NACCM EXAM WITH FULL PACK
SOLUTIONS
Estate Planning Documents - correct answers -Living will, Powers of Attorney/Durable
Powers of Attorney, health care proxy, HIPAA Releases, Advanced Directives
Definition of a Will - correct answers -Document executed by an individual directing how
his/her estate is to be distributed after his/her death
•Does NOT give authority to the executor (or other responsible person as the titles differ
by state) to do anything during the individual's lifetime
•Must have legal capacity to execute a will
•Will s may be simple or very complex
What is a Power of Attorney? - correct answers -A durable power of attorney is a written
instrument that allows an individual, called the "principal", to designate someone else as
his or her "attorney-in-fact", or "agent", to act on that principal's behalf.
DPOA Authority includes: Property dealings, Ability to contract. Access & use of
financial resources, Ability to gift, person can have multiple people assigned as an
,agent -ensure can work together, Third parties may rely upon the authority granted in
the POA until the third party receives written notice otherwise, May contain language to
include health care decisions
Always request copy -individuals should not give away originals unless necessary
Ability to contract & give consent; also ability to make gifts
Durable power of attorney survives incapacity
Immediately effective once executed (unless "Springing")
No longer valid once principal dies, if revoked in writing, if principal is determined totally
incapacitated.
Fine Print for Durable Power of Attorney - correct answers -DPOAs are NOT recognized
by federal agencies such as the VA and the Social Security Administration -each has its
own process for determining representation or fiduciary
•DPOAs can be very broad or have restrictions
•DPOAs do not expire yet many places refuse to recognize "old" documents (more than
a few years old) so may need to be re-certified by the attorney who originally executed.
•Many people download forms from the internet but then not tailored for their specific
situation
When is a POA revoked - correct answers -When principal dies, when principal revokes
the document, when Principal is adjudicated as incapacitated -but may remain in place
if durable.
Indicators that client is at risk for financial exploitation - correct answers -Isolation,
loneliness, recent losses, physical or mental disabilities, lack of familiarity with financial
matters, having family members who are unemployed and/or have substance abuse
problems.
What is a Living Will? - correct answers -A document in which you state your wishes
about life-sustaining medical treatment if you are terminally ill, permanently
unconscious, or in the end-stage of a fatal illness. These are not recognized as legal
documents in every state
What is a living will and Durable Powers of Attny for Healthcare - correct answers -They
are both types of Healthcare Advance Directives.
The person you name is called your agent, proxy, representative, or surrogate.
Any document that gives instructions about your health care and/or appoints someone
to make medical treatment decisions for you if you cannot make them for yourself.
What is the function of a Healthcare Proxy/Surrogate? - correct answers -All health care
decisions
Provide informed consent
Make decision believes principal would make if able
Best interest (if surrogate does not know your wishes)
Withhold or withdraw treatment
, Written consent for DNR
If Healthcare Proxy is not designated - correct answers -Proxy provisions vary by state
law but typically is a spouse, child/children or other family members.
What are examples of Advanced Directives? - correct answers -Living will -as noted,
may not be recognized as legal document in every state
•Five Wishes -a nationally recognized format for individuals to give instruction to their
health care agents
•Personal Directive -individually drafted instructions -there are written formats
developed by many organizations
•MOLST (Medical Order for Life Sustaining Treatment) or POLST (Physician Order for
Life Sustaining Treatement) -becoming more widely used in various states to document
wishes and to ensure that wishes are followed across the care continuum. Wishes
include DNR, DNI, DNH, feeding tubes, antibiotics and more
•Comfort Care -generally a physician directed order regarding DNR (do not resuscitate)
orders
Indicators that client is in need of guardian (non-financial decisions--where the ward
lives and what type of medical care the ward gets) and conservator (making financial
decisions--preserves the estate of the ward). - correct answers -The court arranges for
a person or co. to make certain decisions for another person (the ward). This is set up
when the person's decision making capacity is so impaired that the person is unable to
care for his/her own personal safety or to provide for his/her necessities. The person
must be a risk of physical injury or illness. It protects person unable to help themselves
& refuses help. It is a deterrent to individuals who might wish to take advantage of the
ward. deterrent to those who might wish to improperly use the wards assets.
Both guardianship and conservatorship are court processes -expensive and public
•A medical certificate from a physician is required to move forward with a petition
Guardianship/Conservatorship Disadvantages - correct answers -Last resort
Intrusion of the court into the individual's life and into the life of the family
Rigid and burdensome reporting requirements;
The expense of setting up and maintaining a guardianship
The delay in transacting the financial affairs of the ward because of necessary court
approvals
Abuse, neglect or exploitation issues - correct answers -inflicting physical force resulting
in bodily injury, inflicting pain or impairment (sexual or non-consensual contact),
emotional or psychological abuse, inflicting pain, distress, or creating anguish, or
financial or material exploitation -- illegal or improper handling of the elder's funds or
properties, abandonment like a desertion of elder/individual for which they have custody
or not finding place for this care for
Neglect - correct answers -Refusal or failure to fulfill any personal obligations for this
individual
SOLUTIONS
Estate Planning Documents - correct answers -Living will, Powers of Attorney/Durable
Powers of Attorney, health care proxy, HIPAA Releases, Advanced Directives
Definition of a Will - correct answers -Document executed by an individual directing how
his/her estate is to be distributed after his/her death
•Does NOT give authority to the executor (or other responsible person as the titles differ
by state) to do anything during the individual's lifetime
•Must have legal capacity to execute a will
•Will s may be simple or very complex
What is a Power of Attorney? - correct answers -A durable power of attorney is a written
instrument that allows an individual, called the "principal", to designate someone else as
his or her "attorney-in-fact", or "agent", to act on that principal's behalf.
DPOA Authority includes: Property dealings, Ability to contract. Access & use of
financial resources, Ability to gift, person can have multiple people assigned as an
,agent -ensure can work together, Third parties may rely upon the authority granted in
the POA until the third party receives written notice otherwise, May contain language to
include health care decisions
Always request copy -individuals should not give away originals unless necessary
Ability to contract & give consent; also ability to make gifts
Durable power of attorney survives incapacity
Immediately effective once executed (unless "Springing")
No longer valid once principal dies, if revoked in writing, if principal is determined totally
incapacitated.
Fine Print for Durable Power of Attorney - correct answers -DPOAs are NOT recognized
by federal agencies such as the VA and the Social Security Administration -each has its
own process for determining representation or fiduciary
•DPOAs can be very broad or have restrictions
•DPOAs do not expire yet many places refuse to recognize "old" documents (more than
a few years old) so may need to be re-certified by the attorney who originally executed.
•Many people download forms from the internet but then not tailored for their specific
situation
When is a POA revoked - correct answers -When principal dies, when principal revokes
the document, when Principal is adjudicated as incapacitated -but may remain in place
if durable.
Indicators that client is at risk for financial exploitation - correct answers -Isolation,
loneliness, recent losses, physical or mental disabilities, lack of familiarity with financial
matters, having family members who are unemployed and/or have substance abuse
problems.
What is a Living Will? - correct answers -A document in which you state your wishes
about life-sustaining medical treatment if you are terminally ill, permanently
unconscious, or in the end-stage of a fatal illness. These are not recognized as legal
documents in every state
What is a living will and Durable Powers of Attny for Healthcare - correct answers -They
are both types of Healthcare Advance Directives.
The person you name is called your agent, proxy, representative, or surrogate.
Any document that gives instructions about your health care and/or appoints someone
to make medical treatment decisions for you if you cannot make them for yourself.
What is the function of a Healthcare Proxy/Surrogate? - correct answers -All health care
decisions
Provide informed consent
Make decision believes principal would make if able
Best interest (if surrogate does not know your wishes)
Withhold or withdraw treatment
, Written consent for DNR
If Healthcare Proxy is not designated - correct answers -Proxy provisions vary by state
law but typically is a spouse, child/children or other family members.
What are examples of Advanced Directives? - correct answers -Living will -as noted,
may not be recognized as legal document in every state
•Five Wishes -a nationally recognized format for individuals to give instruction to their
health care agents
•Personal Directive -individually drafted instructions -there are written formats
developed by many organizations
•MOLST (Medical Order for Life Sustaining Treatment) or POLST (Physician Order for
Life Sustaining Treatement) -becoming more widely used in various states to document
wishes and to ensure that wishes are followed across the care continuum. Wishes
include DNR, DNI, DNH, feeding tubes, antibiotics and more
•Comfort Care -generally a physician directed order regarding DNR (do not resuscitate)
orders
Indicators that client is in need of guardian (non-financial decisions--where the ward
lives and what type of medical care the ward gets) and conservator (making financial
decisions--preserves the estate of the ward). - correct answers -The court arranges for
a person or co. to make certain decisions for another person (the ward). This is set up
when the person's decision making capacity is so impaired that the person is unable to
care for his/her own personal safety or to provide for his/her necessities. The person
must be a risk of physical injury or illness. It protects person unable to help themselves
& refuses help. It is a deterrent to individuals who might wish to take advantage of the
ward. deterrent to those who might wish to improperly use the wards assets.
Both guardianship and conservatorship are court processes -expensive and public
•A medical certificate from a physician is required to move forward with a petition
Guardianship/Conservatorship Disadvantages - correct answers -Last resort
Intrusion of the court into the individual's life and into the life of the family
Rigid and burdensome reporting requirements;
The expense of setting up and maintaining a guardianship
The delay in transacting the financial affairs of the ward because of necessary court
approvals
Abuse, neglect or exploitation issues - correct answers -inflicting physical force resulting
in bodily injury, inflicting pain or impairment (sexual or non-consensual contact),
emotional or psychological abuse, inflicting pain, distress, or creating anguish, or
financial or material exploitation -- illegal or improper handling of the elder's funds or
properties, abandonment like a desertion of elder/individual for which they have custody
or not finding place for this care for
Neglect - correct answers -Refusal or failure to fulfill any personal obligations for this
individual
