News & Resources: Blog

Planning for the End of Life

Published: March 9, 2023

We tend not to talk or think about end-of-life planning because it’s a difficult topic for us. But without planning for it, we will have fewer options and things may not go as well as we would like for them to.

You may wish to pass away in the comfort of your home, but without making proper arrangements in advance, you may end up in a hospital or nursing home. Or, without proper planning, you may be kept alive by artificial means for a long period even if you would rather be allowed to pass on.

By planning for your end-of-life care in advance, you can rest easier knowing that you will be able to live the last part of your life the way you want.

Things to Consider When Planning for End-of-Life Care

End-of-life experiences differ from person to person. For some people death comes quickly. For others, the process can take days, weeks, or even months. In some cases, a person’s body weakens while their mind remains lucid. In other cases, the body continues to function but the mind fades, such as with dementia. Sometimes, due usually to a severe accident, a person is in a comatose state before their body and mind both cease to function.

People who are near the end of their lives generally need care in four areas:

Physical comfort
Mental and emotional comfort
Spiritual comfort
Help with daily tasks

Think about how you want your needs met in these areas and your preference for where you want to receive care. Do you want to spend the end of your life in your home? Would you prefer to be in a nursing home? Do you want family and friends with you? Would you prefer to be in a hospital receiving treatment till the end? How long would you want to receive palliative care? At what point would you want to begin hospice care?

Palliative Care

Palliative care is specialized medical care for people with serious illnesses, such as cancer. In addition to receiving treatment for their serious illness, patients receive palliative care for the symptoms of the illness or the effects of the treatment, or both. An example of palliative care would be a patient receiving care for anemia that is caused by treatment for cancer.

Palliative care enhances the patient’s life by focusing on the quality of their life. Palliative care can be provided anywhere, from hospitals to clinics to nursing homes to the patient’s home. Some private health insurance providers cover some palliative care. Veterans may be eligible for palliative care through the VA. The public may have access to palliative care through Medicaid and Medicare.

Hospice Care

Many people with terminal illnesses reach a point when their treatment is no longer effective. At this stage, they have the option of ending the treatment for their terminal illness and switching to hospice care. Like palliative care, hospice care focuses on comfort and quality of life, but without trying to cure the terminal illness. The number of patients who are choosing hospice care is growing. Hospice care also provides support for the patient’s family.

Since hospice care is more of an approach to care than a type of treatment, hospice patients can receive care wherever they are, including in the comfort of their home. Hospice care may be covered by Medicare, the VA, and health insurance companies. Check with your insurance provider to find out if they cover hospice care.

Communicating Your Wishes

End-of-life planning is a highly personal matter. Take the time to decide what types of treatments and care you want near the end of your life. Give equal consideration to what types of treatments you don’t want to receive. It may help to discuss your wishes and options with your family and an elder law attorney.

Once you have made your decisions about your end-of-life care, formalize them in the appropriate legal documents. Make sure your loved ones know what your wishes are and where they can find your legal documents. If you are unable to communicate with medical professionals due to serious illness or injury, you will want your health-care agents to promptly start making decisions on your behalf.

It is important to keep your legal documents updated if you change your mind about what is in them. It is never too early to start planning for end-of-life care or medical emergencies. Contact us today to learn how we can help you and your loved ones rest more easily by planning for the future.

Our law firm is dedicated to keeping you informed of issues that affect seniors who may be experiencing declining health. We help you and your loved ones prepare for potential long-term medical expenses and the need to transition to in-home care, assisted living care, or nursing home care.

If you have questions or would like to discuss your legal matters, please do not hesitate to contact our office at 215-364-1111 to schedule a consultation.

CLIENT Testimonial

It can be quite confusing to determine which Medicare plan is best for you. There are several types of plans, and each has its own advantages and disadvantages. Understanding some basic features will help you decide how to maximize your healthcare dollars and choices. You should review your choice periodically, especially as elements of the Inflation Reduction Act of 2022 change prescription medication and vaccine policies. Coverage can also change from year to year..

There are three basic types of plans:

Original Medicare
Medicare Advantage
Medigap

Original Medicare

Medicare is a government health insurance plan for people 65 and older. Original Medicare, sometimes called traditional Medicare, comes in several parts. Each part covers different things and has various associated costs.

Most people do not pay for Part A as it was deducted from their taxes paid while working. It is primarily for hospital visits and nursing care. However, there are many fees associated with being in a hospital that Medicare does not cover, which you still might have to pay out of pocket.

Part B requires monthly premiums, which can be deducted from your social security. You can elect to enroll in part B through Original Medicare. It covers a portion of doctors' visits, durable medical goods, and more.

Part D covers the cost of many prescription medications. You can add it to Original Medicare or purchase it as part of a Medicare Advantage plan.

Medicare Advantage

Medicare Advantage is offered through private insurance companies that Medicare approves. Most plans include Parts A, B, and D of Original Medicare with some variations from the original. There are a wide variety of Medicare Advantage plans, including Preferred Provider Organizations (PPO) or Health Maintenance Organizations (HMO). PPOs tend to have higher premiums and offer more choices than HMOs. Medicare Advantage HMOs and PPOs often have higher premiums than traditional Medicare because they usually cover more expenses, including prescription drug costs, vision, hearing, and dental.

However, the overall costs, premiums, plus out-of-pocket expenses for Advantage plans can be lower than Original Medicare because the private insurers manage patient care and limit choices. They assemble networks of hospitals and physicians to control their costs and reduce their customer's premiums. They also restrict access to certain providers and increase the cost of care obtained out-of-network.

Traditional Medicare allows people to seek care from any provider participating in Medicare, which includes virtually all hospitals and physicians.

Medigap

Medigap is a co-insurance or supplement to Original Medicare. You can enroll when you first enroll in Part B. It is also available through Medicaid, a union, or a former employer when you qualify for both programs. You can’t have both Medicare Advantage and Medigap plans. Medigap helps cover expenses that Original Medicare does not cover, such as co-pays and deductibles. Due to the enrollment restrictions, you should strongly consider Medigap when you first become eligible.

The Right Choice for You

With all the different plans, parts, choices, and restrictions, it is crucial to consider your priorities for care. Limited access to doctors and hospitals may become important if you need specialized medical care, such as cancer treatment. Before enrolling, consider what specialty hospitals are included in Advantage plans. Likewise, Advantage plans can make it difficult to see a specialist for ongoing and chronic conditions due to limitations in long-term care services. An estate planning lawyer or elder law attorney can help address long-term care planning and the potential to qualify for Medicaid when necessary.

The Kaiser Family Foundation has put together a cost analysis to help you determine when Medicare Advantage would save you money. As you can see, the longer you stay in the hospital, the less advantageous an Advantage plan becomes.

Consumer Reports notes that the JAMA reported that seniors on Advantage plans often get more preventive care than those on traditional Medicare plans. JAMA published a comprehensive paper about how Medicare plan choice affects spending and discovered that Medicare Advantage enrollees usually spend less.

A Guide in Choices after 65

Enrolling in the right Medicare coverage is one of many decisions that will affect your quality of life in your senior years. We are here to help you navigate a wide variety of choices.

If you have questions or would like to discuss your legal matters, please do not hesitate to contact our office at 215-364-1111 to schedule a consultation.

- Medigap, Medicare Advantage, and Traditional Medicare

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