Tuesday, January 28, 2014

Changes to NH Advanced Directives

The New Hampshire legislation has enacted changes to advanced directives relating to medically administered nutrition and hydration. These changes became effective on January 1, 2014. 

The intent of the legislature was to clarify the definition of medically administered nutrition and hydration and include it under the definition of life sustaining treatment. 
Unfortunately, while life sustaining treatment is defined to include medically administered nutrition and hydration in the statute, medically administered nutrition and hydration is not included on the definition on the proposed new advanced directive form. Furthermore, the legislature inadvertently neglected to change the disclosure form which specifically states that if you want to give your health care agent the power to withhold or withdraw medically administered nutrition and hydration, you must say so in your directive. Otherwise, your health care agent will not be able to direct that. This is problematic since a question relating to medically administered nutrition and hydration does not exist on the new health care power of attorney.                                          To resolve these issues, it is thought that the legislature will be making further changes to the statute in its upcoming session. For these reasons, we have modified our advanced directives slightly, but until the legislature addresses the present ambiguity and conflict in the statute, our advanced directives still include a question that specifically addresses medically administered nutrition and hydration.                                            We will continue to keep you updated.

Thursday, January 2, 2014

Caregiver Questions?

As noted in our previous post, holidays or the beginning of a New Year are often good times to initiate conversations with loved ones about difficult topics, one of which is end of life wishes.

Here are a few ideas about important issues you might want to discuss:
  1. These end of life wishes may include: Who should make the decisions regarding health care/financial matters when your loved one cannot? What medical treatments are acceptable? What are not? Whether or not your loved one wants to be resuscitated? Where your loved one wants to be in the event of a terminal illness?
  2. Ensure that your loved one executes a health care power of attorney and financial power of attorney. If he/she already has these documents, they should be reviewed by an elder law attorney to ensure that they are in order.
  3. How does your loved one want his or her assets to be distributed after death? Are the assets titled appropriately? Have steps been taken to minimize probate upon death? Are they consistent with your loved one's wishes? What is important to your loved one? Simplicity? Protecting his/her spouse? Providing an inheritance for children? Protecting a special needs beneficiary? Other concerns?
Questions relating to end of life topics can also be initiated by an elder law attorney. Our office, when possible, encourages family meetings so that everyone is on the same page. We find that good communication can often alleviate conflict and make planning easier for all involved.