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Showing posts with label #healthcaredirective. Show all posts
Showing posts with label #healthcaredirective. Show all posts

Wednesday, February 9, 2022

Power of Attorney: There’s Always Room for Family Conflict


Anyone who grew up in a dysfunctional family understands the potential for discord when it comes to the family estate and an inheritance. But even in the closest of families, if there’s money involved, there’s room for conflict.

Power of Attorney: Choose the person you can trust

In Alana’s case, the dust was still settling on her third divorce, and one of her kids was in and out of rehab for substance abuse. The youngest of three siblings, Alana always struggled to measure up to her rock-star brother and sister—they were the ones who excelled at everything they did, winning awards, graduating with honors and building successful careers. She was the one who always seemed to make a mess of everything.

And now her parents had named her brother their Agent for their Power of Attorney. She was hurt because this was something she had wanted to do—a chance to redeem herself to her family. But the fact that her own financial affairs were a mess and she couldn’t balance her own checkbook led her father to appoint her investment banker brother. It was he who would also be the Executor of the estate. Her sister, a doctor, would be their parents’ Agent for their Healthcare Directives. Alana was left out once again.

Your Power of Attorney is the person who will act on your behalf if you become incapacitated, the one who will take over your financial affairs, pay your bills and taxes, open bank accounts, withdraw funds, cash checks and trade stocks. It must be someone you trust; ideally, it’s someone who lives close by.

Parents tend to appoint one of their children as Power of Attorney for practical reasons. Many put their faith in their oldest child or choose the son or daughter who lives closest or the one who has a financial services background. In the same vein, for their Agent for an Advance Healthcare Directive, parents are likely to choose a son or daughter with healthcare experience.

There are limits on the powers of the Power of Attorney designation

  • Right to information. The parent does not have to disclose to friends and family whom he or she named as Agent under the Power of Attorney. Likewise, that Agent is not obligated to provide information about the parent to his or her siblings.
  • Limits on the powers of a Power of Attorney. A Power of Attorney designation does not enable the Agent to do whatever he or she wants. An Agent cannot change the principal’s will, breach his or her fiduciary duty or change or transfer the Power of Attorney designation to someone else.
  • Power of Attorney expires at death. When the parent dies, the Power of Attorney ends and the Executor of the estate – appointed by either the principal or the court – takes control over the decedent’s property.
  • Revocation of a Power of Attorney. The parent can revoke whomever he/she has appointed as the Power of Attorney. The revocation must be in writing and the former Agent Power of Attorney should be advised of the revocation.

Avoiding the potential for sibling discord

Sometimes conflict is inevitable. One child may be resentful that he or she was not chosen. Another child may not trust the chosen sibling to act according to the parent’s wishes. Just knowing that a Power of Attorney can be challenged in court is often enough for a sibling to act on his or her distrust or resentment. To minimize confrontations, as the principal appointing the Power of Attorney, there are alternative solutions:

  • Designate co-Agents in the Power of Attorney document. Appointing two persons can be problematic if the Agents cannot get along. You could create separate responsibilities for each Agent, but that can be unwieldy and still can lend itself to conflict.
  • Avoid appointing a family member altogether. Name a close friend, fiduciary or a bank. Avoiding conflicts and court involvement is important to ensure your wishes will be followed.

A Living Trust: One of the most thoughtful things you can do for your family

A Living Trust is a legal document that contains instructions for what you want to happen to your assets when you die. For my family, it meant that when my parents died, all of their affairs were in order, they had transferred all of their assets into the Living Trust and identified their heirs. Without a Living Trust, their estate would have gone into Probate and my brother and I would have been dealing with this long, expensive process—even while mourning the death of our parents.

Guideway is proud of our comprehensive Living Trust package that includes a Power of Attorney and Advanced Healthcare DirectiveBest of all, we guide you through it and we prepare the legal documents. Schedule an appointment with Guideway today.

Guideway services the entire Bay Area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.

Wednesday, January 26, 2022

Wearables Have Stepped up to Monitor Your Health


A Guideway Trust client, Shirley, decided that the new year was time for making long overdue changes to her life. She made an appointment to create a Living Trust, which includes a Power of Attorney and an Advance Healthcare Directive, that she’d been putting off for years. She started doing yoga twice/week and got serious about using the smartwatch her kids gave her for Christmas.

Smartwatches keep getting smarter

A 62-year old bookkeeper, Shirley has high blood pressure and some other health issues. She’s delighted with her smartwatch—she sets alarms during the day that remind her to get up from her desk and stretch–this is especially important as tax season looms. She now takes a brisk walk during her lunch break, and she’s using her smartwatch to monitor her blood pressure and oxygen levels.

Today’s smartwatches and other health-related wearables do a lot more than count steps or let you see how many calories you’ve burned.



Socks monitor foot temperature, helping reduce foot ulcers for diabetes patients

San Francisco-based Siren is producing a wearable for your feet–machine-washable socks for people living with diabetes and neuropathy. The socks come with a Bluetooth hub that plugs in and lets a team of nurses monitor the temperature of the foot, which Siren says has been shown to reduce diabetic foot ulcers by up to 87.5 percent. On the market for about five years, Medicare covers the cost. You need a prescription but not a smartphone.

Other health wearables on the cusp

  • Swiss startup Aktiia announced plans to bring its automated wrist-worn 24/7 blood pressure device to the United States. The company has about 15,000 customers in Europe.
  • Abbott announced a new line of consumer “biowearables” to continuously track signals for glucose, ketones and lactate. It will eventually track alcohol levels.
  • Worn on the back of the arm, FreeStyle Libre is about the size of two stacked quarters and is used widely by diabetics. A tiny filament the width of three human hairs is placed just below the surface of the skin, where it measures molecular biomarkers. Data is sent via Bluetooth to an app on your smartphone every minute, giving users insights into what’s going on in real time. It’s available by prescription and lasts 14 days, when the user peels it off and applies a new one.

Information accuracy is best when backed up by a doctor or FDA

While there are no guarantees with these wearable devices, you generally can put more faith in a device that your doctor prescribes or recommends, or that has the blessing of the FDA.

Swiss company Aktiia plans to make its blood pressure watch available through doctors rather than as a direct-to-consumer offering, at least initially. The company is engaged in clinical partnerships and pilots in the U.S., including a study with hypertension patients at Brigham and Women’s Hospital in Boston. As the technology evolves, so will the safety and data protocols.

Data must be understandable and secure

When in doubt, reach out to your doctor. The onus is on the makers of the wearable devices to clearly explain what the data mean and the consequences. You should also be informed about a device’s limitations. A good example: When you launch the ECG app on the Apple Watch, you’ll see a message that says “Apple Watch never checks for heart attacks.”

If you’re not aware of privacy issues these days, you’re not paying attention. Find out how the device makers and medical providers plan to safeguard your information and keep it confidential. The FTC affirmed in September 2021 that health apps and connected devices that collect or hold fertility, glucose level, heart health and other health data must notify consumers in the event of a breach.

With the promise comes peril

“There’s promise in all of this technology, but also peril,” says Patrice Harris, chief executive officer and cofounder of digital health care company eMed and former president of the American Medical Association. “I always say proceed with caution and have some curiosity.”

Creating a Living Trust: One of the most thoughtful things you can do for your family

A Living Trust is a legal document that contains instructions for what you want to happen to your assets when you die. For my family, it meant that when my parents died, all of their affairs were in order, they had transferred all of their assets into the Living Trust and identified their heirs. Without a Living Trust, their estate would have gone into Probate and my brother and I would have been dealing with this long, expensive process—even while mourning the death of our parents.

Guideway is proud of our comprehensive Living Trust package that includes a Power of Attorney and Advanced Healthcare DirectiveBest of all, we guide you through it and we prepare the legal documents. Schedule an appointment with Guideway today.

Guideway services the entire Bay Area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley,

Wednesday, December 29, 2021

The Holidays. The Perfect Time to Talk about a Living Trust!


My family tried for years to get my folks to create a Living Trust. While my mom was an easy sell, it was my stepfather, Charlie, who was the holdout. A retired Navy pilot, we figured it was some kind of macho-military thing. He wouldn’t listen to my mom, his daughters or me. But one year during the holidays, my brother brought the subject up, explaining how difficult Probate can be for grieving families. Bingo. It took the intervention of a male for Charlie to take this seriously.


Charlie and my mom finally created their Living Trust when they were in their mid-70s. It took my brother’s intervening again to get my folks to update that Trust when they were in their early 90s. By that time, they were very frail, though they still had testamentary capacity. This update was important, as they’d made some good investments, and one of Charlie’s daughters had died.

Let’s face it—there’s never a great time to talk about end-of-life planning

Yet if your efforts to get your parents or other family members to create a Living Trust have fallen flat, it might be that the holidays are the time for this conversation to resurface. Additional family members may provide the support you need.

A Living Trust provides peace of mind

A Living Trust is a legal document that contains instructions for what you want to happen to your assets when you die. For my family, it meant that when my parents died, all of their affairs were in order, they had transferred all of their assets into the Living Trust and identified their heirs. Without a Living Trust, their estate would have gone into Probate and my brother likely would have been the one having to work through the Probate process for our family.

Our Trust package includes a Power of Attorney and a Healthcare Directive

Financial Power of Attorney, a written authorization to represent or act on another’s behalf is an important part of life planning. As people age, it’s not unusual for their memories to fade and their thinking to become unclear. The time often comes when they can no longer pay their own bills, interact with their healthcare providers, insurance representatives and other professionals—yet it’s critical that they continue these services. Having a trusted family member or friend step in as Financial Power of Attorney means that the services and care they require will seamlessly continue.

An Advance Healthcare Directive specifies what actions should be taken for your health if you are no longer able to make decisions for yourself because of illness or incapacity. We all like to think that we’re going to age gracefully and die peacefully in our sleep at a ripe old age, but the reality is that people have massive strokes, fall into comas and have debilitating accidents. Planning ahead and creating an Advance Healthcare Directive makes it easier for your family to care for you if an unfortunate situation arises.

A thoughtful gift for your family this holiday: Create or update your Living Trust.

With families gathered for the holidays, it’s the perfect time to encourage procrastinating relatives to create or update their Living Trusts. We’re proud of our comprehensive Living Trust package that includes a Power of Attorney and Advanced Healthcare Directive. Best of all, we guide you through it and we prepare the legal documents. Schedule an appointment with Guideway today.

 

Guideway services the entire Bay Area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.

Wednesday, October 27, 2021

Planning Your Living Trust: Four Things You May be Overlooking


As you start thinking about what belongs in your Living Trust, here are four things that often get overlooked—and can have significant, often costly consequences.

Creating Joint Tenancy Assets

In Living Trust conversations, joint tenancy generally refers to real estate and how you hold title to a property. If two people own a property, joint tenancy (with the right of survivorship) means that if one owner dies, that owner’s interest in the property will pass evenly to the surviving owner or owners without having to go through Probate.

Funding, the process of transferring assets into a Living Trust, is part of the Living Trust process. A Grant Deed transfers real property into the Trust. This Deed will also remove property from your Trust–many banks require your home to be removed from your Trust in order to refinance. Guideway can help remove your property from the Trust, then place it back in after the Refi is complete.

Disposing of family keepsakes 

You can’t put a price tag on sentimental value. Small insignificant items that may not hold any monetary value can be important sentimental icons for family members. They can also be the cause of family strife. Smart families divide these up long before anyone dies. In my own family, as my folks aged, they encouraged us to take things home with us when we visited. Other families explicitly identify these items and their distribution in their Living Trusts. When Robin Williams died, his kids sued his wife to get possession of the substantial collection of memorabilia that their father had collected over his career. If he’d identified their distribution in his Trust he would have saved his family a whole lot of grief.

RELATED CONTENT: We Learned Many Things from Robin Williams . . . and Now We’re Learning from His Estate Plan

Assets passing outside of the Trust

Assets such as life insurance, annuities and retirement plans fall outside a Living Trust. Naming a beneficiary for these accounts supersedes whomever you might name in your Trust.

We see this one all the time. You named your ex-wife as your beneficiary for your 401k—but that was in happier times. After your divorce, you removed her as the beneficiary in your Trust. But unless you also remove her as the beneficiary in your 401k account, it’s your ex who will benefit if something happens to you.

Naming backup Executors and alternates

Think carefully about whom you name as your Executor and alternate. Your brilliant banker cousin Jerry may be the perfect choice because he totally gets this stuff, but he’s 67, he’s still sneaking cigarettes and he has a heart condition. Keep Jerry, but identify an alternate who is healthier and younger.

As you update your Trust over the years, plan to review your Executor and alternate appointments. Make sure they’re still available and capable of taking on the responsibilities of this role.

Guideway, we’re a single point of contact

When creating your Living Trust, you’ll work with a dedicated specialist who is available for questions and support throughout the process. We’ve been in business since 2003 and have expanded to three Bay Area offices–Dublin, Oakland and Walnut Creek. More than 60% of our business comes from referrals and repeat business.

We’re also proud of our comprehensive Living Trust package that includes a Power of Attorney and Advanced Healthcare Directive. We provide a hard copy as well as a soft copy of your documents. More questions? Contact us today.

Guideway services the entire Bay Area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.

RELATED CONTENT:

5 Steps to Funding Your Trust

Your Living Trust: Avoiding the Pitfalls

Is It Time to Check Your Beneficiary Designations?

Wednesday, October 13, 2021

Covid Survivors Belatedly Update Their Living Trust


Tom and Gina came into our Oakland office to update their Living Trust—something they regretted not doing years before. Both Tom and Gina are Covid survivors. An RN at Kaiser, Gina became sick in the early days of the pandemic, and Tom soon became infected as well. Both were in their 50s, healthy, with no preexisting conditions.

Tom was moderately affected and was hospitalized for a week; Gina spent a month in the hospital and nearly died. It was four months before she could return to work on even a part-time basis. Tom’s a teacher, and he was off work for several months. After more than a year, the couple is still struggling to regain their health and stamina. Neither is able to return to full-time employment, so the ordeal has had an economic impact as well as compromising their health. Tom and Gina want to make sure that if their health fails, their two adult sons will inherit their home and other assets. They’ve named their older son, Jerry, as their Power of Attorney.

RELATED CONTENT: Your Living Trust: Avoiding the Pitfalls

Sometimes it’s hard to imagine a future without Covid

This is especially true for those Long Covid, as they call the long-term effects of the disease that take many forms, including fatigue and brain fog that make it difficult to return to work and resume a normal life. Headaches are another chronic problem, along with muscle and joint pain, sleep problems, fever and dizziness. Some people are experiencing complications as serious as organ failure.

For those who work in the food and wine industries, loss of the ability to smell and taste is another serious consequence. In one account, a woman is studying to become a perfumer. Its practitioners need a discerning sense of smell. Covid is threatening the careers of professionals in these industries.

guideway legal let us answer your questions

Deferred maintenance: Another way Covid has affected Americans’ health

Health providers are seeing the consequences of more than a year of pandemic-delayed preventive and care. Think about our regular appointments to have our teeth cleaned or for our yearly physicals. These wellness checks are cost-effective preventative medical care.

Delayed response attributed to fear of going to the hospital

Dr. Brian Rah, chair of the cardiology department at Montana’s Billings Clinic, was confused in the early days of the Covid pandemic. He couldn’t figure out why there was a sudden drop in heart patients. And some patients were arriving hours after first experiencing chest pains. Two patients, both of whom suffered greater heart damage by delaying care, provided what came to be typical answers.

  • One said he was afraid of contracting Covid by going to the hospital.
  • The other patient went to the emergency room in the morning, left after finding it too crowded, and then returned that night when he figured there would be fewer patients–and a lower risk of catching Covid.

Delayed treatment can result in death or long-term compromised health

“For a heart attack patient, the first hour is known as the golden hour,” Rah said. After that, the likelihood of death or a lifelong reduction in activities and health increases, he said. Dr. JP Valin, executive vice president and chief clinical officer at SCL Health of Colorado and Montana, said he is “kept awake at night” by delays in important medical tests. “People put off routine breast examinations, and there are going to be cancers that are not identified, potentially delaying intervention,” he said.

  • Timely treatment of appendicitis symptoms. Valin is also concerned that patients aren’t seeking timely treatment when suffering appendicitis symptoms like abdominal pain, fever and nausea. A burst appendix generally involves more risk and a week’s hospitalization, instead of one day of treatment for those who get care quickly, he said.
  • 80% drop in colonoscopies. Fola May, a gastroenterologist who is also quality director and a health equity researcher at UCLA Health, worries about the consequences of an 80% to 90% drop in colonoscopies during the first months of Covid.

New medical problems emerging from the pandemic, many stress-related

Along with exacerbating existing health problems, the Covid pandemic has also caused a host of new medical issues in patients. We will be coming out of the pandemic with teeth worn down from grinding, back problems from slouching at makeshift home-work stations and mental health problems from a combination of isolation and being too close to family.

Dr. Despina Markogiannakis, a dentist in Chevy Chase, Maryland, said patients don’t argue when she tells them they have been grinding or clenching their teeth and might require a root canal, dental implant or night guard.

“These are people stuck at home all day, feeling lonely and feeling a little depression. It is induced by the world we live in and all the changes in our lives,” said Markogiannakis.

  • Tooth grinding. A recent American Dental Association survey found that more than 70% of member dentists reported an increase in patients grinding or clenching their teeth since Covid.
  • Stress-related teeth conditions. More than 60% reported an increase in other stress-related conditions, such as chipped and cracked teeth.
  • Depression and weight gain. Gerard Mosby, a Detroit pediatrician, finds his young patients are suffering more stress, depression and weight gain than before the pandemic. Confined in their homes, many are living in multigenerational homes or foster homes or have experienced Covid illnesses or death among family members.
  • Eye strain from too much computer time. Optometrist Matthew Jones, who practices in Blytheville and Osceola, Arkansas, reports worsening eye conditions for patients, some of whom stopped taking drops during Covid for conditions like glaucoma. He’s also seeing much more eyestrain “because people are spending so much time in front of a computer screen” and recommends eyeglasses that filter out blue light to his patients.
  • Pain makeshift workstations. Physical therapist Kaylee Smith, who runs a treatment studio in La Jolla, California, says she is seeing more injuries related to poor posture due to makeshift home workstations used during the pandemic.Patients are reporting more pain and injuries related to poor posture.

While we’d love to put Covid behind us, we never leave home without our masks. And that remains the reality for the foreseeable future.

Guideway, creating and updating your Living Trust

We’re proud of our comprehensive Living Trust package that includes a Power of Attorney and Advanced Healthcare Directive. We provide a hard copy as well as a soft copy of your documents. More questions? Contact us today.

Guideway services the entire Bay Area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.