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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No longer valid once principal dies, if revoked in writing, if principal is determined totally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
Self Neglect correct answers Mentally competent person understands consequences that their
acts do threaten health and their safety.
Definition of Elder Abuse correct answers Elder mistreatment (i.e. abuse and neglect) is
defined as intentional actions that cause harm or create a serious risk of harm (whether or not
harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust
relationship to the elder. This includes failure by a caregiver to satisfy the elder's basic needs
or to protect the elder from harm.
Elder Abuse correct answers Federal Law doesn't address the elder abuse. Federal legislation
does fund the national center for elder abuse NCEA. all 50 states have APS programs for
victims. Most elder abuse laws are similar to child abuse laws and don't have an age cap.
There is an elder mistreatment assessment.
Categories of Elder Abuse correct answers Physical abuse, sexual abuse, emotional and
psychological abuses, financial exploitation, abandonment/neglect, and self neglect.
Elder Abuse: APS correct answers Funded through the state government. Interventions
include Receiving and investigating reports
•Evaluating victim
•Assessing victim's ability to understand risk and give informed consent
•Drafting a case plan
•Arranging for care
•Monitoring of care
Elder Abuse Perpertrators correct answers 1 out of 10 experience abuse, 90% of abusers are
family members, less than 20% get reported, Most elder abuse cases happen in the home or
the home of the caregiver, perpetrators usually family members (adult children, spouses,
partners or others). Victims are often confused about this abuse.
Alcohol Abuse and the Elderly correct answers Fastest growing problem, frequently
underestimated, underdiagnosed, and undertreated, 4 out of 5 seniors seeking treatment for
substance abuse have problems with alcohol vs. other drugs, 9% of Medicare beneficiaries
drink 30+ drinks per month and more than 4 drinks in one sitting
Alcohol Effects and the Elderly correct answers Sensitivity to alcohol increases with age
Alcohol causes increased health problems
Interacts poorly with prescription meds
Signs of Alcohol Abuse
•Non adherence with medical appointments
•Poorly controlled HTN
•Recurrent accidents and falls
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
Self Neglect correct answers Mentally competent person understands consequences that their
acts do threaten health and their safety.
Definition of Elder Abuse correct answers Elder mistreatment (i.e. abuse and neglect) is
defined as intentional actions that cause harm or create a serious risk of harm (whether or not
harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust
relationship to the elder. This includes failure by a caregiver to satisfy the elder's basic needs
or to protect the elder from harm.
Elder Abuse correct answers Federal Law doesn't address the elder abuse. Federal legislation
does fund the national center for elder abuse NCEA. all 50 states have APS programs for
victims. Most elder abuse laws are similar to child abuse laws and don't have an age cap.
There is an elder mistreatment assessment.
Categories of Elder Abuse correct answers Physical abuse, sexual abuse, emotional and
psychological abuses, financial exploitation, abandonment/neglect, and self neglect.
Elder Abuse: APS correct answers Funded through the state government. Interventions
include Receiving and investigating reports
•Evaluating victim
•Assessing victim's ability to understand risk and give informed consent
•Drafting a case plan
•Arranging for care
•Monitoring of care
Elder Abuse Perpertrators correct answers 1 out of 10 experience abuse, 90% of abusers are
family members, less than 20% get reported, Most elder abuse cases happen in the home or
the home of the caregiver, perpetrators usually family members (adult children, spouses,
partners or others). Victims are often confused about this abuse.
Alcohol Abuse and the Elderly correct answers Fastest growing problem, frequently
underestimated, underdiagnosed, and undertreated, 4 out of 5 seniors seeking treatment for
substance abuse have problems with alcohol vs. other drugs, 9% of Medicare beneficiaries
drink 30+ drinks per month and more than 4 drinks in one sitting
Alcohol Effects and the Elderly correct answers Sensitivity to alcohol increases with age
Alcohol causes increased health problems
Interacts poorly with prescription meds
Signs of Alcohol Abuse
•Non adherence with medical appointments
•Poorly controlled HTN
•Recurrent accidents and falls
