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Estate Planning Musts for the Hospital

Estate planning isn't just about the end of your life. Many of us will go to a hospital at some point in our lifetime, whether planned or unplanned. While the matter may not be life-threatening, it could still require some observation, treatment, or even surgery. No matter how routine the trip or procedure may be, there is also the risk of complications and to prepare for such in advance is an extremely smart measure.


The first document that you will want to make sure that you have executed is a Medical Power of Attorney. In the event that you become incapacitated and you are unable to communicate to the physician or nurse your medical desires, and they need to make a decision which was not already discussed with you, the person that you named as your medical power of attorney (also known as your health care agent) will be able to communicate with your medical team and a decision will be made on your behalf. In my opinion, this is the absolute most important document in the estate plan because it protects you as a person.  Your health care agent should be someone that you know and trust - someone that you discuss your desires with regarding your medical care. 


The second document that you want to make sure you execute goes hand in hand with the Medical Power of Attorney. This document is known as a HIPAA Privacy Authorization Form (sometimes called a HIPAA release form), which is more specifically for, as the form's subtitle suggests, "Authorization for Use or Disclosure of Protected Health Information."


The Health Insurance Portability and Accountability Act, a federal law passed in 1996, was established to keep individuals' health records confidential and secure. Because of the law, an individual has to give written permission to allow for two things that he or she will typically want while in the hospital: for close family members and friends to be able to get information about how the patient's doing, and for the hospital to get medical records from other healthcare institutions that have previous contact with the patient.


You may already be familiar with a variation of this form that your family doctor, dentist, etc. may have you sign when you go to their office for a visit, but this general HIPAA Release can be used by your health care agent to receive medical information from any facility.


The last document is not "necessary," but it is certainly helpful in directing your loved one of your specific desires and alleviating the stress they may have if faced with this decision. This document is the Directive to Physicians more commonly referred to by the lay person as a living will but also sometimes referred to as an Advanced Directive. In your Directive to Physicians, you are able to instruct your medical team what you would like them to do in regards to life sustaining treatments should you fall into an irreversible condition, or a terminal illness. Examples of life sustaining measures include, but are certainly not limited to artificial nutrition (e.g. feeding tube), mechanical ventilation (e.g. trachea) or transfusions. You may be very specific as to your restrictions or you may keep it broad.   


If you're relatively young and healthy, you may not want any restrictions placed on what measures the medical staff will take to save your life. However, if you are further along in your path in life, you may not want any measures at all.  This is entirely up to each individual and should be a choice that is personal to you without any outside influence, as with all estate planning decisions. 


I consider the Directive to Physicians to be a very live document since your decisions about treatment may change should your overall medical status change between hospital visits or you age. You can update the Directive to Physicians with your lawyer to specify what you do and don't want done on your behalf at any time so long you are deemed to have mental capacity and are lucid.


The Medical Power of Attorney, HIPAA Release and the Directive to Physicians can be used for multiple hospitalizations, although most hospitals will require you to produce each document and that it be accounted for by the hospital admission staff for each individual stay.

I understand that this subject is not light or easy, but it is certainly an important one for everyone that has reached the age of majority and is able to make decisions for themselves. Please take the time to think about you, and what you would want should you ever need anyone to make these decisions for you, and take the time to have that communicated in the appropriate document.

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