NACCM Exam
Estate Planning Documents - ANS-Living will, Powers of Attorney/Durable Powers of
Attorney, health care proxy, HIPAA Releases, Advanced Directives
Definition of a Will - ANS-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? - ANS-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No longer valid once principal dies, if revoked in writing, if principal is determined totally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 - ANS-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 - ANS-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 - ANS-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? - ANS-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 - ANS-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? - ANS-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 - ANS-Proxy provisions vary by state law but
typically is a spouse, child/children or other family members.
What are examples of Advanced Directives? - ANS-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). - ANS-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 - ANS-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 - ANS-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 - ANS-Refusal or failure to fulfill any personal obligations for this individual
Self Neglect - ANS-Mentally competent person understands consequences that their
acts do threaten health and their safety.
Definition of Elder Abuse - ANS-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.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Hkane. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
