Anyone With A Medical Power Of Attorney?

[+ Gar1eth]

Since I'm single-no kids, without a significant other (most likely never to have one), no close friends, and have *myasthenia gravis-a disease that can have potentially serious (but if I'm lucky, hopefully not) consequences, I'm about to set up a medical power of attorney. Considering my social circumstances, I probably would need to do it even if I didn't have myasthenia. But the MG makes it more of a certainty. I'm going to name my older brother as the 'attorney'.

 

Does anyone else have one?

 

Gman

 

* In case anyone is interested, I'm doing really well with my myasthenia. I was on 60 mg of prednisone daily for about 2 months. Since then I've been weaning the dose every 4 weeks. I'm currently at 25 mg. After starting the steroids, I became really weak for a while. I had trouble holding my head up. Also I could barely hold a pen to write. And I was having a lot of trouble eating due to trouble swallowing and difficulty chewing due to weak jaw muscles. Sometimes my speech was affected due to a weak tongue although often I was the only one who could notice. Some of this could have been a side effect of the steroids. A significant percentage of patients get weaker when 1st starting steroids before their symptoms get better from them. But it's not like I wasn't having problems before the steroids too. One hypothesis is that steroids have two mechanisms of action. The first is muscle toxicity. That's what causes the weakness and occurs first. The second mechanism is to down regulate whatever part of the immune system is producing the antibodies attacking the muscles. And this is what reduces the symptoms and actually gets the disease under control.

 

Prior to the steroids, I had been down about 20 pounds due to the trouble eating and some depression. I have gained about 30 pounds since starting the prednisone. And my main symptoms now are some mild trouble swallowing, and some back/neck muscle pain/weakness. But that's the main side effect I've seen. It's never really affected my mood.

 

G

[+ FreshFluff]

Gman, so glad that things are going well with the myasthenia and you're able to get better while reducing the steroid dose. Are you feeling less of the weakness now?

 

Have never given medical power of attorney although I've thought about it. Definitely can't hurt.

[+ MasssageGuy]

Nolo Press in Berkley has great POA forms that can save you big bucks if you need.

[instudiocity]

California has Medical Advance Directive instead.

 

My roommate of 15 years and my brother are my medical Powers of attorney. Either can make any decision.

[Guest]

Yes, I have one and I've been the appointed party in multiple others (and had to make the "tough decision" more than once). Having these things is a necessity. Having a back up in case your brother can't act is important too. Don't forget Living Wills/Advance Directives as well...you can place them on file at local hospitals while you're healthy so that they're there when you need them to have them. My state has standard forms available online that meet the statutory requirements...maybe yours does too.

[bigvalboy]

Yes as @instudiocity mentions, in California it is a Medical Directive. My father had one which I was in charge of and I have one which my sister is in charge of. It gives me peace of mind knowing that if I'm incapable of making decisions, there will be someone there that can.

 

As always...glad to know that you are doing better.

 

All the best

[+ Funguy]

Glad to hear you are doing better with the MG.

Having some sort of document, be it Medical POA or, as in California, an Advance Directive, is very important. I have also found, through experience, that sometimes close relatives, i.e. your brother, may need a back up in case emotions get in the way. So think of a number 2.

[+ Gar1eth]

Any lawyers on here-would in most states a spouse be entitled to make the decisions without the need for a power of attorney, or would spouses need to be named on POA too?

 

Gman

[+ Gar1eth]

Gman, so glad that things are going well with the myasthenia and you're able to get better while reducing the steroid dose. Are you feeling less of the weakness now?

 

It's funny you mention weakness. By being of a member of an MG group on Facebook, people have talked about feeling weak on steroid weans if they wean too quickly, or in some cases if they wean to too low a dose. This isn't specific to MG. Once your body becomes steroid dependent, it can have trouble responding to physiologic stress. Other people have talked about muscle pains on weaning steroid. The past two days I've had some sinking spells-but I don't know whether it's just generally not being in shape, the myasthenia gravis, the steroid wean, or maybe it's just being a bit under the weather.

 

Also my tongue is acting up a very little bit today. Probably no one else could tell by hearing me speak. But my tongue feels a bit thick. However because I've been feeling so well lately, the last few days I've taken less of my Mestinon (that's the medicine I take that combats symptoms only-it does nothing to control the underlying pathology causing the disease). It's totally fine if I can get by with less Mestinon. As it is only a medicine for symptoms, if I'm not symptomatic I can reduce my dose. In fact previously I was taking more than my neurologist really liked. If you take too much, it can overstimulate your muscles. One of the muscles it can overstimulate is the diaphragm. An overstimulated diaphragm can become paralyzed and prevent you from breathing. So I basically titrate the amount of Mestinon I take depending on my symptoms.

 

 

 

Have never given medical power of attorney although I've thought about it. Definitely can't hurt.

 

Years ago when if you were seriously ill, you basically died, POAs might not have been as necessary. These days with all of our life extending technologies POAs for singles seem more of a necessity.

 

Glad to hear you are doing better with the MG.

Having some sort of document, be it Medical POA or, as in California, an Advance Directive, is very important. I have also found, through experience, that sometimes close relatives, i.e. your brother, may need a back up in case emotions get in the way. So think of a number 2.

 

That's a good idea. But I really only have relatives to depend upon. So the second person would be my older sister. My Mom is still alive and 'with it,' but I don't think I should put the responsibility on her at the age of 83.

 

Gman

[+ ButchAtl]

Yes, as well as POA for financial affairs. Also living will.

[samhexum]

Anyone With A Medical Power Of Attorney?

 

I had disc fusion surgery on my neck in 2003 & 2012, and 2 mini-strokes in May, 2017 (just over a week after I joined this site, not that I'm assigning any blame...), so my sister has my medical power of attorney.

[+ purplekow]

Working with many persons with dementia and psychiatric issues for the long term, I have seen disasters befall people who were in your situation. When there is no one to say stop, the obligation is to do everything.

 

In NJ. You need to have a POLST (Physician Orders for Life Sustaining Treatment) which designates your desires and names your representative. While it is a good plan to have someone as a back up, having two people with the decision making power is opening up a can of worms for a potential controversy as to whose decision is the ultimate decision.

So please name one person. And name a backup not a codecider.

Make it clear to that person what your end of life wishes are.

Fill out a POLST and make sure you have it with you so that treatment is not started against your wishes.

Be careful with a power of attorney however, as I have seen legal battles over the fitness to decision make between the patient and their named representative. This has been the case several times when there is a partner and a child and the child is given the POA and the partner is left out in the lurch.

 

The Power of Attorney does insure an easy transition of financial decision making but again, make sure the person who is given that power will always have your best interests at heart. In one case with which I am dealing now, a child with a drug problem which was in remission was given the POA and then a few years later, after a relapse of the drug problem, the change to another POA was not made. Disaster has ensued.

 

Good luck with the MS. I am glad you can tolerate steroids. I was on Prednisone for 4 days and had to stop as a result of side effects.

 

Stay healthy.

Make good decisions.

Do not be afraid of difficult conversations which discuss unpleasant realities.

[Muscle Lover 2]

Yes, GMan, most states will generally allow your spouse and, if none, your immediate family to make decisions without a Power of Attorney. When it comes to gay relationships, I hate to rely on that and would strongly urge that you have documents legally drawn up. While others on here point you toward sites where you can assemble your own documents at a lower cost, I recommend you not do that. Forms are made for only certain people in certain circumstances. It is like reading the internet and diagnosing your own illness. If you are right, great, you saved a lot of money and no harm done. If you are wrong, you could pay with your life. I've seen clients do their own divorce decrees, for example, and it ended up costing them, in one instance, $ 70k in back due child support they forfeited because the order was not properly drawn up and, in another, a house, because they did not understand which party was the Petitioner and which the Respondent and the house got awarded to the wrong person. That mistake cannot be undone in most instances. If you truly want peace of mind, have a professional draw up your legal documents. Legal stuff is not where you want to try to save a buck.

[+ SundayZip]

Rather than jump right into trying to establish a medical power of attorney, you might consider first stepping back and taking a more comprehensive look at your estate, financial and health/medical planning needs. A good estate planning lawyer will work with you to clarify your life (and death) objectives and help you setup what you need to meet those objectives. This might include a will or trust, power(s) of attorney for financial and health/medical decisions, advanced directives and whatever else you need to protect yourself and your survivors in the event of your death or incapacity. I did this several years ago and it was time and a few dollars very sell spent.

 

... I strongly urge that you have documents legally drawn up. While others on here point you toward sites where you can assemble your own documents at a lower cost, I recommend you not do that. Forms are made for only certain people in certain circumstances. It is like reading the internet and diagnosing your own illness. If you are right, great, you saved a lot of money and no harm done. If you are wrong, you could pay with your life.

.... If you truly want peace of mind, have a professional draw up your legal documents. Legal stuff is not where you want to try to save a buck.

 

Amen.

[+ Charlie]

I have had a medical POA for years, and I have held one for others. It is important to have a back-up person named in case the primary POA is unavailable for any reason at a critical moment. It is also important to update the document if your situation changes (the POA holder becomes unable to act effectively, your relationships change, etc.). You should also carry it with you when you are traveling. At one time I held the primary POA for a friend, but when he unexpectedly became critically ill while on a European vacation, it was his family who were contacted, not me, and I didn't even learn that he was ill until after they had brought him home and he had died.

[+ sync]

A lot of helpful information here for me. When I asked my physician for a DNR document to keep in my apartment, he refused. He told me going into a hospital with a DNR is as good as a signed death warrant. He went on to tell me that hospitals will let you die from a bad case of the flu if you have a DNR. I don't know if he was exaggerating or not, but it scared me away from a DNR document. I'll look into the other options mentioned here; I live in New York State.

[+ honcho]

... my physician .. went on to tell me that hospitals will let you die from a bad case of the flu if you have a DNR. I don't know if he was exaggerating or not

 

That's fairly close to what happened to my father's sister. She was living by herself, had excrutiating arthritis, fell, couldn't get up and was on the floor of her apartment (in Chicago) for 3 days before on of her neighbors heard her yells.

After going into the hospital, she developed pneumonia, and they did not put her on assisted breathing.

 

She was in such terrible pain from her arthritis though, that it was clear this action was consistent with her wishes.

[LADoug1]

California has Medical Advance Directive instead.

 

My roommate of 15 years and my brother are my medical Powers of attorney. Either can make any decision.

 

I live in California and have one. Got it through Legal Zoom. Easy and absolutely necessary regardless of one’s health condition.

[+ sync]

That's fairly close to what happened to my father's sister. She was living by herself, had excrutiating arthritis, fell, couldn't get up and was on the floor of her apartment (in Chicago) for 3 days before on of her neighbors heard her yells.

After going into the hospital, she developed pneumonia, and they did not put her on assisted breathing.

 

She was in such terrible pain from her arthritis though, that it was clear this action was consistent with her wishes.

 

Thank you for your input. It gives me more respect for my doctor's counseling, and gives me inspiration to explore other DNR options.

[bnm73]

That's fairly close to what happened to my father's sister. She was living by herself, had excrutiating arthritis, fell, couldn't get up and was on the floor of her apartment (in Chicago) for 3 days before on of her neighbors heard her yells.

After going into the hospital, she developed pneumonia, and they did not put her on assisted breathing.

 

She was in such terrible pain from her arthritis though, that it was clear this action was consistent with her wishes.

Thank you for your input. It gives me more respect for my doctor's counseling, and gives me inspiration to explore other DNR options.

 

A DNR is "Do Not Resuscitate." It is not "Do Not Treat."

 

If you went into the hospital with the flu, then the doctors have to treat you for the flu.

 

If you were to die from the flu, though (heart stops, for example), then no CPR or other "heroic measures" to bring you back if you have a DNR. Most DNRs do not allow for intubation -- though you can still consent to it if you are conscious. So if you were to develop pneumonia, they couldn't give you a breathing tube without your express consent to override your DNR.

[+ sync]

If you went into the hospital with the flu, then the doctors have to treat you for the flu.

 

That was my doctor's point. Unfortunately, there are many hospitals laboring with "faltering ethics."

[bnm73]

That was my doctor's point. Unfortunately, there are many hospitals laboring with "faltering ethics."

Ah....I wasn't clear on that from your prior post.

 

Knowing your rights is important. If a hospital refuses to treat you just because you have a DNR, then they open themselves up to malpractice (either by you or your estate/survivors).

 

On the other hand, if they use "heroic efforts" to keep you alive and you have a DNR, they are potentially open to charges of assault.

 

The flu DOES kill people every year....but if the thought of dying because of something like the flu gives you pause, than a DNR may not be the best choice for you. Making sure someone else can make medical decisions on your behalf in case you are incapacitated becomes doubly important.

 

(See the nice segue back to the original topic of the thread? *chuckle* )

[instudiocity]

My brother who owns an ambulance service, employees MDs and EMTs did not know that my mom’s hospital required a copy of the DNR upon every admission.

[Nvr2Thick]

A few years ago I set up a living trust (easier to enact than a regular will, avoids probate) along with financial and medical power of attorney. My brothers are named as executors/agents for everything. For the trust and financial power of attorney the executor and agent follow a line of succession in the event that one or more of my brothers becomes unfit or precedes me in death. For the medical power of attorney it's more of a "jump ball" so that whomever is reached first can make timely decisions if I'm incapacitated. If a critical medical decision were to be disputed the majority of agent/brothers would decide, with senior age being the tie breaker if it came down to two brothers.

 

My retirement accounts also have defined "executors" and beneficiaries. There can be a conflict between the names you provide to your financial institutions and your trust or will, so I had a VP from my bank present and available as a contact when my lawyer worked out these documents. The living trust calls out my accounts by name and directs the trust and its executor to the intentions defined within bank records for my accounts.

 

I've sat down with my brothers and reviewed all the documents, and I've provided them with copies in well-marked folders with cover sheets noting the date/version of the documents. I've already had to provide two updates, which I sent to each brother along with updated cover sheets and instructions to discard certain older versions. The cover sheet also contains locations of the originals (safe deposit box) and my "official copies" (private home safe), along with instructions on how to access each. I had to go through a somewhat involved process with my bank to make sure that all my brothers have access to my safe deposit box. My lawyer noted that some of these documents become useless or much more difficult to enact if the originals cannot be accessed. I've also sent my lawyer a note for their files indicating the location of the original documents and a list of people with access.

 

It's a good idea to have more than one agent for medical power of attorney -- in case someone is not available, or someone becomes unfit or dies and you don't get around to updating the PoA. I've had a few friends tell me that granting medical power of attorney, in my situation, is less precious than I might imagine. It doesn't have to be someone near and dear to my heart -- just someone who can act according to my defined wishes and not leave a void for hospitals to try to fill undirected.

Edited August 27, 2018 by Nvr2Thick