When Siblings Don’t Agree About Mom and Dad’s Care

Remember the fights you used to have with your brother over who got the last Ring Ding?  (Okay, maybe that was only me).


I’m an independent woman, an elder lawyer, no less.  Yet, when it comes to making decisions about my Mom, I turn first to my brother.  After all, my Mom is his Mom, and I don’t want to totally take charge, although it would be easy to do so. But mostly I like having someone to share the burden with.  Although I help families make decisions about their aging parents, when it comes to mine, I lean on family.


But what happens when you never got over that sibling rivalry?  Or when you honestly just disagree about how your parents should be cared for?


This article offers one solution—elder mediation.  A mediator may well be able to help siblings struggling with how to care for elderly parents and how to pay for that care.  Many elder lawyers are equipped to help work through solutions, but there are mediators in New York who specialize in elder problems.


George Clooney Doesn’t Have His Facts Straight about Living Wills

I wasn’t quite sure why, unlike most people, I didn’t really like The Descendants. (see this article that predicts that the movie will win the Golden Globes).  Then I saw the Wikipedia article that states “Matt learns that Elizabeth will never awaken from her coma, which means that under the terms of her living will she must be disconnected shortly from life support.” It’s a faulty premise.

I’m here to promise you that no one can be forced to disconnect your life support because your living will says so.  It’s unfair to blame the document for that sort of decision.  It was a simply an expression of Elizabeth’s wishes of how she would like her life to end.  Her doctors and the hospital would also have input into that decision.

In New York, a living will is not a legal document, it is an expression of your health care desires if you are unable to express those wishes yourself, if you are in a coma or perhaps in an advanced state of Alzheimer’s.   In New York, you should also sign a health care proxy, that nominates a person who will actually make those decisions for you.  The person you nominate to serve as your proxy can make real time decisions about real situations; not just advance decisions about hypothetical situations.  Those decisions will hopefully be framed by the wishes you expressed in your living will.

No one is “pulling the plug” because of the terms of your living will.  Don’t let fear stop you from signing the most important health care directives:  Your health care proxy, living will and power of attorney.  Even if George Clooney used to play a doctor on TV.



A Physician’s Guide to End-of-Life Decisions (MOLST)

The denial of death is one of the strongest of human defense mechanisms. In fact, there’s an entire book about it.  We don’t want to think about our end-of-life care wishes. (Although some have instructed, “Wave a martini in front of me — if I don’t respond, pull the plug.”) I don’t like to think about it any more than the next person. But I also don’t like to think about my family and doctors arguing over keeping me on a ventilator when I could have easily told them in advance what I want in that situation. In the past, the only option would be the use of an “advance directive” or health care proxy.  That’s still a good idea, but some might wish to also involve their doctors in the discussion. Another technique known as Medical Orders for Life-Sustaining Treatment (or MOLST) is becoming more popular. As a recent article in The Wall Street Journal makes clear, a growing number of states, including New York, are promoting MOLST to help guide physicians with a patient’s specific instructions.

New York is one of the more forward-thinking states in instituting the program known as Medical Orders for Life Sustaining Treatments (MOLST)

MOLST is different from other advance directives such as living wills and health care proxies because it is physician generated instead of client/patient generated.  A licensed physician must always sign the MOLST.  It is printed on bright pink paper so that hospitals and nursing homes cannot fail to notice it.

While the MOLST is a good addition to helping people get their wishes fulfilled, it is most often employed for the elderly who are in need of life-sustaining care.  It should not replace the health care proxy and living will you would create along with your wills and financial powers of attorney.

I found myself filling one of these out several years ago, when we had to check my mother into a nursing home.  Despite years of seeing gerontologists and living in an assisted living facility, this was the first time we’d been presented with the option of discussing the MOLST.

You may want to discuss this with your physician or elder law attorney so that you too can participate in your own decisions on your end-of-life care.