May 30, 2023

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

In today’s archived episode Tom discusses a case in which a woman in a long-term care facility died because there was confusion about her end-of-life wishes as documented in her chart and her Living Will.

Spreaker podcast player iconApple Podcasts podcast player iconSpotify podcast player iconAmazon Music podcast player iconiHeartRadio podcast player iconRSS Feed podcast player iconCastro podcast player iconCastbox podcast player iconDeezer podcast player iconPodcast Addict podcast player iconPodchaser podcast player iconJioSaavn podcast player icon

In today’s archived episode Tom discusses a case in which a woman in a long-term care facility died because there was confusion about her end-of-life wishes as documented in her chart and her Living Will.

WEBVTT

1
00:00:31.640 --> 00:00:37.439
Well, good afternoon, Michiganders.
It is Tuesday, May thirtieth, twenty

2
00:00:37.520 --> 00:00:42.399
twenty three, and of course this
is Tuesday with Tom, Michigan's only weekly

3
00:00:42.479 --> 00:00:48.719
podcast where we answer your questions about
a state planning and a state settlement in

4
00:00:48.840 --> 00:00:51.960
Michigan, and we don't send you
a bill. As always, I'm your

5
00:00:51.960 --> 00:00:56.640
host, Tom Doyle, a state
planning attorney, lifelong Michigan resident, and

6
00:00:56.799 --> 00:01:02.679
the ambassador for all things good in
this G eight state of Michigan. Welcome

7
00:01:02.719 --> 00:01:10.239
to today's program, and welcome to
summer. Hopefully all of you had a

8
00:01:10.280 --> 00:01:23.079
good holiday weekend last week's episode.
If you are interested in farmland preservation keeping

9
00:01:23.159 --> 00:01:27.799
farmland from being developed, I would
invite you to listen to last week's episode,

10
00:01:27.840 --> 00:01:36.319
which was about using an agricultural conservation
easement to protect farmland from development.

11
00:01:36.439 --> 00:01:42.439
I had an interview with Kara O'Connor
from American Farmland Trust, and during that

12
00:01:42.599 --> 00:01:51.359
interview, Kara explained what an agricultural
easement is and how they are used to

13
00:01:51.480 --> 00:01:57.760
protect farmland from development. So,
whether you're a farmer who's interested in having

14
00:01:59.280 --> 00:02:04.920
his or her land and protected,
or you're just interested in how farmland can

15
00:02:04.959 --> 00:02:10.639
be protected from development. I encourage
you to listen to last week's episode well

16
00:02:10.680 --> 00:02:20.919
today, reaching back long time ago, it seems to a previous episode in

17
00:02:21.000 --> 00:02:28.120
which I talked about don't die because
of confusion about your end of life wishes.

18
00:02:29.280 --> 00:02:32.639
But please remember what I'm about to
discuss during the program is, as

19
00:02:32.680 --> 00:02:39.159
always for educational purposes only. It
is not intended to be legal advice.

20
00:02:39.360 --> 00:02:45.000
As all weaks, you need to
work with your attorney to determine what is

21
00:02:45.039 --> 00:03:00.879
appropriate for you and your estate plan. Again, reaching back to a previous

22
00:03:00.960 --> 00:03:07.520
episode of the program, which was
about don't die because of confusion about your

23
00:03:07.719 --> 00:03:15.439
end of life wishes? Program all
the way back from February two thousand and

24
00:03:15.240 --> 00:03:25.439
twenty. So here is the episode
in which I discussed that topic. Back

25
00:03:25.479 --> 00:03:32.319
to today's topic, don't die because
of confusion about your end of life wishes.

26
00:03:32.360 --> 00:03:38.319
And this topic I have to thank
our former secretary Becky, whom many

27
00:03:38.400 --> 00:03:45.919
of you know after leaving the office. One of the many jobs that Becky

28
00:03:46.039 --> 00:03:54.199
has as she reviews various decisions and
writes articles about those decisions, all involved

29
00:03:54.800 --> 00:04:00.800
in the healthcare industry. And so
today's topic is the result of a case

30
00:04:00.919 --> 00:04:08.479
that she had reviewed and shared information
with us and so what happens. So

31
00:04:08.560 --> 00:04:13.560
as part of your state plan,
you might have a power of attorney for

32
00:04:13.639 --> 00:04:18.040
healthcare, and certainly in our power
of attorneys for healthcare, as I have

33
00:04:18.199 --> 00:04:25.680
discussed in previous episodes, we include
end of life wishes. What do you

34
00:04:25.720 --> 00:04:30.560
want to have happen? For example, if you're in a permanent vegetative state,

35
00:04:30.680 --> 00:04:36.120
irreversible coma, etc. Other states
have a particular legal document that's called

36
00:04:36.240 --> 00:04:44.199
a living will, and essentially that
living will is a statement of your end

37
00:04:44.240 --> 00:04:46.680
of life wishes. So in this
particular case that Becky was looking at,

38
00:04:47.600 --> 00:04:57.399
a woman had been admitted to a
long term care facility and during the three

39
00:04:57.480 --> 00:05:04.480
weeks that she was there, she
had repeatedly stated, and it was noted

40
00:05:04.600 --> 00:05:12.040
in her chart in more than one
location, that she did want to be

41
00:05:12.160 --> 00:05:17.199
resuscitated if she stopped breathing or her
heart stopped beating. So in her case,

42
00:05:18.120 --> 00:05:23.639
she said to the facility, look, if something happens to me where

43
00:05:23.680 --> 00:05:28.839
I stopped breathing or my heart stopped
beating, yes, I do want you

44
00:05:28.920 --> 00:05:34.279
to call the code. Yes I
do want to be resuscitated. And again

45
00:05:34.319 --> 00:05:41.000
that was noted in several places in
her chart. Additionally, she did not

46
00:05:41.360 --> 00:05:45.439
have a D and iron place,
so she did not have it do not

47
00:05:45.600 --> 00:05:49.240
resuscitate order in place. So,
as far as all of the documentation at

48
00:05:49.279 --> 00:05:56.959
the facility was concerned, if something
happened to her where she stopped breathing or

49
00:05:57.000 --> 00:06:02.240
her heart stopped beating, she clearly
wanted everything to be done to try and

50
00:06:02.319 --> 00:06:08.800
save her life and to resuscitate her. Now. While she was at the

51
00:06:08.879 --> 00:06:12.639
facility, and I don't have the
particular details on how this came about,

52
00:06:13.199 --> 00:06:17.639
she signed a living will. Again, don't know where the living will came

53
00:06:17.720 --> 00:06:23.639
from, don't know why that was
all done, but apparently in the living

54
00:06:23.720 --> 00:06:30.480
will that she signed, she indicated
that she did not want life saving measures

55
00:06:30.600 --> 00:06:36.839
if she was in a terminal state
or in a permanent coma. So as

56
00:06:36.839 --> 00:06:43.399
far as the documentation in this living
will, I'm assuming it said something similar

57
00:06:43.439 --> 00:06:47.319
to what our language and our power
avertnity for healthcare if I'm in a permanent

58
00:06:47.959 --> 00:06:54.759
vegetative state or terminal state or permanent
coma, in those cases, I don't

59
00:06:54.800 --> 00:06:59.600
want life supporting measures. So if
you just stopped right there, you could

60
00:06:59.600 --> 00:07:03.639
ask herself, well, right,
So there's documentation at the long term care

61
00:07:03.680 --> 00:07:10.120
facility saying she wants to be resuscitated, and now there's a d n R

62
00:07:10.439 --> 00:07:16.240
giving some exceptions to apparently what she
had told the facility that she would want

63
00:07:16.360 --> 00:07:25.839
to have done. Sadly, a
nurse one day found this woman barely breathing.

64
00:07:26.759 --> 00:07:31.480
She was unresponsive, She had a
faint heart rate and shallow breaths,

65
00:07:31.519 --> 00:07:40.000
and the nurse could not detect any
blood pressure. What happened, the nurse

66
00:07:40.720 --> 00:07:46.079
did not attempt to resuscitate her once
she stopped breathing and she no longer had

67
00:07:46.120 --> 00:07:54.879
a pulse, and as a result, she died. And when this issue

68
00:07:54.959 --> 00:07:59.800
was brought about because the government got
involved in looking at the nursing home,

69
00:08:00.319 --> 00:08:05.800
the long term care facility argued that, hey, the living will was a

70
00:08:05.920 --> 00:08:11.959
legal document and it said do not
resuscitate her. Well, an administrative judge

71
00:08:11.959 --> 00:08:16.439
she reviewed it on behalf of the
government disagreed and essentially said, look,

72
00:08:18.120 --> 00:08:24.319
the living will said don't resuscitate me
only if I'm in a terminal state or

73
00:08:24.360 --> 00:08:31.800
a permanent coma, And she was
not in a terminal state or a permanent

74
00:08:31.879 --> 00:08:37.559
coma at the time the nurse found
her. And because in her chart she

75
00:08:37.679 --> 00:08:45.519
had clearly indicated that she would want
to be resuscitated if she stopped breathing or

76
00:08:45.559 --> 00:08:52.759
her heart stopped beating. In that
situation, the administrative judge disagreed with a

77
00:08:52.840 --> 00:09:01.440
long term care facility and concluded that
the long term care facility in fact should

78
00:09:01.759 --> 00:09:05.519
have resuscitators. So what's the message, what's the what's what is to be

79
00:09:05.639 --> 00:09:11.080
learned? Well, what's to be
learned I think from this situation is you

80
00:09:11.159 --> 00:09:16.240
need to make sure that you're on
the same page with whatever facility they're in

81
00:09:18.399 --> 00:09:26.120
about your end of life wishes and
how to handle what would appear to be

82
00:09:26.320 --> 00:09:33.960
conflicting documentation. It appeared that there
was a possible conflict in this case where

83
00:09:35.200 --> 00:09:41.519
in the documentation at the long term
care facility, she repeatedly indicated that she

84
00:09:41.679 --> 00:09:46.480
wanted the code called, that she
wanted to be resuscitated, yet she had

85
00:09:46.559 --> 00:09:54.440
a living will that appeared to make
some exceptions to that. If you're in

86
00:09:54.480 --> 00:10:00.960
a facility, if you're not able
to do make sure if family member makes

87
00:10:01.120 --> 00:10:09.200
make sure that there is consistency between
what you tell them, what you want

88
00:10:09.240 --> 00:10:18.399
there to be in your records regarding
calling a code or resuscitating you and what

89
00:10:18.559 --> 00:10:22.600
your legal documents say. And if
there appears to be a conflict, and

90
00:10:22.600 --> 00:10:26.799
in this case, quite frankly,
legally there wasn't. But you can't really

91
00:10:26.919 --> 00:10:35.000
necessarily express the nurse to be the
legal decision maker upon the difference. Make

92
00:10:35.039 --> 00:10:39.120
sure that if there appears to be
some conflict, or if you understand there's

93
00:10:39.120 --> 00:10:46.519
a conflict or a possibility that someone
might interpret or misinterpret what is that you

94
00:10:46.559 --> 00:10:52.639
want to be done. You need
to make sure that the facility understands what

95
00:10:52.679 --> 00:10:58.360
your wishes are, that those wishes
are documented, and that there is no

96
00:10:58.840 --> 00:11:03.759
room for confusion. Again, if
you can't do it, make sure that

97
00:11:03.919 --> 00:11:09.720
a loved one does that. Make
sure that the facility understands what in fact

98
00:11:09.799 --> 00:11:16.320
your wishes are. Because tragically,
for this woman, it was too late.

99
00:11:16.399 --> 00:11:22.840
Yes, the administrative law judge determined
that they shouldn't have listened to the

100
00:11:22.919 --> 00:11:26.840
living will because she was not an
a terminal state or a permanent coma.

101
00:11:28.559 --> 00:11:35.519
They should have revived her because that
was what she had said in her documentation

102
00:11:35.600 --> 00:11:39.600
at the long term care facility.
Yes, all of those things are determined

103
00:11:39.639 --> 00:11:46.200
by the administrative judge, but unfortunately
for her loved ones, the woman is

104
00:11:46.240 --> 00:11:54.480
still debt. Again, make sure
that your documentation is clear, and don't

105
00:11:54.960 --> 00:12:26.399
die because of some confusion about your
end of life wishes. Of course,

106
00:12:26.440 --> 00:12:30.559
Amanda and I would be honored to
have the opportunity to help you protect your

107
00:12:30.679 --> 00:12:35.000
loved ones by either putting together in
a state plan or perhaps amending a plan

108
00:12:35.120 --> 00:12:41.480
that you already have, or assisting
you in settling a loved one's estate.

109
00:12:43.360 --> 00:12:48.759
We have in office consultations, we
have consultations via zoom via telephone, so

110
00:12:48.000 --> 00:12:52.039
for wherever you happen to be in
this great state of Michigan, we can

111
00:12:52.159 --> 00:12:56.919
likely be of assistance to you.
Simply head on over to our website Doyle

112
00:12:58.000 --> 00:13:03.840
awpc dot com. There you'll find
information on how to schedule appointment. We

113
00:13:03.960 --> 00:13:09.159
have a free estate planning guidebook that
you can download that will have tons of

114
00:13:09.200 --> 00:13:15.799
information about estate planning, a worksheet
to help you in developing your own plan.

115
00:13:16.279 --> 00:13:22.039
Plenty of information there, and again
the ability to schedule a consultation with

116
00:13:22.120 --> 00:13:26.600
us, be it in person or
virtual. As always, we also have

117
00:13:26.720 --> 00:13:33.960
our legal store that's available through Doi
LAWPC dot com. The legal store has

118
00:13:33.120 --> 00:13:37.559
individual documents, so perhaps all you
need is an update and healthcare power of

119
00:13:37.600 --> 00:13:45.200
attorney. You can order that through
the legal Store and it can be delivered

120
00:13:45.279 --> 00:14:03.960
to you in your emails, so
again please visit Doi LAWPC dot com.

121
00:14:03.000 --> 00:14:07.840
Well, that's going to be it
for today. As always, though,

122
00:14:07.919 --> 00:14:11.000
if you have a comment about the
program, or perhaps a topic that you'd

123
00:14:11.000 --> 00:14:18.120
like to have me discuss, or
maybe you would be interested in being a

124
00:14:18.240 --> 00:14:24.639
guest on the program to talk about
topic that is relevant to Michigan estate planning,

125
00:14:24.679 --> 00:14:31.840
Michigan settlement, to asset protection,
farms, etc. Please send me

126
00:14:31.879 --> 00:14:37.200
an email that would be Tom at
Tuesday with Toom dot com. As always,

127
00:14:37.200 --> 00:14:39.759
we invite you follow us on Facebook
and invite your friends and family to

128
00:14:39.799 --> 00:14:45.799
follow us as well again at Tuesday
with Tom and the office is Doyle Law

129
00:14:46.320 --> 00:14:52.559
PC. Remember too, Tuesday with
Tom is available on Apple Podcasts, Spotify,

130
00:14:52.799 --> 00:14:58.639
Google Podcast, iHeartRadio, Spreaker,
perhaps any online service that you u

131
00:15:00.240 --> 00:15:05.639
to listen to podcast you will find
Tuesday with Tom is available and you can

132
00:15:05.720 --> 00:15:13.000
always ask your smart speaker to play
Tuesday with Tom. Well, thank you

133
00:15:13.080 --> 00:15:18.120
again for spending some of your time
with us today and as always, I

134
00:15:18.159 --> 00:15:26.600
hope that you have an awesome summer, an awesome week at an awesome day

135
00:15:26.679 --> 00:15:35.879
in Michigan. Stay safe. Tuesday
with Tom has been brought to you by

136
00:15:35.919 --> 00:15:41.840
the estate planning attorneys at Doyle Law
PC. To learn how we can help

137
00:15:41.919 --> 00:15:45.879
you with your estate plan or with
settling a loved ones estate, please call

138
00:15:46.000 --> 00:15:50.440
us today at five one seven three
two three seven three six six. That's

139
00:15:50.480 --> 00:15:52.679
five one seven three two three seven
three six six