End of Life Decisions: Know Your Options

Life Care Planning is what we do at Elder Law of East Tennessee.  The focus is always on getting good care and maximizing our clients’ quality of life.  Unfortunately the effects of some diseases become overwhelmingly incapacitating, painful, or emotionally intolerable.  The suffering is too great.  Our clients or their closest loved ones begin to see death as a preferable option.  At that point the choice may be to end curative or life-sustaining treatments and to engage hospice or palliative care.For many of our clients and their families, having the right health care documents in place is an important part of ensuring that only desired medical treatment is given even when an individual is unable to communicate for him or herself.  The Advance Directive form issued by the State of Tennessee asks people to designate what medical conditions they find acceptable and unacceptable and, in the event they find themselves in an unacceptable quality of life, what types of medical treatment they would want and which ones they would refuse.  This document is an important part of an individual’s estate plan and guides family members in guilt-free decision making on behalf of their loved one.There are cases, however, where the quality of life is extremely poor and yet the medical condition is stable.  The client or family sees no end in sight. The seemingly unending suffering causes them to question their attorney or elder care coordinator about what they can do to actively bring an end to the intolerable situation.  Only a handful of states (OR, WA, VT, MT, & CA) have any statutory provisions for aid in dying.  Though unsuccessful as of yet, terminally ill Tennessee attorney John Jay Hooker has been fighting for Aid in Dying legislation and for court rulings that will allow him to end his own suffering and his own life in what he views as a dignified way.Besides lending a good ear and developing as good of a care plan as possible, what can Elder Law of East Tennessee offer to clients in this situation?  Final Exit is a resource that “provides education on all end of life choices as well as a compassionate presence to those who are suffering from incurable diseases and have chosen to end their suffering.”  Final Exit may not have the answers or solutions that are desired, but they can share all the options available within the confines of state and federal law.  Engaging with Final Exit can help clients and their families be sure that they’ve left no stone unturned.Many of the resources Final Exit offers can help to guide families through tough conversations and end-of-life decisions regardless of what those decisions may be.  No one likes feeling helpless or hopeless.  Final Exit links those who are suffering from terminal conditions with a support network and gives them the opportunity to affect change that may give others more choices in the future.At Elder Law of East Tennessee, we do not make judgments about the right or wrong of our clients’ wishes or choices.  We do, however, recognize that maximizing quality of life includes knowing and preparing for the full array of choices available to those who are suffering or in the final stages of life.

Amelia Crotwell, JD

Amelia Crotwell, founder and managing partner at Elder Law of East Tennessee, has guided families through long-term care and special needs challenges for nearly two decades. Specializing in Life Care Planning and special needs trusts, Amelia also collaborates across all areas of elder law, including wills, trusts, Medicare, Medicaid, probate, and veterans benefits planning. Certified as an Elder Law Attorney since 2011, she is president-elect of the Life Care Planning Law Firms Association and co-chair of their strategic planning committee. Amelia is deeply involved in the Special Needs Alliance and a prominent member of the National Academy of Elder Law Attorneys. She played a key role in founding the Tennessee chapter of NAELA, serving as its first president. A member of the Tennessee Bar Association and past chair of its Elder Law Section Executive Council, Amelia also dedicates time to pro bono work and community education. She earned her J.D., summa cum laude, from the University of Tennessee College of Law and teaches Elder Law there as an adjunct professor since 2018.

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The Elder Care Continuum

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Planning for the Long Term: America's Avoidance of the Issue