to receive assets and benefits that are available to you upon the death of a loved one. If none of these above apply because the asset was in the individual's name alone without a beneficiary, it will be essential for you to seek the advice of a qualified attorney who will be able to help you through the probate process. We hope that this blog has assisted in understanding different benefits and how a spouse can obtain them easily. If you have any further questions or would like to get additional information, please reach out to our office at 717-220-8312 or check us out on the web at www.bellomoassociates.com.
Estate planning and elder law is a wonderfully rewarding and fulfilling practice area. As an attorney, I am blessed to work with families who are not in crisis and are merely planning for their families. To the extent that we are dealing with people who are in crisis, we are oftentimes able to assist with strategies that produce a positive result for the family that they are so happy and so relieved, which makes the relationship all the better. The hardest thing I have had to watch during my career is that families are ripped apart for numerous reasons. We often joke that we've seen siblings fight over five dollars or that family members will kill each other over Grandma's clock. While most times, we are joking and saying it in jest, the truth is families can often become divided over very basic and nominal things. Disputes can often arise when an elderly adult individual is receiving care in their home from another family member or when an individual dies and assets are being distributed pursuant to the Last Will and Testament or another device. The instinct for most people is to immediately call an attorney and litigate or fight over an issue; however, I truly believe that mediation can oftentimes not only save lots of money for the families involved but also is a pathway for the family relationship to remain intact. The job of a mediator is to lead all parties through a conversation to a mutual agreement that they have entered on their own accord rather than a judge issuing a final order or decree. Oftentimes with an order or decree, nobody feels like they got what they want and are always resentful and never happy with the result. We have referred numerous clients over the years to different local mediators, and the results have been overwhelmingly positive.We have had numerous clients who have come back to us and thanked us for the referral to the local mediators because they were trained in conflict resolution and were able to dissolve or diffuse the emotions to get to the root of the problem. Litigation immediately puts people on opposite sides and often has an end ugly because people are fighting over the principle of the matter, or they are digging their heels in just because they can. We highly recommend that you contact a local mediator if you are in a family conflict, regardless of the root cause. If you do not know of one, please feel free to contact our office and we can provide the names of several in the area who are very good at their craft.With the realization of the value of a mediator, we have now also been able to eliminate the very few situations that would have ended very badly for the family and allowed them to come to a mutual agreement. We hope that this article provides another alternative to litigation and how conflicts can be resolved. If you have any further questions or would like to get additional information, please reach out to our office at 717-220-3120 or check us out on the web at www.bellomoassociates.com.