Casey Kasem’s recent passing was sadly preceded by a court fight between his wife and his children by a previous marriage over who should make his medical decisions and what decisions he would have wanted. Sadly, even the rich and famous may not prepare themselves and their families for medical decisions and end of life decisions.
Over the last few years of his life, Kasem suffered from Lewy Body dementia, a brain disease that can cause severe cognitive and emotional deterioration. I have had two friends lose parents to Lewy Body dementia in recent years, and one had serious difficulties working with relatives to arrange care for the dying parent. In that case, the parent’s wishes were fairly well documented and communicated. In Kasem’s case, they weren’t.
Kasem’s children believed that he wanted to die peacefully, without life support. His wife disagreed publicly. In 2013, a California court appointed Kasem’s wife conservator, but ordered the children be allowed visitation. In May 2014, Kasem’s wife moved him from California to Washington without notice, and the court temporarily suspended her power to make health care decisions for Kasem, in favor of his daughter. In early June, a Washington court confirmed his daughter’s power over his medical care, but also allowed him to travel with his wife if doctors approved. The family continued to dispute Kasem’s care after his daughter had him taken by ambulance to a hospital. On June 11, the court approved the removal of life support, and Kasem died on June 15.
That fight didn’t have to happen.
There are several documents that can be prepared to ensure that your decisions about your medical care are carried out. The exact form varies from state to state, but the general idea is to appoint someone to make decisions on your behalf if you are unable to do so yourself, and to instruct the person making your decisions about what you want. If you are concerned about handling your finances, you can also sign a power of attorney, and in most states, the power of attorney can be written to take effect only when a court or one or more doctors confirm that you are unable to handle matters.
I tell my clients that a document stating their health care decisions is only as good as people know about it. I recommend giving copies not only to the person chosen to make the decisions, but also to doctors, and in Oregon, hospitals keep a “pink sheet” to make the decisions easy to find. In addition, it’s a good idea to have a conversation with your family so that they are informed of your decisions – and so you can gauge if any of them are going to disagree to the point of giving power to someone else.
If you change your mind, change your documents and tell everyone you spoke to before. People need to be kept informed about health care decisions. If they aren’t, you might not be able to tell them later.