Many attorneys doing regular small estate planning do not include a nomination of guardian form with their standard battery of documents. But this document can make the difference between harmony and ruin when it comes time to make long term care decisions. The reason is that, quite simply, life changes. It especially changes for a senior citizen who is crossing the line between active senior and elderly person. Perspectives, desires, choices, can all become different.
The law favors spouses, children, and other relatives to make decisions for a senior. So, it should be easy to pick from among a group of candidates who may need to obtain guardianship over a senior in order to make treatment and financial decisions. But it is not always so.
In years past, lawyers and clients looked upon the subject of death as an inevitable result of being human, as an event. But, in reality, death has become a process. Choices are not as simple as pain or no pain. Indeed, many people will endure a bit of pain to be lucid and participating in some activity with loved ones. Still others will forgo life-extending treatment if they can be medicated so that pain does not interfere with ongoing activities. There are as many combinations of these, and a thousand other variables, as there are individuals.
In the end, if differences of opinions arise, there are assumptions about how treatment should be carried out in the medical community that may not fit the desires of the patient. So, while powers of attorney are very useful, it may become necessary to have a court grant a guardian the legal power to direct the efforts of caregivers. In such a situation, having selected a guardian, and having made clear to that guardian what you do or do not want, in detail, can make the difference between being alive until you die, or dying until you cannot live anymore.