Don’t Die Because of Confusion About Your End-Of-Life Wishes (Episode #282)

0:31 Well, good afternoon, Michiganders. It is Tuesday, May thirtieth, twenty twenty three, and of course this is Tuesday with Tom, Michigan's only weekly podcast where we answer your questions about a state planning and a state settlement in Michigan, and we don't send you a bill. As always, I'm your host, Tom Doyle, a state planning attorney, lifelong Michigan resident, and the ambassador for all things good in this G eight state of Michigan. Welcome to today's program, and welcome to summer. Hopefully all of you had a good holiday weekend last week's episode. If you are interested in farmland preservation keeping farmland from being developed, I would invite you to listen to last week's episode, which was about using an agricultural conservation easement to protect farmland from development.

1:36 I had an interview with Kara O'Connor from American Farmland Trust, and during that interview, Kara explained what an agricultural easement is and how they are used to protect farmland from development. So, whether you're a farmer who's interested in having his or her land and protected, or you're just interested in how farmland can be protected from development. I encourage you to listen to last week's episode well today, reaching back long time ago, it seems to a previous episode in which I talked about don't die because of confusion about your end of life wishes.

2:29 But please remember what I'm about to discuss during the program is, as always for educational purposes only. It is not intended to be legal advice. As all weaks, you need to work with your attorney to determine what is appropriate for you and your estate plan. Again, reaching back to a previous episode of the program, which was about don't die because of confusion about your end of life wishes? Program all the way back from February two thousand and twenty. So here is the episode in which I discussed that topic. Back to today's topic, don't die because of confusion about your end of life wishes.

3:32 And this topic I have to thank our former secretary Becky, whom many of you know after leaving the office. One of the many jobs that Becky has as she reviews various decisions and writes articles about those decisions, all involved in the healthcare industry. And so today's topic is the result of a case that she had reviewed and shared information with us and so what happens. So as part of your state plan, you might have a power of attorney for healthcare, and certainly in our power of attorneys for healthcare, as I have discussed in previous episodes, we include end of life wishes. What do you want to have happen? For example, if you're in a permanent vegetative state, irreversible coma, etc. Other states have a particular legal document that's called a living will, and essentially that living will is a statement of your end of life wishes. So in this particular case that Becky was looking at, a woman had been admitted to a long term care facility and during the three weeks that she was there, she had repeatedly stated, and it was noted

5:04 in her chart in more than one location, that she did want to be resuscitated if she stopped breathing or her heart stopped beating. So in her case, she said to the facility, look, if something happens to me where I stopped breathing or my heart stopped beating, yes, I do want you to call the code. Yes I do want to be resuscitated. And again that was noted in several places in her chart. Additionally, she did not have a D and iron place, so she did not have it do not resuscitate order in place. So, as far as all of the documentation at the facility was concerned, if something happened to her where she stopped breathing or her heart stopped beating, she clearly wanted everything to be done to try and save her life and to resuscitate her. Now. While she was at the facility, and I don't have the particular details on how this came about, she signed a living will. Again, don't know where the living will came from, don't know why that was all done, but apparently in the living will that she signed, she indicated that she did not want life saving measures if she was in a terminal state or in a permanent coma. So as

6:36 far as the documentation in this living will, I'm assuming it said something similar to what our language and our power avertnity for healthcare if I'm in a permanent vegetative state or terminal state or permanent coma, in those cases, I don't want life supporting measures. So if you just stopped right there, you could ask herself, well, right, So there's documentation at the long term care facility saying she wants to be resuscitated, and now there's a d n R giving some exceptions to apparently what she had told the facility that she would want to have done. Sadly, a nurse one day found this woman barely breathing.

7:26 She was unresponsive, She had a faint heart rate and shallow breaths, and the nurse could not detect any blood pressure. What happened, the nurse did not attempt to resuscitate her once she stopped breathing and she no longer had a pulse, and as a result, she died. And when this issue was brought about because the government got involved in looking at the nursing home, the long term care facility argued that, hey, the living will was a legal document and it said do not resuscitate her. Well, an administrative judge she reviewed it on behalf of the government disagreed and essentially said, look, the living will said don't resuscitate me only if I'm in a terminal state or a permanent coma, And she was not in a terminal state or a permanent coma at the time the nurse found her. And because in her chart she had clearly indicated that she would want to be resuscitated if she stopped breathing or her heart stopped beating. In that situation, the administrative judge disagreed with a long term care facility and concluded that the long term care facility in fact should

9:01 have resuscitators. So what's the message, what's the what's what is to be learned? Well, what's to be learned I think from this situation is you need to make sure that you're on the same page with whatever facility they're in about your end of life wishes and how to handle what would appear to be conflicting documentation. It appeared that there was a possible conflict in this case where in the documentation at the long term care facility, she repeatedly indicated that she wanted the code called, that she wanted to be resuscitated, yet she had a living will that appeared to make some exceptions to that. If you're in a facility, if you're not able to do make sure if family member makes make sure that there is consistency between what you tell them, what you want there to be in your records regarding calling a code or resuscitating you and what your legal documents say. And if there appears to be a conflict, and in this case, quite frankly, legally there wasn't. But you can't really necessarily express the nurse to be the legal decision maker upon the difference. Make

10:35 sure that if there appears to be some conflict, or if you understand there's a conflict or a possibility that someone might interpret or misinterpret what is that you want to be done. You need to make sure that the facility understands what your wishes are, that those wishes are documented, and that there is no room for confusion. Again, if you can't do it, make sure that a loved one does that. Make sure that the facility understands what in fact your wishes are. Because tragically, for this woman, it was too late.

11:16 Yes, the administrative law judge determined that they shouldn't have listened to the living will because she was not an a terminal state or a permanent coma. They should have revived her because that was what she had said in her documentation at the long term care facility. Yes, all of those things are determined by the administrative judge, but unfortunately for her loved ones, the woman is still debt. Again, make sure that your documentation is clear, and don't die because of some confusion about your end of life wishes. Of course, Amanda and I would be honored to have the opportunity to help you protect your loved ones by either putting together in a state plan or perhaps amending a plan that you already have, or assisting you in settling a loved one's estate.

12:43 We have in office consultations, we have consultations via zoom via telephone, so for wherever you happen to be in this great state of Michigan, we can likely be of assistance to you. Simply head on over to our website Doyle awpc dot com. There you'll find information on how to schedule appointment. We have a free estate planning guidebook that you can download that will have tons of information about estate planning, a worksheet to help you in developing your own plan. Plenty of information there, and again the ability to schedule a consultation with us, be it in person or virtual. As always, we also have our legal store that's available through Doi LAWPC dot com. The legal store has individual documents, so perhaps all you need is an update and healthcare power of attorney. You can order that through the legal Store and it can be delivered to you in your emails, so again please visit Doi LAWPC dot com.

14:03 Well, that's going to be it for today. As always, though, if you have a comment about the program, or perhaps a topic that you'd like to have me discuss, or maybe you would be interested in being a guest on the program to talk about topic that is relevant to Michigan estate planning, Michigan settlement, to asset protection, farms, etc. Please send me an email that would be Tom at Tuesday with Toom dot com. As always, we invite you follow us on Facebook and invite your friends and family to follow us as well again at Tuesday with Tom and the office is Doyle Law PC. Remember too, Tuesday with Tom is available on Apple Podcasts, Spotify, Google Podcast, iHeartRadio, Spreaker, perhaps any online service that you u to listen to podcast you will find Tuesday with Tom is available and you can always ask your smart speaker to play Tuesday with Tom. Well, thank you again for spending some of your time with us today and as always, I hope that you have an awesome summer, an awesome week at an awesome day in Michigan. Stay safe. Tuesday with Tom has been brought to you by

15:35 the estate planning attorneys at Doyle Law PC. To learn how we can help you with your estate plan or with settling a loved ones estate, please call us today at five one seven three two three seven three six six. That's five one seven three two three seven three six six