At Fleming & Curti, PLC, we are keenly interested in more than the legal aspects of estate planning and also care about broader developments surrounding people who are aging and/or coping with disability. Maybe that’s because we’re naturally curious. But more likely it’s because the firm and most of the attorneys are licensed fiduciaries, and it’s part of the job.
We serve as guardian, conservator, trustee, and agent under power of attorney. That means we are responsible for assuring that the people we serve have the highest possible quality of life — up to and including the end. Our July roundup includes several developments that stem from that side of our practice. If you would like us to address a topic or see a news item out there that might be of interest to our readership, please let us know.
Hospice: Often Misunderstood Service
Actress Valerie Harper has been battling cancer since at least 2013, and it appears the illness is progressing. The “Rhoda” star’s husband shared that doctors have recommended Hospice care, but he can’t bring himself to put her there. His position reflects some common misunderstandings about Hospice, and fans quickly pointed that out in responses to his post.
Hospice is generally provided when doctors believe a patient’s life expectancy does not exceed six months. Although facilities do provide hospice care, “Hospice” is a service, not a place. Being on Hospice means treatment shifts from life-prolonging to comfort care. Medicare covers it, and services include home visits by doctors, nurses, social worker, caregivers; medication for pain and other symptoms; equipment and medical supplies; inpatient care, needed; respite care for caregivers; and grief and loss counseling. In many circumstances, the extra help is a great relief, and patients and families are grateful.
Doctors don’t know everything, though. Patients on Hospice sometimes get better and resume regular treatment.
Hospice: Often Underutilized Service
The reality is that people are getting Hospice services too late. The median stay is just 24 days. That’s according to BJ Miller, a hospice and palliative medicine physician, who wrote an opinion piece for CNN on things he wishes he could share with patients and caregivers. One of them: don’t wait for your doctor to bring up Hospice. Ask the doctor: “Would you be surprised if I died in the next year?” If the answer is no, it may be time to consider Hospice.
He explains: “The healthcare system is wired to extend physical life, without much regard to the psychological, spiritual, or financial costs. . . . [I]t’s well known that doctors tend to presume you want aggressive care, even when care geared toward your comfort may be more in line with your wishes. Unless you say otherwise, the doctor’s presumption rules the day. This means that at some point you may need to say ‘no’ to that next treatment. So be sure to look up now and again and check that the care you’re getting is the care that suits you.”
Developments in Alzheimer’s Research
The Alzheimer’s Association’s International Conference took place this month in Los Angeles. Each year, the conference breaks news about Alzheimer’s and other types of dementia. Here are some of the more interesting developments:
- Lifestyle improvements may decrease the risk of cognitive decline.
- Blood tests may be used for diagnosis.
- PET scans show promise in predicting progression of illness.
- New clues as to why women get Alzheimer’s at higher rates.
- LGBTQ populations report more memory loss problems.
Read more coverage here.
Your Safe Deposit Box Is Not Safe
You may not want to keep anything important, including your estate planning documents, in a safe deposit box. Here’s why: if the items go missing, there may be no hope of recovering them or anything from the financial institution that lost them. That’s according to a New York Times article, which featured people who have sued banks over valuables that went missing with heartbreaking results. As the story says, “There are no federal laws governing the boxes; no rules require banks to compensate customers if their property is stolen or destroyed.” And the fine print in leasing contracts often limits the bank’s liability. If you have a box, ask the bank for the contract that governs (it might not be the one you signed), and ask yourself if you are comfortable with the terms.