Definitions

Brief Explanation of Common Terms

Disclaimer: While these definitions and context intended to inform and guide, it should not be considered a substitute for personalized legal, medical, financial, or professional advice or definitions offered by your trusted professionals who are advised by your specific situation. These definitions are not comprehensive in their descriptions, but are here to guide your research.

Caregiver Terminology

Companion: assists with housework, shopping, meal preparation, and transportation to medical appointments. Perfect for people who are living independently, but find the day to day activities to be more taxing than their endurance on a semifreqent basis.

Home Attendants/Personal Care Aides: These caregivers provide the services of a companion, but also assist with the dexterity of basic personal care as needed such as bathing, dressing, and grooming. Most often, this arrangement involves people who could do it independently, but have some physical impediment to doing it on their own.

Home Health Aide: Trained assistants to support cognitive and/or functional issues. They are skilled at helping transfer to and from the bed to a chair or mobility device, Most often under the supervision of a registered nurse these aides should be trained to provide oxygen, perform basic range of motion exercises and help with other tasks (depending on state regulations).

Licensed Vocational Nurse (LVN) is a healthcare professional who provides basic medical care under the supervision of registered nurses (RN) or a physician. LVN is used in Texas and California, while other states use Licensed Practical Nurse (LPN). They are trained to monitor vital signs, administer mediations, assist with patient hygiene and maintain medical records. Credentialing at this level requires completion of state-approved nursing program (typically 1-2 years) and passing an exam.

Legal Terms

Healthcare Proxy

Medical Power of Attorney (MPOA): Specifically grants an agent authority to make health care decisions on your behalf if you become incapacitated. It is a type of durable power of attorney because it remains effective even if you are incapacitated. This form is available online and can be signed without a lawyer, but requires two witnesses.

Durable Power of Attorney (DPOA-HC): This is largely the same as MPOA but it emphasizes the carryover power in the event of incapacity. It focuses mainly on medical decisions and includes end of life care. It is considered broader than a living will. This form is available online and can be signed without a lawyer, but requires two witnesses.

Your healthcare proxy should have an electronic copy at all times to provide a doctor, EMT, or hospital in the event of an emergency. Make sure your Healthcare Proxy also has copies of any Advances Care Directives and is clear on your healthcare wishes.

Advance Care Directive: These are forms that instruct your doctor as to the level of care you would like to receive in the event of an emergency. Your doctor can help you understand and decide your threshold of care. They will discuss items such as Do Not Resuscitate, or other options such as no ventilation or feeding tubes, but all other lifesaving measures. This document should be available at your bedside and on your phone to be used in case of emergency for EMTs. Research shows that you are more likely to get the care you want if you have conversations about your future medical treatment and put a plan in place. It may also help your loved ones grieve more easily and feel less burden, guilt, and depression.

Living will: A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies. It also addresses larger issues such as organ donation, CPR, pain control, and comfort care. Make sure your healthcare providers and health proxy have an electronic copy of your Living Will, if you have one, to send to a doctor, EMT or hospital if necessary. A Living Will does not replace the need for an informed health care proxy since many situations are unforeseeable and you need an advocate that understands your wishes.

Common Advance Care Directive Forms:

Do not resuscitate (DNR) order: A DNR becomes part of your medical chart to inform medical staff in a hospital or nursing facility that you do not want CPR or other life-support measures to be attempted if your heartbeat and breathing stop. Sometimes this document is referred to as a do not attempt resuscitation (DNR) order or an allow natural death (AND) order. Even though a living will might state that CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital. Posting a DNR next to your hospital bed might avoid confusion in an emergency. Without a DNR order, medical staff will attempt every effort to restore your breathing and the normal rhythm of your heart.
Do not intubate (DNI) order: A similar document, a DNI informs medical staff in a hospital or nursing facility that you do not want to be on a ventilator.
Do not hospitalize (DNH) order: A DNH indicates to long-term care providers, such as nursing home staff, that you prefer not to be sent to a hospital for treatment at the end of life.
Out-of-hospital DNR order: An out-of-hospital DNR alerts emergency medical personnel to your wishes regarding measures to restore your heartbeat or breathing if you are not in a hospital.
Physician orders for life-sustaining treatment (POLST) and medical orders for life-sustaining treatment (MOLST) forms: These forms provide guidance about your medical care that health care professionals can act on immediately in an emergency. They serve as a medical order in addition to your advance directive. Typically, you create a POLST or MOLST when you are near the end of life or critically ill and understand the specific decisions that might need to be made on your behalf. These forms may also be called portable medical orders or physician orders for scope of treatment (POST). Check with your state department of health to find out if these forms are available where you live.

Dementia-Specific Planning:

Because dementia progressively impairs cognitive function, people may want to provide more specific guidance.

Dementia Directive:

This is a supplemental tool that can be used alongside a standard Advance Health Care Directive.
It allows individuals to express their wishes regarding future care in the event of dementia, including specific stages of the disease.
It can help clarify preferences for things like:

Levels of intervention.
End-of-life care.
Quality of life considerations.

It is important to understand that a Dementia Directive is designed to help guide decision making, and to help your assigned health care proxy to better understand your wishes. It is designed to be used in conjunction with a standard Advance Health Care Directive.

Capacity:

Legal capacity refers to the ability to make informed decisions.
Dementia can affect capacity, and advance planning is essential to ensure your wishes are respected.

Key Points:

Using a well-crafted Advance Health Care Directive, and supplementing it with a Dementia Directive, can provide greater clarity and peace of mind.
It is critical to discuss your wishes with your healthcare agent and your physician.
Legal counsel from an elder law attorney is highly recommended to ensure your documents are legally sound and reflect your intentions.

Financial Proxy

Durable Financial Power of Attorney Financial POAs can provide a way to protect a person's assets and manage their financial affairs in the event they become unable to do so themselves, or they can simply be used to delegate financial tasks for convenience.

Springing vs Non Springing (Durable) Power of Attorney A springing Power Of Attorney requires a specific event or condition for the POA to take action. Durable power of attorney is effective as soon as the document is signed and can be used without further action. This can be applied to both Healthcare Proxy as well as Financial Proxy.

Trust and Wills Related Terms

Key Terms For Wills

Testator/Testatrix:

The person who creates the will.

Beneficiary:

The individual or entity that receives assets from the will.

Executor/Executrix:

The person designated to carry out the instructions in the will.

Probate:

The legal process of validating a will and distributing the estate.

Intestate:

Dying without a valid will.

Heir:

A person legally entitled to inherit property.

Codicil:

An amendment or addition to an existing will.

Bequest:

A gift of personal property by will.

Key Terms for Trusts:

Grantor/Settlor/Trustor:

The person who establishes the trust.

Trustee:

The person or entity responsible for managing the trust assets.

Beneficiary:

The person or entity that benefits from the trust.

Revocable Trust:

A trust that can be changed or terminated by the grantor.

Irrevocable Trust:

A trust that cannot be easily changed or terminated.

Living Trust:

A trust that is created during the grantors lifetime.

Corpus/Principal:

The assets held within the trust.

Successor Trustee:

The person who takes over management of the trust if the original trustee is unable to continue.

Important Considerations:

Estate planning laws can vary by state, so it's essential to consult with an attorney.
These documents are crucial for ensuring your wishes are carried out regarding your assets and healthcare.

By familiarizing yourself with these terms, you'll be better equipped to navigate the process of creating a trust or living will and requesting information from the professionals you use throughout the aging process.