The holidays bring us together as families and friends to enjoy the accomplishments of the year, to share good times and to make plans for the future. Many of us spend a lot of time thinking about the future. Individuals can use the holidays as a time to review their current advance directives, to update them with family and to make changes for the future.
As we plan for the future, many of us do not take into account planning for such things as our last wishes. Colorado recognizes many documents that should be considered when completing advance directives. Probably the most important documents include powers of attorney.
Colorado statute provides for a Financial Power of Attorney that gives very broad powers or that can be limited. An agent who is appointed as a Financial Power of Attorney can be given the power to pay bills, as well as to buy and sell real estate, investments, and other real property. The Financial Power of Attorney can take effect immediately or at some point in the future.
Colorado law also provides for a Durable Medical Power of Attorney. The purpose of the Medical Power of Attorney is to appoint a trusted individual to make medical decisions for health care, housing, transportation, and access to medical records. A Medical Power of Attorney can be durable meaning it takes effect immediately or it can take effect upon disability. Most often a Medical Power of Attorney takes effect immediately, even if it might not be used by the agent until sometime in the distant future.
For those individuals who fail to appoint a Medical Power of Attorney, Colorado law provides for the appointment of a Medical Health Care Proxy. This is a document drawn up by interested parties to assign an individual the right to make medical decision for the incapacitated individual who is unable to make decisions. Although Colorado does not have a prescribed form, most medical institutions have a Medical Health Care Proxy form they require to be signed authorizing the Proxy to make medical decisions.
Colorado also recognizes the Five Wishes as a legally valid medical designation of a health care agent. The Five Wishes document is a qualitative description of many of the last wishes. It is distributed by Aging With Dignity of Tallahassee, Florida.
More recently, Colorado has adopted the Medical Orders for Scope of Treatment (MOST) form. The MOST form is a physician’s order that directs the patient’s preferred course of treatment, usually during end of life care. The MOST form follows the patient to all care settings such as hospitals, nursing homes, assisted living and hospice. The MOST form outlines wishes for care, including the use of CPR, antibiotics, artificially administered nutrition and the level of medical intervention.
The CPR Directive, also known as the Do Not Resuscitation (DNR-Order) instructs medical personnel to withhold cardiopulmonary resuscitation in the event the patient’s heart or breathing stops. Unless the CPR Directive is part of the patient’s record, it is presumed that the patient gives full consent to CPR. The CPR is usually signed by the physician, but not required.
Other forms that can be signed are Living Wills which give direction to loved ones and the physician about preferred life support systems. A Living Will directs loved ones that when two physicians agree that the individual is in a persistent vegetative state with no medical reason to believe that function will be regained, that all life supports including ventilators, dialysis machines and feeding tubes may be discontinued and that no effort will be made to start the heart should when it quits beating.
Unmarried individuals who do not have other estate planning tools can use a Designated Beneficiary Agreement to establish certain rights and protections between each other. These can include rights of property, survivorship, beneficiaries of insurance policies and retirement plans, visitation, inheritance and other end of life decisions. The individual must be competent to engage in a legal contract, not married and not engaged in another Beneficiary Agreement. The form must be notarized and filed with the county clerk and recorder. The agreement terminates upon marriage of either party, revocation by a filed form or death, though the rights of survivorship outlive the death of the other party.
Individuals are encouraged to seek legal counsel when making advance directives, as many individual situations require special language to provide the best directions to trusted agents carrying out legal actions. The Colorado Gerontological maintains a list of legal resources that can help with legal planning. In addition, individuals can contact the Colorado Bar Association or the National Academy of Elder Law Attorneys.
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