Certified Senior Advisor End-of-Life Planning Questions and Answers — Questions and Answers
Question 1: A client is preparing her advance directives and wants to appoint her son to make medical decisions on her behalf only if she becomes incapacitated and unable to communicate her own wishes. Which of the following documents specifically achieves this goal?
- Last Will and Testament
- Living Will
- Physician Orders for Life-Sustaining Treatment (POLST)
- Durable Power of Attorney for Health Care (Correct answer)
Correct answer: Durable Power of Attorney for Health Care
A Durable Power of Attorney for Health Care (also known as a health care proxy) is a legal document that allows an individual (the principal) to appoint a trusted person (the agent or proxy) to make health care decisions on their behalf if they are unable to do so themselves. A Living Will states wishes for end-of-life care but does not appoint an agent. [6] A Will deals with assets after death. [8] A POLST is a medical order for those with a current serious illness. [1, 10]
Question 2: Which of the following best describes a Physician Orders for Life-Sustaining Treatment (POLST) form?
- A set of actionable medical orders for current treatment preferences for individuals with a serious illness or advanced frailty. (Correct answer)
- A legal document required for all adults that appoints a financial decision-maker in case of future incapacity.
- A statement of general wishes for future, hypothetical medical situations, typically completed by healthy adults.
- A document that directs the distribution of personal property after an individual has passed away.
Correct answer: A set of actionable medical orders for current treatment preferences for individuals with a serious illness or advanced frailty.
A POLST (or MOLST/POST in some states) is a specific type of advance directive that translates a patient's wishes into actionable medical orders signed by a healthcare provider. [3, 19] It is intended for individuals with a current serious, life-limiting illness and is honored by emergency medical personnel. [1, 2] It differs from a standard living will, which outlines future wishes and is not a medical order. [10]
Question 3: A 78-year-old client with a serious chronic illness is exploring comfort-focused care options. What is the primary distinction between palliative care and hospice care that the Certified Senior Advisor should explain?
- Palliative care is only provided in a hospital, while hospice care is only provided at home.
- Only hospice care utilizes a team-based approach that includes spiritual and emotional support.
- Palliative care can be provided at any stage of a serious illness alongside curative treatments, whereas hospice care is for terminal patients who have forgone curative treatments. (Correct answer)
- Hospice care is fully covered by Medicare, while palliative care is never covered by any insurance.
Correct answer: Palliative care can be provided at any stage of a serious illness alongside curative treatments, whereas hospice care is for terminal patients who have forgone curative treatments.
The core difference is the treatment philosophy. Palliative care focuses on symptom and stress relief and can be given at any time during a serious illness, concurrently with treatments meant to cure the disease. [4, 21] Hospice care is a specific type of palliative care for individuals with a terminal prognosis (typically six months or less to live) who are no longer seeking curative treatments. [15, 22]
Question 4: Mr. Garcia wants to ensure his classic car is given to his grandson and his home is given to his daughter upon his death. He also needs to name an executor to manage the distribution of his assets. Which legal document is essential for Mr. Garcia to formally state these specific wishes and appoint an executor?
- Durable Power of Attorney for Finances
- Last Will and Testament (Correct answer)
- Advance Directive
- Living Trust
Correct answer: Last Will and Testament
A Last Will and Testament is the primary legal document for directing the distribution of property after death and for naming an executor to manage the estate. [6, 14, 18] A Durable Power of Attorney for Finances is for managing assets while alive and terminates at death. [5] An Advance Directive pertains to healthcare decisions. While a Living Trust also distributes assets, a Will is the fundamental document for these purposes and covers assets not held in a trust.
Question 5: What is the most likely legal consequence if an individual dies 'intestate'?
- The state's succession laws will determine how the deceased's property is distributed among heirs. (Correct answer)
- All of the deceased's assets are automatically forfeited to the state government.
- A court-appointed attorney is granted full discretion to decide who the beneficiaries will be.
- The deceased's assets are placed in a trust managed by the federal government for 10 years.
Correct answer: The state's succession laws will determine how the deceased's property is distributed among heirs.
Dying 'intestate' means dying without a valid will. [17] In this situation, each state has specific intestacy and succession laws that dictate the hierarchy of who inherits the property (e.g., spouse, children, parents, siblings). [7, 12] The assets are not automatically forfeited to the state unless no living relatives can be found. [12]
Question 6: A client has a Durable Power of Attorney for Finances, effective immediately, naming her son as her agent. Which of the following actions is the son legally permitted to perform on her behalf?
- Consent to a surgical procedure on her behalf.
- Amend the terms of her Last Will and Testament.
- Change the beneficiary on her life insurance policy to himself without her consent.
- Pay her monthly utility bills and file her income tax return. (Correct answer)
Correct answer: Pay her monthly utility bills and file her income tax return.
A Durable Power of Attorney for Finances grants the agent authority over financial matters only, such as paying bills, managing bank accounts, and handling taxes. [5, 9, 25] It does not grant authority to make medical decisions, which requires a separate healthcare power of attorney. [13] An agent cannot change the principal's will, and changing a beneficiary to oneself is a significant conflict of interest and typically not permitted unless explicitly authorized.
Certified Senior Advisor End-of-Life Planning Questions and Answers
A client is preparing her advance directives and wants to appoint her son to make medical decisions on her behalf only if she becomes incapacitated and unable to communicate her own wishes.
Which of the following documents specifically achieves this goal?