How Can I Sign New York Banking Living Will

Electronically sign advance directive

[Music] hey what's up everyone I'm Risa we're moto and welcome to the modern age which had innovative an alternative ideas for creating a better life for aging parents and loved ones see that subscribe button on YouTube click that and the little bells here always sure to be notified when new episodes are uploaded ok if you're like 80% of people who don't know or have not filled out an advanced directive for yourself with a loved one in need to watch this episode seriously trust me on this I had to find out the hard way where my mom had a massive stroke completely out of the blue when she was only 65 and it sucked big time that was over 18 years ago when you get a car you get car insurance and hitches in case you get into an accident you buy a home my home insurance to protect your home so why wouldn't you do that for your life in the event of a health crisis My dear super longtime friend Linda real estate became a fancy elder law attorney we actually became reconnected because of this show which is so awesome she breaks down what an advance directive living will health care proxy DNR is and that all that is at stake and these forms filled out so check it out [Music] Linda I'm so excited that you're here thanks for asking me know if this is this is a super important topic it's something that my family had to deal with when we were in crisis mode when my mom had her stroke in the hospital and that is absolutely the time you do not want to be dealing with advanced directives right fair enough how old was your mom by the way 65 she's happy and we were having lunch and she was fine moments before and that's why I feel like it's so important for people to address this and get those forms filled out so to start off can you tell me so what is an advanced directive so before we start let me just preface this because unfortunately lawyers have to say these things that we don't have an attorney-client relationship and I'm not giving legal advice but I I'm really glad that you asked me on to give some broad strokes about what our advanced directives the importance of advanced directives and the consequences basically if not having advanced directives advanced directives are a series of legal documents that allow you when you have capacity to tell everyone what it is you want done for end-of-life decisions so for example you're able to to communicate your cultural ethical religious preferences moral preferences and so that you still always remain in control of your decisions you know they're they're very simple forms and the biggest takeaway from today should be when people shut down and see this they should go and they should at the very least execute a health care proxy and a living well and should also have a conversation with respect to what their wishes are so not only is it documented but also they have an open and frank conversation with the person who's going to make the decision for them what happens if you don't have the advanced directive right so I'm sure you remember the the nightmare of Terri Schiavo and and you know Karen Ann Quinlan and those who become you know have come in between when you don't know what your end-of-life preferences are and you have not shared it with anybody it's it's fairly impossible for the doctors choose and they're not allowed to substitute judgment so they are looking for they're looking to other people to fill in the gaps and decide what you would want a wouldn't want well if you've never expressed what those preferences are you're opening yourself to to parents and siblings and you know close cousins and friends you know all coming in to argue what you would have wanted and and why they think this is what you would have wanted so it's not even like only end-of-life right it's just if you become incapacitated as well that's a fair point right because there are times when you know God which is almost worse right so if you want to get over a hump Manou right you you want to make sure that you have that spokesperson in charge making decisions on your behalf for that period of time that you can't make the decision so there are a couple of kinds of advance directives the first thing is a health care proxy so a health care proxy it's a very simple form that you sign in front of two witnesses and it allows you to nominate someone to act as your proxy you know someone who stands in your shoes and makes decisions based on your preferences the good news is you can always change your mind you can revoke it at any time did I file it with anybody you don't but I can tell you when my practice is to make several copies and by the way a copy is just as effective as an original but the first thing you want to do is you want to talk to the person and ask the person who you're asking to be your proxy whether or not he or she is willing to serve that's the first conversation the next conversation is you need to tell them what you want right and have that conversation and make sure that he or she is comfortable executing your wishes so what do you mean by what you want so let's say for example you have a stroke and you are a decision needs to be made whether or not to intubate you or to you know put breathing tubes in mechanical ventilation artificial hydration and nutrition those are the basic decisions that you want to be in control of when you don't have capacity anymore even if it's temporarily you want to make sure that that person who you've appointed as your agent understands and has had this conversation with you probably not once but but a few times so that he or she is clear there have been situations where people have declined to serve as proxy because their specific religious beliefs preclude them from honoring your wishes so you know you you think oh I'll just pick so-and-so because I'm sure he'll do what I want not always you know it's a really personal conversation that you have with somebody so and don't be insulted because you want the right person in that role and I respect people when they decline you also have the ability to appoint a successor agent in the event the the initial person you appointed either can't serve or for whatever reason declines so you need to have the conversation with a success or agent as well most importantly you can revoke it you can change your mind this is a fluid document for the most part so that's what you feel in one year you know you might change your mind so you you don't have to formally revoke you literally rip it up you make sure you have a conversation with your agent and say well whatever I told you before I change my mind right guys right you know I was too many glasses of wine that night but people evolved and they're there you know and as you get older your preferences might change for me personally you know my husband is my proxy although you know I joke because if I had my sister as my proxy I would be hooked up to every machine an idea live till I was 112 and with my husband I think he's gonna trip over my cord just has a cold what are you doing no no she doesn't want anything so you need to find the right balance but you could you know your your ideas evolve about what your end-of-life decisions are but what I also recommend in with the healthcare proxy which by the way is there is a statute governing that in New York State there is something called a living will a lot of people think a living well is either something that disposes of your property it isn't at all what it what it does is it allows you to memorialize what your wishes are with respect to intubation you know tube feeding mechanical ventilation artificial hydration nutrition anything you want to put in there you can put in there you can even define what circumstances here's a set of circumstances where I would want to be kept alive so for example if you were in a horrific car accident but the doctors say you know what if we put her on a vent we believe she's going to come off of it in a period of time and if you're you're young you have children or other considerations you you may tell your you're eight you know you may write out under those circumstances you know by all means put me on but if it becomes clear that I'm not going to recover and/or breathe on my own so you really have a lot of flexibility in drafting this it is not a one-size-fits-all document and that's why I encourage you to really sit down with an elder law professional to make sure that you get it right and again it can be revoked you could change your mind you modify it but as a standalone document doctors are not allowed to rely on that oh yeah a little-known fact so you can use it and I think it's a great tool in conjunction with your health care proxy because it can direct your health care agent in case he or she forgot here here's the living will it's memorialized so it really even gives your agent a little more comfort that he or she knows he's following your directives but it should not be used as a standalone what do you mean by that so the doctor one can still make a decision that's not in line with your living will that's correct that's correct so that's why you know the point of the agent is against important thing what if I was in the coma and I woke up I'd be like you're kidding me right now right right I mean it's evidence of but it's not you know it's not governed by any statute in the state of New York so while it's evidence of the doctor would still want to know whether or not you expressed your wishes to an agent or you know live up to that person right so let me turn to exactly what the legislature in New York did in 2010 to address this issue they under under Governor Paterson and after the family health care decisions Act so what that statute says is listen in the event you don't have any advanced directives you know you blew it if you forgot you didn't do it we're gonna give a pecking order as to who makes decisions on your behalf and the first person in line is a court-appointed guardian the second crazy the second person is a spouse the third person is an adult child and then the the next act they believe is parents that's your dog but so the court-appointed guardian is top dog top dog but there's good reason for that and you know off off line you had said to me why why would a court-appointed fiduciary who may not know anything about you be entitled to make that decision as opposed to a spouse who is in the second position under under our guardianship law which is article 81 of the Mental Hygiene law we have we have provisions where you put the spouse on notice that a guardianship proceeding is being brought so a judge is making a decision as to whether or not the spouse should in fact be the Guardian and whether or not the spouse has the ability to make maybe he or she doesn't has maybe diminished capacity him or herself so there would be a good reason why a spouse would not have been the personal needs Guardian which is the person who would make the decision with respect to a DNR but there's also a second layer of protection so a guardian under article 81 to ask permission for the court has to make an application on notice to everybody you know people who are interested in in the proceeding in an article 81 which would generally include family or close family members you know spouses immediate family right so the application to have a DNR put in place as a guardian needs to be on notice in front of a judge and you have to bring in doctors as witnesses to you know to get to allow the authority of a guardian to put DNR in place so say just for example you know my dad didn't have any advanced directives but I as a child so the court is going to appoint to get a guardian but cannot I can't petition that or I can ask the child no if there's no gora if there is no guardian in place then you cross that off the listen you go down to the second category of eligible folks to make oh so this is so they're not gonna put in a court-appointed guardian unless there already is exactly so in the event there was a court-appointed Guardian that's why he or she is the personalized that decision and then the spouse and in which case so your mother would not be able to make a decision on behalf of your father so we drop down to you and your sister so what happens if there's a fight what if you think one thing in your sister thinks another I mean which is very common it's confident in a lot of families if you know I I thankfully not ours but but we also know that you you and your sister have had that conversation and I've had that with my sister but but that is that's what the statue tried to do is at least give a pecking order as to who makes decisions but you could see right there when you get to pass the spouse and I'm sorry it's a spouse or a domestic partner when you get past the spouse and you start with children you know there's room for argument and why would you want to strip the person you know who can't make that decision of his or her dignity and you know this is this is why we do this this is why we're having this conversation to make sure that his or her wishes are honored I've actually heard that the number of people who fill out advance directives is only at like 20% or something crazy it's crazy that's probably true that's probably true so we practitioners try to get the word out you know but this is why I'm thrilled that you asked me to come on because I hope at least some of your audience will say yeah you know what it's let's do this while I'm healthy yeah so please just get it out of the way exactly and I know that so-and-so is in charge and here are my wishes and and then you know you check the box off and you're done right and it's really not difficult it's it's just something you really should address one of those things that you just hope you don't need but it's good 200 percent 100% so there's also a DNR right so is that considered an advanced directive or not necessarily so there are so you can or define a DNR right so it's a do not resuscitate and there's a non-hospital form that has to be completed with your physician so people think that they can just tattoo DNR author Cheston which is actually happened it has happened and but the the better way to go is on there's a website for the New York State Department of Health and you can print out a DNR form bring it to your doctor certainly have a discussion I I think the most important thing to do is not just fill out a DNR because you think that's what you should be doing because that's conventional wisdom or that's what your friends are doing talk to your doctor you know have it explained to you at you know especially if particularly if you're if you're older what do chest compressions feel like you know what can be the result what is your overall endgame and you know your doctors are pretty willing to have that conversation with you and then you can make an educated decision as to what you think you want and if do not resuscitate is right for you then your physician signs off on it generally he or she puts it in in in his or her file and they try to review it every 90 days it's it's not you know it's not a party dance fool I know well I know it's not a hard and fast rule but that's how serious you know if the doctors are taking it that seriously you know it should signal that we should take it that seriously right so does each D because you were saying that New York you can file it with the New York's with New York State or you can get the floor from you you can get the form does that mean so it's a state by state law it is so for sure don't don't go to the New Jersey Department of Health website and and execute that and I can't say whether or not it would be honored I actually don't know yeah because you think it would just be a blank form right you would think so I think this safer route to go is to execute a wherever you live and I understand you know you move people move so obviously we execute every time you know you go into a different state but what happens if say I have a stroke in Colorado right so your DNR will follow you regardless of what jurisdiction you are in I think but from a best practices standpoint so if you establish yourself as a citizen of Colorado and that's where your domicile to the next ten years you know go go ahead and and and we execute that form but for sure if if you should carry it on you I know it's not practical but what folks are doing now is they are storing it digitally on their phones but of course folks have to know that it's there and that it exists right so don't like that wouldn't like your mid list you know your medications list or whatever you just stored on your phone what I've understood from friends of mine who are EMTs is some people have there's been a if you can't just put it on your refrigerator I think stainless steel doesn't put the magnets anyway some folks have put their advanced directives in the freezer really yeah why I I don't but this was an EMT I don't know who's pull on my leg no he was tough Paul if you pull my leg yeah it was no no no that's it but we we've heard this is where you look for EMTs for advanced directives and I have no idea if that's true or not but anyway you should put it conspicuously you know like you know on the the table you know somewhere someone could see it carrying your frame in your like frame it right no doubt your your agent should have whomever you your point is your health care proxy they should probably have a copy of your DNR so as to provide it to the doctor and this is a non hospital DNR which means so you you're doing this with your physician as I said in in a non hospital setting and when you're in a hospital setting there's something called a most forum which is essentially you're the physician the attending physician sits with you and if you are able to express your wishes about various like we had discussed before artificial hydration nutrition mechanical ventilation etc and a DNR and that's all in one document that is generally it can be out of hospital as well you can do that with your physician but they will do that in a hospital generally for folks who are expected not to live more than six months or otherwise you know it appears that you know they are approaching end-of-life so this is a great thing to do as a family then maybe had a Christmas time here everyone right right but people can just download advanced directives so let me just so I brought one for you to take yet so it's you can get this on the website at wwlp.com and it's a non hospital order to not resuscitate I I can always guarantee you your physician should have these and probably every state health department will have absolutely absolutely yeah and then what about health care proxies and living wills is that something that one should just you know get generic forms online or there's a health care proxy form available online from York state gov you know that the health website health health New York gov and you can you know you could hand fill it in it doesn't need to be fancy it just needs to accurately reflect your wishes and there are blank spaces as to you know here are my wishes you can handwrite them you don't have to worry about the terms you're using use plain English right you know as long as you are satisfied that you are conveying you know what your wishes are or some people right my healthcare agent is aware of my preferences and some people leave it at that Wow yeah yeah it's it's a it's a preference some people think it's daunting to sit and write every single contingency or any contingency at all so they would just rather have that conversation with their agent and they've I think people fear if that if they don't update the document and they change their mind that they're they they want someone they would want so if you had that living will but then you told your agent hey disregard what might my living well states obviously your healthcare proxy will be bound by what you've told him or her verbally but so people get a little sketchy about wanting to necessarily put that in there he'll write no I didn't see that right right it's whatever you're comfortable with but by all means designate that agent and have that conversation with him or her okay so to wrap up and just to kind of review because it's so much information so the takeaway is this should not be a daunting task it should be something that you you say oh I really need to get this done speak to speech you're the person that you want to make healthcare decisions on your behalf have that frank conversation you can have it over tea have a glass of wine just have it it's you know that the paperwork is is not daunting but it it should be done and there's really no time like the present Linda and I would love to hear her thoughts of please feel free to leave a note in the comment section below if you found the video helpful please share with your friends and family and be sure to subscribe so you'll always be notified as soon as new shows are uploaded feel free to DM me on Instagram or Facebook at this is watered aging the best way to keep it about our latest episodes and other upcoming programs this is not a foggy Melton at this modern to live your best life tomorrow and you need to start today so thank you so much for watching and we look forward to seeing you next time on the water [Music]