Durable Power

In Maryland, there are three types of advance directives stipulating whether a patient wants to remain alive by artificial means: (1) a living will, (2) durable power of attorney for health care and (3) documented discussion with a doctor. None is irrevocable.Living will: Applies only to patients with terminal diseases whose death is imminent. Maryland residents may use the document to express their wish not to have their lives prolonged artificially, but they must add language specifying a desire not to be given food or water through tubes.

You never expect that it's going to happen to you. But as the West Warwick, R.I., nightclub fire shows, everybody's vulnerable. If you were to suffer serious injury or die suddenly, what would your loved ones do? Fortunately, there are steps you can take now that would not only provide for your loved ones, but also give you peace of mind, says Jordan E. Goodman, author of Everyone's Money Book on Financial Planning. So don't delay. Instead, use the nightclub fire, the Sept. 11 terrorist attacks and other such misfortunes as a kind of wake-up call, to spur you into action, Goodman advises.

Effective tomorrow, a new federal law, the Patient Self-Determination Act, requires health care facilities to inform adult patients of their right to make advance directives -- documents that allow patients to say whether they want to remain alive by artificial means. In Maryland, there are three types: a living will, durable power of attorney for health care and LTC documented discussion with a doctor. None is irrevocable.The law requires hospitals, nursing homes, hospices, home health agencies and health maintenance organizations (HMOs)

For older generations of Americans, discussing finances just wasn't done, especially with their children. But with people living longer, decisions about finances and health often fall to adult children in their 40s and 50s. Still, parents and children typically delay such talks until it's too late. Elder-law specialists and financial planners encourage middle-age children to start broaching the tough topics with their parents while they're still in good health. "Work with your parents, and make it a process where you're involved," in decisions regarding long-term planning and care," said Neal E. Cutler, director of survey research for the National Council of the Aging in Washington.

Q: My daughter has power of attorney for me. Do I need to obtain forms for a living will? Isn't it possible I can write a living will requesting no life-prolonging treatments and give her this information to keep for me until the time is right? -- E.W., Salisbury, Md.A: Both the durable power of attorney in health care matters and the living will are examples of "advance directives" -- documents that enable you to retain some control over the kinds of decisions made about your medical care in the event that you become unable to make decisions yourself.

A few years ago, after a Carroll County woman suffered a stroke at a local senior citizens center, her friends were shocked when they visited her in the hospital and found her attached to feeding tubes, said Betty Bates, a legal assistant with the Legal Aid Bureau.Ms. Bates said, "Many people asked, 'She didn't want tubes. How come she's on food and water tubes?' "Ms. Bates said the incident caused "an onslaught" of the woman's friends coming to Legal Aid to ask for help preparing "living wills."

A new federal law requiring hospitals and nursing homes to inform patients of their right to refuse medical treatment under certain circumstances could cause a flood of requests for "living wills," say county health-care providers and attorneys.Attorneys and doctors heresay they already have noticed increased interest in living wills, which spell out a person's wishes for medical treatment should he or she become terminally ill.And they expect that the federal law, which will go into effect next November, will only increase the number of people asking for the legally binding document to be drawn up.Several area health-careadministrators said they think the trend toward obtaining living wills, along with a second document called a medical durable power of attorney, can only facilitate the care of terminally ill patients or those in a permanent coma.

PERRY: THANKS FOR THE vote of confidenceFrom: Marsha G. PerryDistrict 33 delegateI would like to thank the voters of District 33 for their support in the Nov. 6 election.Four years ago, when I ran for public office for the first time, I promised to devote all my energy to the concerns of our families and our communities. I promise now to continue that strong commitment.My focus in the legislature has been on restoring and preserving our natural environment and on helping children in need.

It may seem like a million times that you've told your daughter, son or significant other where to find your will, your health-care directive, the durable power of attorney and other crucial documents they'll need when you're gone. But will they remember that the third drawer in the guest closet holds this information? Or the fishing tackle box in the workshop, or some other arcane spot? Worse yet, maybe you haven't told them anything about your last wishes. When a death occurs, survivors often feel swamped with details, not to mention grief.

Elizabeth Sosnowski had heard about living wills, but the 56-year-old Severna Park woman didn't decide to look into one until her husbandwas rushed to the hospital Dec. 11 for an apparent heart attack.After her husband was transferred from the emergency room to the intensive care unit -- it turned out he had heart problems but had not had a heart attack -- he was presented a pamphlet titled, "Exercise Your Right: Put Your Health Care Decisions in Writing."Distributing the pamphlet is the way the Harbor Hospital Center in South Baltimore is complying with a new federal law. The Patient Self-Determination Act, which went into effect Dec. 1, requires that patients entering hospitals and other health-care facilities be informed of their rights to refuse medical treatment.

It may seem like a million times that you've told your daughter, son or significant other where to find your will, your health-care directive, the durable power of attorney and other crucial documents they'll need when you're gone. But will they remember that the third drawer in the guest closet holds this information? Or the fishing tackle box in the workshop, or some other arcane spot? Worse yet, maybe you haven't told them anything about your last wishes. When a death occurs, survivors often feel swamped with details, not to mention grief.

A few years ago, after a Carroll County woman suffered a stroke at a local senior citizens center, her friends were shocked when they visited her in the hospital and found her attached to feeding tubes, said Betty Bates, a legal assistant with the Legal Aid Bureau.Ms. Bates said, "Many people asked, 'She didn't want tubes. How come she's on food and water tubes?' "Ms. Bates said the incident caused "an onslaught" of the woman's friends coming to Legal Aid to ask for help preparing "living wills."

In Maryland, there are three types of advance directives stipulating whether a patient wants to remain alive by artificial means: (1) a living will, (2) durable power of attorney for health care and (3) documented discussion with a doctor. None is irrevocable.Living will: Applies only to patients with terminal diseases whose death is imminent. Maryland residents may use the document to express their wish not to have their lives prolonged artificially, but they must add language specifying a desire not to be given food or water through tubes.

End-of-life decisions present some of medicine's toughest ethical dilemmas. But these decisions have become routine: 70 percent of the 13,000 people who die in U.S. hospitals each year die after a decision has been made to remove life sustaining equipment.Often, the decisions themselves are not as difficult as the thorny questions that precede them: who will decide for a patient who cannot make his own decision? And how will these decision-makers reach their conclusions?End-of-life decisions are now governed by a hodge-podge of legal precedent and legislation, which varies from state to state and changes as state legislatures update their laws and as courts issue more decisions.

Elizabeth Sosnowski had heard about living wills, but the 56-year-old Severna Park woman didn't decide to look into one until her husbandwas rushed to the hospital Dec. 11 for an apparent heart attack.After her husband was transferred from the emergency room to the intensive care unit -- it turned out he had heart problems but had not had a heart attack -- he was presented a pamphlet titled, "Exercise Your Right: Put Your Health Care Decisions in Writing."Distributing the pamphlet is the way the Harbor Hospital Center in South Baltimore is complying with a new federal law. The Patient Self-Determination Act, which went into effect Dec. 1, requires that patients entering hospitals and other health-care facilities be informed of their rights to refuse medical treatment.

Effective tomorrow, a new federal law, the Patient Self-Determination Act, requires health care facilities to inform adult patients of their right to make advance directives -- documents that allow patients to say whether they want to remain alive by artificial means. In Maryland, there are three types: a living will, durable power of attorney for health care and LTC documented discussion with a doctor. None is irrevocable.The law requires hospitals, nursing homes, hospices, home health agencies and health maintenance organizations (HMOs)

Betty C. Cole's daughter didn't ask for a new stereo or a red convertible when she turned 18. Instead, she wanted two legal papers guaranteeing her right to die.The gift seemed a little strange for a healthy college freshman. But Cole, an Annapolis attorney who specializes in estate and trust law, understood her daughter's unusual wish.It was prompted by the plight of Nancy Beth Cruzan, the Missouri woman who has spent nearly a decade lying in a coma after a car crash almost claimed her life.

The demand for living wills and their companion, the durable power of attorney, has risen dramatically as more people become aware that their wishes regarding the withholding of life support in the event ofterminal illness may not be honored without the documents."

Q: My daughter has power of attorney for me. Do I need to obtain forms for a living will? Isn't it possible I can write a living will requesting no life-prolonging treatments and give her this information to keep for me until the time is right? -- E.W., Salisbury, Md.A: Both the durable power of attorney in health care matters and the living will are examples of "advance directives" -- documents that enable you to retain some control over the kinds of decisions made about your medical care in the event that you become unable to make decisions yourself.

A new federal law requiring hospitals and nursing homes to inform patients of their right to refuse medical treatment under certain circumstances could cause a flood of requests for "living wills," say county health-care providers and attorneys.Attorneys and doctors heresay they already have noticed increased interest in living wills, which spell out a person's wishes for medical treatment should he or she become terminally ill.And they expect that the federal law, which will go into effect next November, will only increase the number of people asking for the legally binding document to be drawn up.Several area health-careadministrators said they think the trend toward obtaining living wills, along with a second document called a medical durable power of attorney, can only facilitate the care of terminally ill patients or those in a permanent coma.