DocuBank Blog

Reconnect with clients and engage prospects during NHDD!

Fri, 13 Apr 2018 12:00:00 -0400

National Healthcare Decisions Day (NHDD) is next week! Initially conceived as a day to raise awareness of the importance of advance care planning, NHDD has blossomed to a full week: April 16-22. NHDD organizers developed daily themes to guide participants through the week. Randi Siegel's guest blog post for the American Academy of Estate Planning Attorneys adapts those themes for your practice so you can start the conversation in your personal life, reconnect with clients, and engage prospects.

Reconnect with clients and engage prospects during NHDD!

Fri, 13 Apr 2018 12:00:00 -0400

Can you turn your body into a legal document?

Wed, 13 Dec 2017 12:00:00 -0400

"Do Not Resuscitate" joins barbed wire, anyone’s name you’re dating, and a self-portrait on the list of things you should think twice about getting tattooed on your body. It's easy to see why a DNR tattoo is an appealing idea. A tattoo ensures that the DNR statement is quite literally always on your person, doctors would see the tattoo before performing CPR, and anyone that takes the time to get a tattoo must be sincere about their wishes.

But, a recent case involving a Florida man with such a tattoo illustrates the flaws with this idea. You can read Randi Siegel’s recent guest blog post on the American Academy of Estate Planning Attorneys blog to read about the confusion this tattoo caused and some lessons that can be gleaned from this case.

Can you turn your body into a legal document?

Wed, 13 Dec 2017 12:00:00 -0400

Here are some ways to help clients prepare for their end-of-life care

Tue, 05 Sep 2017 12:00:00 -0400

My guest blog post this month for the American Academy of Estate Planning Attorneys investigates a new survey on American’s views about end-of-life care and suggests ways for you to incorporate this information into your practice. The survey, which was conducted by the Economist and the Kaiser Family Foundation, asked about financial factors, family relationships, medical decisions, physician communications, and more. Click here to read the article.

ER doctors can't find advance directives in electronic health records!

Thu, 09 Feb 2017 12:00:00 -0400

Electronic Health Records (EHRs) fail to provide access to most patients’ advance directives in the ER according to two recently published studies in the Journal of Palliative Medicine. Most hospitals have switched over to computerized systems, but the data shows those systems do an abysmal job of making your clients’ advance directives accessible to doctors.

The first study looked at patients over 65 and found that 59% completed an advance directive, but the ER staff could only locate the advance directive for 13% in the EHR. That means that the ER failed to obtain the advance directive for more than ¾ of the patients that completed one.

One obvious explanation is that the patients never provided their advance directive to the hospital, so therefore it wasn’t in the EHR. Not so, according to the research. The patient’s advance directive couldn’t be found in 69% of the cases where they reported previously giving their document to the hospital. Needless to say, these are numbers that do not work in favor of your clients.

Many clients may feel they’re protected since their primary care doctor is in the same network as the hospital, and theoretically that would make it easy for the hospital to obtain their directive. Again, the data refutes this logical assumption. Shockingly, the advance care planning document could not be found for nearly 80% of the patients whose primary doctor was part of the same hospital system as the Emergency Department.

The second study surveyed ER physicians and shows they are aware of electronic records' poor track record with advance directives. Fewer than 1/3 of ER doctors were "very confident” or "extremely confident" that they could find patients’ advance directives or other ACP documentation in the EHR—when it exists.

Advance directives provide critical information to your clients’ doctors and family members about your clients’ wishes. A 2015 survey found that 93% of ER doctors feel “less frustrated” and 88% felt the patients’ family members were “more satisfied” with the medical care when the advance directive is available. This glaring failure of EHRs creates an information gap that frustrates your clients’ doctors and stresses their loved ones.

The alarming results of these studies reinforce the importance of providing your clients immediate access to their advance directives with DocuBank. Your clients’ emergency wallet card gives hospitals and doctors all the instructions they need to instantly obtain your client’s advance directive from any hospital, regardless of the EHR. Your clients are always protected in a medical emergency 24/7/365.

If you’re already providing DocuBank to your clients, use these studies to tell your clients about this EHR problem and the solution for their advance directives that you've given them! This is the perfect opportunity to remind them why you provided a DocuBank card and membership. Contact us for free newsletter content and publish it on your blog, print it in your next newsletter, or design a marketing campaign and mail it to clients you haven't heard from in a while.

If you aren’t currently offering clients a DocuBank card, contact us at 610-667-3524 or email me to learn more.

ER doctors can't find advance directives in electronic health records!

Thu, 09 Feb 2017 12:00:00 -0400

If you aren’t currently offering clients a DocuBank card, contact us at 610-667-3524 or email me to learn more.

Studies on health care surrogates provide marketing opportunities for estate planning attorneys

Mon, 19 Sep 2016 12:00:00 -0400

My guest blog post this month for the American Academy of Estate Planning Attorneys analyzes two studies that found that health care surrogates are called on to make medical decisions very frequently. You can use these results in your marketing to new clients or as an opportunity to reconnect with existing clients. Read the full article here.

Studies on health care surrogates provide marketing opportunities for estate planning attorneys

Mon, 19 Sep 2016 12:00:00 -0400

Computerized records dont make clients advance directives available

Thu, 28 Apr 2016 12:00:00 -0400

Electronic medical records are not the answer to making clients’ advance directives easily available at a hospital when they’re needed, according to a recent news report. Contrary to what we all might assume, most physicians cannot get their patients’ advance directives easily—if at all—through electronic health records (EHRs).

In a USA Today article, Kaiser Health News uncovered a surprising set of technical problems that stand in the way. One major barrier: many EHRs are incompatible with each other and can’t share your clients’ advance directives (as well as other medical information) among them. For example, if your client’s doctor uses one system and the emergency room uses a different EHR, the emergency physician may not be able get a copy of the advance directive from the hospital, or even know that your client has one.

The issue is compounded when your client receives treatment from numerous facilities.

Another problem: the advance directive frequently doesn’t have its own “tab” in the EHR, which means that no one knows where to look for it within a client’s electronic record. Surprisingly, the doctor or nurse would have to forage through a jumble of scanned files in the patient’s record to search for the document.

“If they’re not able to access the advance directive quickly and easily, they’re honestly likely not to use it,” said Torrie Fields, senior program manager for palliative care at Blue Shield of California

These technology barriers are a huge issue for your clients, who probably (and rightly) assume their directive would be easily accessible through their hospital’s EHR once they’ve provided it.

The article also notes that a handful of states have created online registries to make their residents’ advance directives available. While the specifics vary from state to state, they generally require an online login from the hospital, which then has to search for an advance directive for the patient.

State registries are also problematic for clients those who travel, have multiple residences, or see doctors in multiple states. But primarily, doctors and nurses simply do not have the time to deal with them. “We don’t have extra staff to say, ‘She might have an advance directive somewhere – check the top five directories and let me know,’” said Marian Grant, director of policy and professional engagement at the Coalition to Transform Advanced Care.

As you may already know, the DocuBank advance directives registry addresses all the problems of obtaining a client’s advance directives that are identified in the Kaiser Health News/USA Today piece. It’s the universal way for clients to let their doctors know: “yes, I have an advance directive, and here is how you get it.”

With the emergency wallet card that clients carry, hospitals and doctors have all the instructions they need to instantly obtain your client’s advance directive from any hospital, regardless of the EHR. Unlike some state registries, all information needed to obtain the documents is right on the card. No searching is needed. Your clients are always protected in a medical emergency 24/7/365.

If you’re already providing DocuBank to your clients, use the Kaiser news report to tell your clients about this EHR problem and the solution for their advance directives that you've given them! This is the perfect opportunity to remind them why you provided a DocuBank card and membership. Contact us for free newsletter content and publish it on your blog, print it in your next newsletter, or design a marketing campaign and mail it to clients you haven't heard from in a while.

If you aren’t currently offering clients a DocuBank card, contact us at 610-667-3524 or email me to learn more.

Computerized records dont make clients advance directives available

Thu, 28 Apr 2016 12:00:00 -0400

The issue is compounded when your client receives treatment from numerous facilities.

These technology barriers are a huge issue for your clients, who probably (and rightly) assume their directive would be easily accessible through their hospital’s EHR once they’ve provided it.

If you aren’t currently offering clients a DocuBank card, contact us at 610-667-3524 or email me to learn more.

Computerized records dont make clients advance directives available

Thu, 28 Apr 2016 12:00:00 -0400

The issue is compounded when your client receives treatment from numerous facilities.

These technology barriers are a huge issue for your clients, who probably (and rightly) assume their directive would be easily accessible through their hospital’s EHR once they’ve provided it.

If you aren’t currently offering clients a DocuBank card, contact us at 610-667-3524 or email me to learn more.

Important medicare policy change for your clients and your firm

Fri, 01 Apr 2016 12:00:00 -0400

Beginning in 2016, Medicare will pay doctors to have conversations with their patients about their advance care planning. This change opens the door for you to work more directly with your clients’ doctors -- good news for your clients and your practice. We thought you might appreciate a summary of this new Medicare benefit so that you can help your clients, and also make the most of this new opportunity.

Medicare will now separately reimburse doctors for advance care planning conversations with patients. Physicians were previously disincentivized to have these important, yet often time-consuming, conversations with patients (your clients) due to a lack of compensation.
ACP discussions are voluntary. Either the patient or the physician can bring up the subject, but the patient can choose if they want to engage in the conversation.
ACP discussions are for explaining and discussing advance directive documents, including standard forms. If your clients have already completed their advance directives, their physician should ask them for a copy. If your client is enrolled in DocuBank, they can use their DocuBank card to have a copy immediately sent to the doctor’s office. When you register a new client in DocuBank, you can have them send the advance directives directly to doctor’s office, which is even more valuable to local doctors in light of the new Medicare ACP payments. This is a great marketing tool for your firm, and a valuable service for your client and their physician. Hint: Make sure your firm name appears on the advance directives you create.
ACP is about discussing the patient’s wishes – WHATEVER THEY MAY BE. The goal of the ACP conversation is for the patient and the doctor to explore and understand the patient’s goals for their care. This could mean a discussion about the patient wanting every possible treatment in order to extend their life as long as possible no matter what, or it might be about the patient preferring to be kept as comfortable as possible in the case of a terminal illness. Of course, there may be a myriad of other scenarios and choices in between, which is what makes the conversation so important!
ACP is about knowing whom the patient wants to make decisions for them, and can include what happens to their body after they pass away. Your clients need to name a surrogate decision maker because sometimes the state’s statutory default decision maker will not make wishes consistent with what your client would want.
It is appropriate for a physician to ask your client if they have an advance directive or have had “the conversation,” even if they are healthy. ACP discussions may become a part of Medicare’s “Annual Wellness Visit.” These discussions have been recognized by the medical profession as a component of high quality care.
There is no co-pay for ACP conversations during a Medicare Annual Wellness Visit. If the conversation comes up during the Annual Wellness Visit, the patient does not have a co-pay. If the patient has the conversation during another appointment, they may have a co-pay depending on their Medicare plan.
ACP conversations can be with the doctor or with a non-physician who is supervised by the doctor. Some patients may have a better relationship or feel more comfortable having the conversation with a physician’s assistant or nurse practitioner.
Regardless of what choices the patient makes, research has shown that ACP increases patient and family satisfaction and reduces the emotional distress on caregivers. Many clients may avoid these discussions with doctors or their family because they can be painful or awkward. But, the evidence suggests that having these conversations is a tremendous gift for loved ones.

If you’d like a version of this post in Q&A format that is already edited specifically for clients, contact us.

Important medicare policy change for your clients and your firm

Fri, 01 Apr 2016 12:00:00 -0400

Medicare will now separately reimburse doctors for advance care planning conversations with patients. Physicians were previously disincentivized to have these important, yet often time-consuming, conversations with patients (your clients) due to a lack of compensation.
ACP discussions are voluntary. Either the patient or the physician can bring up the subject, but the patient can choose if they want to engage in the conversation.
ACP discussions are for explaining and discussing advance directive documents, including standard forms. If your clients have already completed their advance directives, their physician should ask them for a copy. If your client is enrolled in DocuBank, they can use their DocuBank card to have a copy immediately sent to the doctor’s office. When you register a new client in DocuBank, you can have them send the advance directives directly to doctor’s office, which is even more valuable to local doctors in light of the new Medicare ACP payments. This is a great marketing tool for your firm, and a valuable service for your client and their physician. Hint: Make sure your firm name appears on the advance directives you create.
ACP is about discussing the patient’s wishes – WHATEVER THEY MAY BE. The goal of the ACP conversation is for the patient and the doctor to explore and understand the patient’s goals for their care. This could mean a discussion about the patient wanting every possible treatment in order to extend their life as long as possible no matter what, or it might be about the patient preferring to be kept as comfortable as possible in the case of a terminal illness. Of course, there may be a myriad of other scenarios and choices in between, which is what makes the conversation so important!
ACP is about knowing whom the patient wants to make decisions for them, and can include what happens to their body after they pass away. Your clients need to name a surrogate decision maker because sometimes the state’s statutory default decision maker will not make wishes consistent with what your client would want.
It is appropriate for a physician to ask your client if they have an advance directive or have had “the conversation,” even if they are healthy. ACP discussions may become a part of Medicare’s “Annual Wellness Visit.” These discussions have been recognized by the medical profession as a component of high quality care.
There is no co-pay for ACP conversations during a Medicare Annual Wellness Visit. If the conversation comes up during the Annual Wellness Visit, the patient does not have a co-pay. If the patient has the conversation during another appointment, they may have a co-pay depending on their Medicare plan.
ACP conversations can be with the doctor or with a non-physician who is supervised by the doctor. Some patients may have a better relationship or feel more comfortable having the conversation with a physician’s assistant or nurse practitioner.
Regardless of what choices the patient makes, research has shown that ACP increases patient and family satisfaction and reduces the emotional distress on caregivers. Many clients may avoid these discussions with doctors or their family because they can be painful or awkward. But, the evidence suggests that having these conversations is a tremendous gift for loved ones.

If you’d like a version of this post in Q&A format that is already edited specifically for clients, contact us.

ER docs LOVE advance directives: Marketing opportunity

Thu, 14 Jan 2016 12:00:00 -0400

My guest blog post this month for the American Academy of Estate Planning Attorneys is about just how badly ER doctors want their patients to have easily accessible advance directives, according to a recent study. Read the full article here.

ER docs LOVE advance directives: Marketing opportunity

Thu, 14 Jan 2016 12:00:00 -0400

Tips to help clients lighten up the conversation on advance care planning

Tue, 15 Dec 2015 12:00:00 -0400

My guest blog post this month for the American Academy of Estate Planning Attorneys offers some lighter ideas for ways family and friends can bring up the subject of advance care planning during the holidays. Read the full article here.

From ESPN to Dr. House: A selection of Randi Siegel's articles on end-of-life issues

Mon, 16 Nov 2015 12:00:00 -0400

Please check out a selection of my blog posts for the American Academy of Estate Planning Attorneys from earlier this year that we haven’t posted here previously.

February's post, Not Too Macho for Meaning: A Sports Anchor Shares Lessons About Life, calls attention to Stuart Scott’s acceptance speech at the ESPYs before his untimely death a few months later after a long battle with cancer. The speech touched on a number of important life lessons that encouraged listeners to take a good look at their own lives and what gives them meaning.

August covered a new finding that having a health care power of attorney is backfiring for many people with cancer. Thinking the job complete with that document alone, they are less likely to actually have conversations about their health care wishes. Read For Clients with Cancer, HCPOA’s Unintended Consequences

In September, I pointed out a growing niche for estate planning attorneys: clients who view members of their non-nuclear family as their most important next-of-kin. Next of Kin is Not Always What We Think: Exercising the Non-Nuclear Option points out that since state statutes do not recognize these relationships, as you know, this is an especially vulnerable group when it comes to making sure the right people are allowed access to medical information or decision-making.

October's piece, That’s Not How Dr. House Did It! TV Misleads Your Clients, looks at how depictions of CPR on popular medical TV dramas are affecting how people make decisions about their own health care wishes.

You’re An Estate Planning Attorney, Not A Doctor – Yet You Can Help Save Lives is this month’s call to help educate clients about organ donation. It is, of course, a personal choice whether to become a donor or not, but you can help give clients the information they need to decide.

From ESPN to Dr. House: A selection of Randi Siegel's articles on end-of-life issues

Mon, 16 Nov 2015 12:00:00 -0400

Please check out a selection of my blog posts for the American Academy of Estate Planning Attorneys from earlier this year that we haven’t posted here previously.

ER doctors want you to have an advance directive!

Thu, 12 Nov 2015 12:00:00 -0400

ER doctors want you to have an advance directive!

A recent survey of emergency medicine physicians has found that 85% believe having an advance directive helps ensure better quality patient care. And 88% felt that patients’ families were more comfortable with how doctors cared for their loved ones when there was an advance directive on file.

These ER physicians also said that advance directives make things easier for themselves. A full 93% said they felt less frustrated in situations where advance directives were easily accessible. 54% even used the word “relief” to describe their feelings upon learning that a patient already had an advance directive.

So do yourself, your family and your ER doc a favor – make sure you have easily accessible advance directives!

ER doctors want you to have an advance directive!

Thu, 12 Nov 2015 12:00:00 -0400

ER doctors want you to have an advance directive!

So do yourself, your family and your ER doc a favor – make sure you have easily accessible advance directives!

JAMA oncology study reveals health care agents are flying blind

Wed, 12 Aug 2015 12:00:00 -0400

A recent study from JAMA Oncology presented some significant findings for the world of estate planning – between 2000 and 2012, the number of people with cancer creating health care power of attorneys has gone up, the number of end-of-life care conversations has stayed the same, and the number of people receiving “all care possible” has dramatically increased. My blog post delves into the possible reasons behind these numbers and how estate planning attorneys can help ensure their clients’ documents are being properly utilized. You can read the article on the Academy blog.

What can Tom Brokaw teach us about advance directives?

Mon, 15 Jun 2015 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was just published! This month’s article is Do Your Clients Have the Same Problems as Tom Brokaw? Working off of a 2012 TED Talk between Brokaw and his daughter, Dr. Jennifer Brokaw, about advance care planning, it lays out the steps to take once an advance directive has been created to ensure its effectiveness – where to store it and who to tell about it. You can read the article on the Academy blog.

Jeb Bush suggests Medicare beneficiaries be required to complete an advance directive

Thu, 11 Jun 2015 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was recently published! This month’s article is Jeb Bush’s Advance Care Planning Surprise. It talks about Bush’s interesting statement on advance care planning and Medicare at a forum in Manchester, NH, and the potential implications of his words. You can read the article on the Academy blog.

Ask Yourself Important Questions this National Healthcare Decisions Day

Thu, 16 Apr 2015 12:00:00 -0400

Today is National Healthcare Decisions Day!

This a day to ask yourself a few very important questions:

Do you have advance directives (healthcare power of attorney, living will, HIPAA) yet?
Have you spoken with your appointed healthcare surrogate about your care wishes and goals should you be unable to make decisions for yourself?
Do they and other loved ones know where you keep your directives?
Do you have an older relative or loved one who has not yet had this conversation with you?

If the answer to any of these questions is no, let today be an impetus for getting the process going. There are many great resources out there to help if you are feeling unprepared or unsure of what to do.

An excellent place to start is The Conversation Project, which provides tools for helping to get the ball rolling on such a difficult discussion with your loved ones.

You can also check out Caring Connections, which has both tips for getting the conversation started as well as links to state specific advance directive forms.

You can also check out our resource page for more options and information. However you choose to go about it, now is the time to get moving on making a plan for your future healthcare needs!

Ask Yourself Important Questions this National Healthcare Decisions Day

Thu, 16 Apr 2015 12:00:00 -0400

Today is National Healthcare Decisions Day!

This a day to ask yourself a few very important questions:

Do you have advance directives (healthcare power of attorney, living will, HIPAA) yet?
Have you spoken with your appointed healthcare surrogate about your care wishes and goals should you be unable to make decisions for yourself?
Do they and other loved ones know where you keep your directives?
Do you have an older relative or loved one who has not yet had this conversation with you?

An excellent place to start is The Conversation Project, which provides tools for helping to get the ball rolling on such a difficult discussion with your loved ones.

You can also check out Caring Connections, which has both tips for getting the conversation started as well as links to state specific advance directive forms.

You can also check out our resource page for more options and information. However you choose to go about it, now is the time to get moving on making a plan for your future healthcare needs!

Dying Neednt Be So Brutal. Boomer, Arise!

Tue, 10 Mar 2015 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was just published! This month’s article is Dying Needn’t Be So Brutal. Boomer, Arise! It discusses a recent study that found that people are dying in more pain and with more psychological distress than they were twenty years ago. It also looks at an op-ed written by Dr. Ira Byock, a palliative care expert, about what should be done. You can read the article on the Academy blog.

New Facebook feature lets users assign a digital heir

Wed, 18 Feb 2015 12:00:00 -0400

Facebook has introduced a new feature that gives its users more control over their Facebook pages after they pass away. Users can now designate a “legacy contact” to manage their account. The legacy contact must be an existing Facebook user, and they’ll be able to add a post to the top of the page to memorialize the person, change their profile picture, and accept new friend requests.

Legacy contacts won’t have total control over a person's account. They can't edit or delete posts made by the user or their friends, remove photos, remove friends, or read private messages that were sent.

Facebook will also recognize a digital heir named in a will and make them the legacy contact, even if the user didn’t designate them with the new tool. This is great news for estate planning attorneys, who can now incorporate this language into their documents and be confident the world’s largest social media site will recognize it.

DocuBank members with a COMPLETE account can take advantage of a similar feature called the Digital Executor. Members can log in online and choose a person who can access their account when they pass away. That person will be able to log in and view all of the files that the member uploaded to their online SAFE.

New Facebook feature lets users assign a digital heir

Wed, 18 Feb 2015 12:00:00 -0400

New Facebook feature lets users assign a digital heir

Wed, 18 Feb 2015 12:00:00 -0400

New Years Resolution: Employ Advance Directives Marketing This Year

Tue, 13 Jan 2015 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was just published! This month’s article is New Year’s Resolution: Employ Advance Directives Marketing This Year. It focuses on different outreach ideas for getting the word out about the importance of advance directives with both current and potential clients. You can read the article on the Academy blog.

Medical Decision-making Controversies Your Clients May Be Talking About

Thu, 13 Nov 2014 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was just published! This month’s article is Medical Decision-making Controversies Your Clients May Be Talking About. It focuses on the controversial article written by Ezekiel Emanuel, M.D., entitled Why I Hope to Die at 75. You can read the article on the Academy blog.

Wisconsin Public Radio Airing 5-part Series on Death

Mon, 10 Nov 2014 12:00:00 -0400

Over the next few weeks, Wisconsin Public Radio, a branch of NPR, will be hosting a five-part series on death on their program, To the Best of Our Knowledge. Each part will focus on one aspect of how Americans deal with death. The parts are, in order of when they will air:

The Reckoning - how to start discussions about death
Exit Plan - the tolls of end of life care and ways to ease the experience
The Last Moment - discussing near-death experiences and the ability of modern medicine to bring people back from brain death
The Wake - how we deal with and experience grief
After Life - mortality and remembrance and how these topics are affected in the digital age

The series began this past Sunday, November 9, and will continue for the next four Sundays. If you miss the live broadcasts, you can listen to all parts of the program here.

New Orleans Attorney Shares DocuBank Story with Sophisticated Woman Magazine

Fri, 05 Sep 2014 12:00:00 -0400

Ronda Gabb has provided DocuBank for her clients for more than 15 years, and she recently shared her personal experience with the service in an article published in Sophisticated Women Magazine.

Ms. Gabb used her DocuBank Emergency Card when she went in for surgery last month. She wrote about how it felt to be the one in that position, worrying about all the what-ifs that go along with a major medical procedure, and how thankful she was that she had already taken care of her own estate planning documents. “The best part of all,” she concluded, “was that none of it was needed…but the comfort of knowing it was all there ‘just in case’ was priceless."

Delaware Law Provides Access to Digital Assets to Legal Executors

Mon, 25 Aug 2014 12:00:00 -0400

In addition to appointing a health care agent to take care of medical needs and an executor to take care of affairs after they're gone, citizens of Delaware can now also appoint a digital executor -- to look after their digital assets such as online bank accounts, social media accounts and email accounts.

A new law coming out of the first state grants the same access to digital assets as heirs or executors have always had over the rest of a person’s estate. Until other states do the same, the rest of us should make our own provisions, as advised in this article in the Washington Post, such as keeping a list of all online accounts and their passwords and making sure someone knows where that is. (As you know, DocuBank SAFE lets folks do just this. It also goes one step further by letting the user appoint a DocuBank Digital Executor -- who can get access to the digital asset password list and entire SAFE account when the user dies or becomes permanently incapacitated.)

Delaware Law Provides Access to Digital Assets to Legal Executors

Mon, 25 Aug 2014 12:00:00 -0400

Delaware Enacts Law to Promote Inclusion for People With Disabilities

Thu, 07 Aug 2014 12:00:00 -0400

Delaware recently passed new legislation to enhance the dignity of disability-related laws by changing the word choices used in existing laws. The initiative is called People First Language, or PFL, and its key point is to make sure that even in just the phrasing of a law, the person -- and not their disability -- comes first. For example, laws should refer to “people with disabilities,” as opposed to “disabled people.”

Delaware Enacts Law to Promote Inclusion for People With Disabilities

Thu, 07 Aug 2014 12:00:00 -0400

Colleague Corner: Jim McVittie on DocuBank and LGBT Clients

Wed, 18 Jun 2014 12:00:00 -0400

In our first Colleague Corner post, Jim McVittie talks about one of the reasons he began providing DocuBank for his clients.

In my area I specialize in serving the LGBT community. The main reason I started providing DocuBank is because a large portion of my client base consists of same-sex couples as well as unmarried opposite-sex couples. I recognized that their DocuBank membership, and the documents stored therein, would be an integral part in my client’s ability to prove the legal authority of the non-ill partner to physicians and hospital staff. In addition to the health care authorization forms that I prepare for my clients, DocuBank stores my client’s domestic partnership agreements, certificate of registered domestic partnership or marriage certificate. As a result, my clients have not had any problems with their agent’s authority being recognized. In addition, a number of our clients are medical professionals, doctors, nurses, and emergency room physicians. I’m always amazed when those medical professionals tell me they wish everyone had something like DocuBank.

I include DocuBank as a regular part of my practice, and have been doing so for about eight years now. New clients get a DocuBank membership as part of their estate planning package. Old clients who did their planning before I started using DocuBank get “upgraded” to DocuBank for free when they update their estate plans. In my initial meeting with clients I review a sample estate planning portfolio with them. When we get to the health care section I show them a sample DocuBank card and explain to them how DocuBank works. Most have never known anything like DocuBank existed and are excited to see how it works. If they had health care authorizations in place previously, they had been packing up their documents and taking them with them when they travel. Most are relieved to know they no longer need to do that.

Jim McVittie is an estate planning attorney serving the Portland, Oregon community. You can learn more about his practice at www.mcvittie-law.com

AMA Recommends Paying Doctors for End-of Life Conversations

Fri, 06 Jun 2014 12:00:00 -0400

The idea of Medicare payment for advance care planning is not new, but past efforts to put such programs into place have been stymied (think “death panels”). A new proposal from the AMA may change that, recommending that doctors who take the time to discuss end-of-life care with their patients be paid for their efforts.

AMA Recommends Paying Doctors for End-of Life Conversations

Fri, 06 Jun 2014 12:00:00 -0400

New Study Analyzes How End-of-Life Choices Change Over Time

Wed, 04 Jun 2014 12:00:00 -0400

A new study about end-of-life choices has some interesting things to say about how people’s wishes change (or don’t) over time. Most people’s preferences seem to stay the same over the years. But -- the groups most likely to change were those who were healthy when they first made their preferences known, and those who originally wanted more intensive care. You can read more about the study at JAMA Internal Medicine.

New Study Analyzes How End-of-Life Choices Change Over Time

Wed, 04 Jun 2014 12:00:00 -0400

2 Pitfalls in Getting Clients Their Desired Results from Advance Directives

Wed, 28 May 2014 12:00:00 -0400

My monthly guest blog post for the American Academy of Estate Planning Attorneys was just published! This month’s is 2 Pitfalls in Getting Clients Their Desired Results from Advance Directives. You can read the article on the Academy blog.

Don't Take Our Word For It

Fri, 18 Oct 2013 12:00:00 -0400

I was recently in Orlando visiting with a group of attorneys I hadn’t seen in several years. It’s amazing how having kids will cut in to your travel time. It was good to see some familiar faces and meet some of our partner firms for the first time face to face. And I had an opportunity to present information on our new services and features, and talk about our new video. It was quick, easy and well received. Just like all good presentations should be.

And then the floor was opened up to questions. An attorney who has been registering clients in our service for more than a decade stood up to share his “DocuBank Story”. He used his wife’s personal DocuBank card at the last conference because she fell ill just as the conference was ending. They were in Tucson. They live in Virginia. His testimonial was glowing and sweet, and he held his personal card aloft with pride and encouraged his colleagues to make sure they carried their DocuBank cards as well. And, without prompting, more than half the attorneys in the room reached into their wallets and pulled out their personal DocuBank cards. It was one of those fun moments that reconfirmed for me that what we do on a daily basis is important. Not just to the attorney’s clients we support, but also for the attorneys themselves.

If you are a providing attorney, I strongly encourage you to enroll yourself and your staff, with our compliments (we want to make sure that you are protected too). And if you have questions about DocuBank and would like to hear from a colleague, contact us; we have a number of firms who have volunteered to act as resources for interested firms. As you know, referrals are priceless. And we are very lucky to have partner firms who will happily refer to us.

Furry Friends Help Patients Feel Better

Tue, 16 Jul 2013 12:00:00 -0400

According to a recent article on USAToday.com, more hospitals are expanding hospital visitation to include canines.

Therapy dogs have been helping patients for years.

“Research has shown that therapy dogs can have measurable health benefits in patients. In a 2007 study, 76 adults with advanced heart failure received either a 12-minute visit from a volunteer with a therapy dog, a 12-minute visit from a volunteer only or 12 minutes of their usual care.

Compared with the usual-care group, the canine group had significantly greater decreases in blood pressure during and after the visit. Compared with the volunteer-only group, they had significantly greater decreases in levels of stress hormones epinephrine and norepinephrine during and after the visit. And compared with either group, they had significantly greater drops in a measure of "total anxiety."

Therapy dogs have also been shown to reduce loneliness and depression and to stimulate conversation among nursing home residents.” Excerpts from this article.

The idea that a visit from your own personal pet would be even more beneficial is easy to understand.

Estate planning attorneys who help their patients with hospital visitation forms may want to start including Fido on that list. Even if the client’s specific hospital won’t allow it yet, it’s possible they might soon. And the documents will be ready!

Furry Friends Help Patients Feel Better

Tue, 16 Jul 2013 12:00:00 -0400

According to a recent article on USAToday.com, more hospitals are expanding hospital visitation to include canines.

Therapy dogs have been helping patients for years.

Therapy dogs have also been shown to reduce loneliness and depression and to stimulate conversation among nursing home residents.” Excerpts from this article.

The idea that a visit from your own personal pet would be even more beneficial is easy to understand.

Furry Friends Help Patients Feel Better

Tue, 16 Jul 2013 12:00:00 -0400

According to a recent article on USAToday.com, more hospitals are expanding hospital visitation to include canines.

Therapy dogs have been helping patients for years.

Therapy dogs have also been shown to reduce loneliness and depression and to stimulate conversation among nursing home residents.” Excerpts from this article.

The idea that a visit from your own personal pet would be even more beneficial is easy to understand.

How Will Law Schools Teach Estate Planning and Elder Law?

Wed, 08 May 2013 12:00:00 -0400

Will elder law will become much more about capacity matters and much less about Medicaid planning? This is one suggestion resulting from The Association of American Law Schools' academic symposium looking at the future of estate law and elder law as our population ages. The AALS undertook this project as a way to plan future law school curriculum in these areas. The result is Capacity, Conflict, and Change: Elder Law and Estate Planning Themes in an Aging World, now available online in the 2012-13 Symposium Issue of the Penn State Law Review.

Senior Designations for Financial Advisors

Wed, 08 May 2013 12:00:00 -0400

Thursday, May 9, from 3-4 p.m. EDT,the Consumer Fraud Protection Bureau is hosting a Twitter chat about “senior designations” used by financial advisers who imply that they specialize in giving advice to seniors. This twitter chat comes on the heels of the CFPB's report last month on this topic.. You can get some community service exposure, and the report might be useful in helping you guide clients toward appropriate financial advisors and steer them away from inappropriate ones.

CFPB’s directions: “Use the #SeniorMoney hashtag. You can join the conversation and help seniors by suggesting resources, answering questions, and providing moral support. You can participate wherever you are -- just watch your Twitter feed and respond to questions and comments with the hashtag #SeniorMoney. Follow us on Twitter -- we're @cfpb -- and on May 9, be ready with tips, answers, and opinions for seniors.”

Reimbursement for Advance Care Planning Proposed in U.S. Congress

Sun, 17 Mar 2013 12:00:00 -0400

The bipartisan advance care planning bill just introduced in the U.S. House of Representatives would provide reimbursement for periodic advance care planning under Medicare and Medicaid. Specifically, The Personalize Your Care Act would cover reimbursement for voluntary consultations with patients about advance care planning and end of life care every 5 years or upon a change in the patient’s health status. Proposed by Rep. Earl Blumenauer with bipartisan cosponsors on March 14, 2013, the bill would also help states establish or expand their programs for Physician’s Orders for Life Sustaining Treatment (POLST) and help ensure that electronic medical records can display patients’ advance directives and POLST documents.

Reimbursement for Advance Care Planning Proposed in U.S. Congress

Sun, 17 Mar 2013 12:00:00 -0400

More Spending on Advanced Cancer May Not Improve Survival Rates

Wed, 13 Mar 2013 12:00:00 -0400

A new study in the Journal of the National Cancer Institute did not find a link between increased survival rates and more spending on patients with advanced cancer. (It looked at Medicare patients with advanced cancer of a variety of types, dividing them by geographic regions and then into 5 groups based on the amount spent on their care.) The differences in patient survival by region were not statistically significant; however, the amount spent on their care by varied by 30 – 40%.

In light of these findings, the authors suggest that healthcare providers adjust the care provided to patients with advanced cancer. Specifically, they should reduce “potentially avoidable hospitalizations,” which were a major source of the increased spending, and also increase “timely access to palliative care for patients with advanced cancer," both of which are part of providing more "patient-centered care."

Geek info
Source: Journal of the National Cancer Institute
Article: Regional Variations in Spending and Survival for Older Adults with Advanced Cancer
Date: March 12, 2013
Author: Brooks, et al.
Media Reporting:

Kaiser Health News

Assisted Suicide Legislation on the Rise

Tue, 12 Mar 2013 12:00:00 -0400

A recent AP article reports that 6 states (maybe yours) now have bills to legalize physician-assisted suicide working their way through the legislative process.

The article does not take a position on what can be a very volatile subject, but rather focuses on the impetus for these legislative developments and touches on the 3 states in which assisted suicide is already legal.

With all of this pending legislation, there are a number of articles on this topic recently, including some in the Wall Street Journal. You can find links to the WSJ pieces here. To learn more about the illegal or legal status of assisted suicide in your state (as of Dec. 2012), see pro/con.org.

Death Cafes Raise Awareness of End-of-Life Topics

Fri, 08 Mar 2013 12:00:00 -0400

Sipping on a cup of Joe makes talking about about anything in life easier, including death. That's the idea behind Death Cafes: candid discussions about death that are being held at coffee shops and other locations around the world.

The conversations are usually organized and facilitated by an expert in the field, such as Lizzy Miles, a hospice volunteer and social worker who organizes Death Cafes around Columbus, OH. "The goal is to raise death awareness with the view of helping people make the most of their lives," said Miles.

The facilitator usually starts with a personal story to get the conversation moving, but the open session can cover whatever topics the audience broaches, including how people want to die, advance directives, near-death experiences, and burial preferences.

Since Death Cafes are free to attend, the facilitator typically accepts donations to cover the costs of the beverages and snacks. Have you heard of any events in your area or know anyone who may want to host one? Perhaps sponsoring a Death Cafe could be a way to spread your name in your community, and certainly communicate that you are open and comfortable talking about this topic.

Health Journalist's Firsthand Encounter with End-of-Life Decisions

Fri, 01 Mar 2013 12:00:00 -0400

In "How Mom's Death Changed My Thinking About End-of-Life Care," journalist Charles Ornstein thoughtfully presents how his personal experience with the uncertainties of medical diagnosis, treatment, futility, end-of-life decisions for his mother differed from his objective, clearer views on these subjects as a veteran health-care reporter. He candidly shares his new-found appreciation for the intense difficulty of figuring out how to apply her general wishes to her specific medical situation -- about whether to try treatments and/or when to stop trying. He also shares insights about the role of hope and a new understanding of "how little the costs to t he broader health-care system matter to the family of a patient." Mr. Ornstein is also current board president of the Association of Health Care Journalists.

Health Journalist's Firsthand Encounter with End-of-Life Decisions

Fri, 01 Mar 2013 12:00:00 -0400

Thanks to Our Advisory Boards - Outgoing and Incoming

Tue, 19 Feb 2013 12:00:00 -0400

In our over 2 decades doing of business, we've worked hard to ensure that we not only meet the expectations of our users -- we exceed them. One very important tool that helps us achieve this goal is our Advisory Board of estate planning professionals. A few years ago, we asked several longtime DocuBank providers to offer their insights and feedback on our services, and they became our first Advisory Board members. We recently said a fond farewell to this group and would like to extend a huge THANK YOU for two wonderful years of service from:

Bradley B Anderson, Anderson, Dorn & Rader, LLC, Reno, NV
Joseph “Chip” Buxton, III, TrustBuilders Law Group, Urbanna, VA
Peter Gilbert, Highpoint Law Offices, P.C., Chalfont, PA
Catherine Hammond, Hammond Law Group, LLC, Colorado Springs, CO
Jerry Shiles, Parman & Easterday, Oklahoma City, OK
Michael H. Smith, Smith Baird, LLC, Savannah, GA
Jim Strull, Strull Law Group, LLC, Hackensack, NJ

Our new Advisory Board members have some big shoes to fill, but we are sure they are up to the challenge. Presenting the 2013-2014 DocuBank Advisory Board:

Ryan Collier, Collier Law, Salem, OR
Robert Feisee, Insight Law, PLLC, Ashburn, VA
Kimberly Hegwood, Hegwood & Associates, Houston, TX
Anthony Minko, Minko Law Office, Brooklyn NY
Philip Wylkan, Hall and Wylkan, Fremont, OH

Our advisory board members also volunteer as references about DocuBank. If you would like to talk with them about their experience with our services, please feel free to contact them directly.

The Conversation Project

Thu, 31 Jan 2013 12:00:00 -0400

The Conversation Project has some great tools to help anyone -- including clients -- start the difficult talk with loved ones about end-of-life care wishes. The free Starter Kit gently coaches people on how to have this conversation. And its short worksheets help people think in simple, non-medical terms about their goals at the end of life and for living with advanced illness.

You might consider referring clients to this site when you counsel them to talk with their families about the healthcare wishes they've just documented in their advance directives. It might help them "get over the hump." You could also use the Starter Kit's valuable tool as a homework exercise for your clients prior to completing their legal advance directive in your office. (Or, you might consider incorporating some of its questions into your client discussion.) You could also attach the worksheets to clients' advance directives as further expression of the client's wishes and guidance to the healthcare agent.

Spearheaded by former syndicated columnist Ellen Goodman, The Conversation Project began with leaders in the media, clergy, and medicine sharing their own storiesof "good death" and "bad deaths" of those they loved.

The Conversation Project

Thu, 31 Jan 2013 12:00:00 -0400

NHDD is April 16

Wed, 04 Apr 2012 12:00:00 -0400

“Nothing in life is certain but death and taxes,” - Benjamin Franklin

With Mr. Franklin’s words in mind, it’s only fitting that April 16, the day after “Tax Day,” is also the date of the fifth annual National Healthcare Decisions Day (NHDD). Founded in 2008, this grassroots initiative is committed to raising public awareness about the importance of advance directives and advance care planning. Since its inception, NHDD has gained momentum and helped keep the national spotlight on this important cause.

There are many ways you can contribute to this worthy endeavor and even benefit your firm, too. None of them are as time-intensive as you may think.

As you’re more than well aware, thinking about being sick, disabled, or near the end of life is an activity that most folks look to avoid. NHDD is another tool in our community tool box that we can use to raise the subject of advance care planning.

- Lead by example: Make sure your family and your staff’s advance directives are up to date. And if you (or they) haven't signed one yet, now's the time to do it!
- Talk with your loved ones about your own wishes, and theirs. Creating advance directives is only half the job. Actually SHARING thoughts with family is just as important to them carrying out your wishes,and feeling good about doing so. (Studies even show this.)
- Encourage your clients to talk with their loved ones about their wishes, too.
- Start planning NOW for how to use NHDD to your professional advantage. Take a quick inventory (a Google search will do) of the NHDD activities and media coverage in your community on and around April 16.
- Find existing NHDD activities where you could volunteer to be a speaker next year.
  - Connect with a reporter or blogger who's written about NHDD this month, and offer to be a legal resource for this person.
  - Consider writing an NHDD follow-up article or op-ed for your local newspaper. The topic could be "Questions now that you've started thinking about your healthcare decisions" or "Things to consider when choosing your health care agent" (see my guest blog post for more on this). If you currently enroll your clients in DocuBank, you can visit our Provider Resource Center for some sample materials. The NHDD website also has an op-ed for general use and other resources that will help.