What you need to know

Putting your mom or dad in palliative care after a stay in the hospital can be one of the hardest things that adult children do for their parents.

There are medical bills to pay, estate planning to look into, and a myriad of other details that require your attention during an incredibly difficult time for you and your whole family.

At Swartz & Swartz P.C., we always put family first. Our focus on helping people and their families is why we are one of Boston’s top, nationally recognized, personal injury law firms. Our firm is too often asked to represent loved ones in nursing homes or extended care facilities, who have suffered from abuse or below-standard care. If you are moving an elderly loved one into palliative care, there are things you should know and consider. Our team at Swartz & Swartz put together this article on end-of-life care to help provide you with useful information in the hopes of making this difficult time easier for you, your family, and importantly, your elderly loved one.

While people enter into palliative care with varying degrees of cognitive ability, they still have legal rights, particularly when it comes medical treatment that might extend their life. If possible, you and your loved one should have a conversation about their preferences for medical interventions while receiving palliative care – what kind of treatments are they comfortable receiving and which interventions they do not wish to have. 

In the United States, the withholding and withdrawal of life support is legally justified primarily by the principles of informed consent and informed refusal, which have their foundations in the common law. The law essentially says that life saving treatment may not be initiated without the approval of patients or their proxies except in emergency situations, and that patients or their proxies have the right to refuse all treatment. 

In Massachusetts, the Department of Public Health provides Medical Orders for Life Sustaining Treatment (MOLST) and Comfort Care/Do Not Resuscitate Order Verification (CC/DNR) forms that communicate a patient’s rights and preferences to accept or refuse potentially life-saving medical treatment. While using a MOLST and CC/DNR forms are entirely voluntary, they are useful because they can be given directly to palliative care staff and health care professionals like doctors, nurses, and emergency responders, clearly communicating your loved one’s wishes. These are often referred to as Advanced Care Directives.

An equally important conversation to have with your elderly loved one, is who they would like to designate as their Health Care Proxy in the event that they are no longer able to communicate. This person, usually a relative or close friend of the patient, is appointed to make heath-care decisions if the patient is no longer able to do so, under Massachusetts’ Health Care Proxy Law. 

Equally important are decisions about designating a power of attorney. In Massachusetts, we have a Springing Power of Attorney or a Durable Power of Attorney, both of which legally designate a person to continue your loved one’s financial affairs when they become unable to do so. 

The Springing POA goes into effect after an “event” – for instance, after your loved loses the cognitive ability to make decisions. Unlike the Durable Power of Attorney, which comes into effect once it’s signed, the Springing POA requires two physicians to verify that your loved one is indeed incapacitated before it becomes binding. We recommend working with a lawyer to draft these kinds of documents to ensure nothing is overlooked.

Get help from Swartz & Swartz P.C.

While finalizing your loved one’s end-of-life care and financial wishes is not easy, it will give you and your loved one peace of mind that these decisions have been taken care of. If you suspect that your loved one has been harmed due to neglect or inadequate care at a nursing home or childcare facility, our lawyers at Swartz & Swartz PC. will work with you to investigate all potential claims efficiently and sensitively develop an end-of-life plan so that you can focus on spending the time you have left with your loved one.