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Three important legal documents that every adult should have are a will, a living trust, and a living will.  Each document defines your decisions for the different areas of your estate and will save your loved ones time, money and stress when you are gone.  These documents are easy to draw up, or you could have a lawyer prepare the documents for a nominal fee.

A WILL dictates how your estate and property is to be distributed after your death and can also designate guardians for children and self should you become incapable or pass away. A regular will must pass through probate court in most states before your estate can be passed on to your heirs. Most state laws do not require that you use a lawyer to prepare your will; you can use a will kit at home.  Probate court can take some time if there are any disputes, so make sure your wishes are clear when writing your will. A LIVING WILL defines your wish to be kept or not kept alive by artificial life support in the event of terminal illness or injury. A living will also give you the ability to set limits on your hospital, medical and funeral costs that can easily drain your estate and leave your loved ones with the bills. If you express your wishes beforehand, it will make the process much less stressful for those involved in your care and the execution of your final wishes. A LIVING TRUST is quite similar to a regular will, but they are different at the core.  Unlike a regular will that cannot be changed after it is written, a living trust can be amended at any time.  A living trust takes effect while you are alive, whereas a will takes effect after you pass. You can put property into your living trust at any time before your death and afterward your estate goes directly to your heirs without passing through probate court. If you ever change your mind about the definitions of your will, you can change or revoke how your estate will be divided at any time by using a living trust. A living trust will also save money and time later on because your loved ones won’t have to go through probate first.
Hospice is not a place. Hospice is a “concept of care” designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.1 The goal of hospice care is to provide patients with comfort and dignity at the end of life with a special emphasis on controlling pain and discomfort and managing symptoms. The focus is on compassionate caring not curing. Hospice care neither hastens nor prolongs life, but this specialized service has been shown to increase quality of life. Hospice is covered by Medicare and Medicaid and most private insurance companies to eligible patients referred by a physician. Hospice services include care by professionals and volunteers and medication, equipment, and medical supplies. Families have no out-of-pocket expenses other than the cost of room and board. The patient and family are at the center of hospice care. The hospice team works with the patient and family to develop a personalized plan of care that respects the individual’s end-of-life wishes. A multi-disciplinary team of physicians, nurses, home health aides, social workers, therapists, spiritual counselors, bereavement counselors, and volunteers provides expert and compassionate care that is available 24 hours a day, 7 days a week. Physicians and nurses are specially trained to address pain and manage symptoms. The team works closely with family members to provide feeding, bathing, turning, administering medications, and monitoring changes in a patient’s condition. Some hospice providers provide alternative therapies such as Pet Therapy or Music Therapy. Spiritual counselors, therapists, and social workers help patients and families with emotional and spiritual concerns and provide bereavement support to family members after a loved one has died. Most people choose hospice care in their own homes, but hospice care is also available in hospitals, nursing homes, and residential care communities for the elderly such as assisted living communities and board and care homes. In 2011, 66.0% of hospice patients received care in the place they call “home,” including private residences (41.5%), skilled nursing facilities (17.2%), and residential communities (7.3%).2 When hospice care is not an option at home, nursing homes, freestanding hospice facilities, and residential care communities like board and care homes are places for families to turn for short-term respite or longer term care at the end of life. The Board and Care model, which provides residential care for fewer residents in a private home, offers a home-away-from-home in an intimate environment that provides a home-like routine and a place for family to gather. Board and Care homes can offer temporary hospice to residents and families who request it. These homes typically work with a number of hospice organizations to provide families with choice for high quality care. The board and care staff coordinate care with the hospice staff and they may provide bedside comfort tailored to the resident’s needs and preferences, such as soft music, reading, and aromatherapy. “Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”3 For additional information on hospice and how to select a quality hospice provider, families may turn to online resources found at the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org). References: 1Hospice Foundation of America. www.hospicefoundation.org. 2Facts and Figures: Hospice Care in America. 2013 Edition. National Hospice and Palliative Care Organization. www.nhpco.org. 3Choosing a Quality Hospice. National Hospice and Palliative Care Organization. www.nhpco.org.   Trina Duke, Master of Science in Gerontology Concierge Gerontology Services