Listen and hit ≡ in the player to subscribe on your favorite podcast platform! Or if you'd rather see our faces 👩🏽⚕️🧑🏼⚕️watch it here on YouTube.
Summary:
In this episode of the CareLab Podcast, hosts Emilia Bourland and Brandy Archie are joined by Rusty Fracassa, an elder law attorney and owner of PASS Elder Law. Rusty shares insights into the complexities and misconceptions surrounding estate planning, the importance of powers of attorney, and the critical decisions involved in end-of-life planning. The conversation touches on both practical and emotional aspects, offering valuable advice for individuals and families navigating these sensitive topics.
Key Takeaways:
- Estate planning is often perceived as complicated, but it is more about familiarity with the process than actual complexity.
- A common misconception is that having a will avoids probate; in reality, a will ensures assets go through probate according to your wishes.
- Powers of attorney should be comprehensive and immediately effective to avoid complications in critical situations.
- Choosing the right person for healthcare and financial powers of attorney is crucial; trust and alignment with your values are key.
- Honest conversations about end-of-life wishes, including quality of life, can ease the burden on loved ones during difficult times.
Transcript
Brandy Archie, OTD, OTR/L, CLIPP
It's CareLive Day. Welcome to CareLive Podcast. And welcome to Rusty. Rusty, thank you for joining us. I'm so excited that we get to have Rusty Fricasse here with us today. He's an attorney at law and the owner of Past Law Firm. And they do excellent work specifically in elder law. And so, you know, we can't be, we come out here and we started talking about all kinds of random stuff, but we felt like if we're going to talk legal, we should probably actually have a lawyer here so that we don't get y 'all in trouble.
Emilia Bourland, OTR, ECHM, CFPS
Yay! Yay!
Emilia Bourland, OTR, ECHM, CFPS
Yeah, you don't want to, no one wants that advice from me and I don't want to give it.
Brandy Archie, OTD, OTR/L, CLIPP
Exactly. So yeah. So Marcy, welcome. Thanks for joining us.
Emilia Bourland, OTR, ECHM, CFPS
Yes, thank you.
Rusty Fracassa
Thanks for having me. Appreciate it.
Brandy Archie, OTD, OTR/L, CLIPP
So we like to start with a random question. And today I'm giving the random question. And so the question is, what's the most unusual thing about your life that impacts your work today?
Rusty Fracassa
Well, when you live enough years, there's kind of a little few unusual things, but I'm actually in the middle of a PhD program in applied theology. So that has to impact when I'm meeting with people and working with people. Yeah.
Emilia Bourland, OTR, ECHM, CFPS
Oh wow!
Emilia Bourland, OTR, ECHM, CFPS
How did you come to decide to do that? Because one, getting a PhD, that's kind of a big deal. How did you make that decision?
Rusty Fracassa
Yeah, I don't it yet. So, I don't know. You know, I get kind of, you hear these people, especially around the clients I work with, talk to their kids or to them and they have these hobbies and you know, they flip houses or they go sit in a deer stand all day and they just have these interests and I have no interests. I have a lot of kids and grandkids, but as far as just,
Brandy Archie, OTD, OTR/L, CLIPP
Heheheheh
Rusty Fracassa
hobbies and what I will do someday if I'm not working so much and I just I have two master's degrees and a JD and so the Juris Doctorate and and so I really kind of just enjoy learning and studying and reading and so I thought PhD be cool and maybe you know someday if I want to write or speak or maybe be a visiting professor.
A JD PhD is respectable. So I thought, hey, I enjoy it. Let's do it.
Brandy Archie, OTD, OTR/L, CLIPP
So one doctor just wasn't enough. Is that basically what you're telling us?
Rusty Fracassa
I've heard that, yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Hahaha!
Emilia Bourland, OTR, ECHM, CFPS
I think that's so interesting though, like you're talking about how you kind of look around at the other folks around you or people in your life and they have like things that they do for pleasure or fun and you're like, huh, I don't really know what that would be for me. And I can say that because I can totally relate that, relate to what you're saying. You know, like if I didn't have the 100 ,000 things on my plate that I have to do,
do every day for like work and my family and all this other stuff. Like what? I don't know what I would do. Brandy, do you know what you would do?
Brandy Archie, OTD, OTR/L, CLIPP
Sorry, y 'all, I'm not on y 'all team. I know exactly what I would do. I have a ton of hobbies and things that have been pushed to the side because of all of the other 100 ,000 things. So if I answer my own question, I think my interest in, am I interested in visual art?
Emilia Bourland, OTR, ECHM, CFPS
Probably.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
I think impacts my work now because it's a creative outlet that I don't get to use very often, but I use that same creative muscle to come up with solutions for my patients, if that makes sense. And so, you know, I flex that muscle early on in like paint and supplies and canvas and all the things. If you come to my house, you'll see art all over the walls that's random and created by me. But that same kind of thought process goes into how I do my work now, I think.
Emilia Bourland, OTR, ECHM, CFPS
See, I knew Brandy the overachiever.
Brandy Archie, OTD, OTR/L, CLIPP
I mean, I don't know about overachieving, but I just, I, the problem with that is I just have too many things that I like to do, so then there's too much distraction. I'm too easily distracted.
Emilia Bourland, OTR, ECHM, CFPS
I do.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah. Okay, I do have a good story about like something unusual that that happened to me. This is a long time ago now. This is like almost probably like 15 or 16 years ago. But it does like it's not related at all to what I do now, but it is it has informed. I think a lot of the way that I try to live my life in terms of my work, but also other.
relationships and it has informed the way that I, you know, teach my kids about moving through the world. So, okay, so a long time ago when my husband was in the Navy, we had to change duty stations. And when we did that, I lost my job, right? Because I had to leave from where we were and we picked up and we moved across the country and went to a different duty station. So for a while I was on unemployment because I lost my job.
And so I'm like trying to find new jobs and you have to like, you have to, when you're on employment, you have to make good faith effort to actually go find a job. So I was doing that, but where we were, where we'd been stationed, there just, there really just wasn't a lot. And there wasn't a lot that was related to my background or skillset. Like I have an undergrad, this is before I was an OT. So I had an undergraduate degree in psychology and I had spent my time before that working with,
Brandy Archie, OTD, OTR/L, CLIPP
Oh, okay.
Emilia Bourland, OTR, ECHM, CFPS
seriously emotional emotionally disturbed children and doing research for like a big time like PhD at a university where we had been stationed before. So there wasn't, I mean, I'm sure there's probably emotionally disturbed children everywhere, but we won't go down that depressing rabbit hole. But there weren't like job opportunities just all over the place for me. So.
So, but there were positions for parole officers.
Brandy Archie, OTD, OTR/L, CLIPP
You're a P .O.
Emilia Bourland, OTR, ECHM, CFPS
No, no, that's what this story. But I applied. So I like I'm just applying for whatever is available because I have to apply for work. So lo and behold, I get called to an interview to be a PO. And and I'm like, oh, my gosh. And it was like 50 miles away, actually, from where we were living. But the point of the story is I go into this job interview to be a parole officer of all things.
And it's like this big group interview and I really the fact is I do not want this job. I don't want it So I just went in there and I had the most honest interview of my life To that point like they would ask me a question. They'd be like, would you be comfortable with this? And I was just like no
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
I'm
Brandy Archie, OTD, OTR/L, CLIPP
No.
Cause you just gotta tell them that you applied. I applied and then it's sent me.
Emilia Bourland, OTR, ECHM, CFPS
You know, like I'm always my my policy is that honesty is always the best policy in any situation. Like otherwise you just dig yourself down deep into old. So like I play by the rules. I try to be honest about things. But but yeah, so anyway, but I walked out of the interview. I do have a point. And it was like such a freeing experience to just be totally honest about what I wanted and what I didn't want.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Emilia Bourland, OTR, ECHM, CFPS
And for them to also just be like, nope, this isn't a fit. Although I still did have to write an essay portion of my interview after I left. That was weird. I've never had to do that before or since. But so the point is that what I learned from that experience is that it was just so much better to be totally honest about what actually would work for me and what wouldn't work for me so that everyone ended up.
happy in the situation. Because if I had lied, if I had said, oh, yeah, I can absolutely do this just to get this job, I would have been miserable. Probably they wouldn't have been happy with me because I wouldn't have done the best job. And it was just better that way. So that was a really important lesson that I learned early on. Just be honest about what you can do, what you can't do, what your boundaries are, what your needs and your wants are. And I'm going to stop.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
and ask other people to be equally honest with you because that's really the way to make a successful business relationship, friendship, whatever it is. That's what I learned, is it's just about that. And you will never feel tied up or guilty or anything like that if you're just honest about what you need. At least that's been my experience. Anyway, that was a long story.
Brandy Archie, OTD, OTR/L, CLIPP
I think that makes a ton of sense. And I wonder, Rusty, too, if you feel like that leads to the lack of honesty leads to more people into your office. Or that they have longer conversations with you because they haven't been honest with each other about what they want for end of life care, all those kinds of things.
Rusty Fracassa
You know what's funny is, because we deal with older people. One time I was at a seminar and there was this lady there and she had like a doctorate in nutrition and she was really into things and she kept talking about longevity. You do this and you'll live so much longer. You do this and you'll live so much longer.
And so toward the end of the day, she even made statements like, if you eat properly, like you're supposed to, 114 is the estimated age. And I told her, I said, you know, those are the people I usually work with and not 114, but older people. And I said, once you get past 85, it's very seldom do I have people that are wanting to live longer. They're wanting to enjoy while they are.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
are living but quantity is not a benefit to them and that's one of the things that I guess it's the because I was a pastor also here not too many years ago and so you know there's that whole counseling part of it but I get a lot of people that are older that ask the question you know why am I here I don't really need to be here and that is there's because of my
personality, there's a lot of those kind of conversations. I don't know. I find exciting. I feel like those people don't have anybody else to talk to because you know the kids don't ask that question and you know being a parent, I'm probably I'm confident. I'm the oldest parent here because you're you guys are probably close to my kids ages. Your parents aren't going to you know they don't want to burden their kids with.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
you know, their irrelevancy or their fears of irrelevancy. So I think that, yeah, the honesty, you know, I had never really thought about that and I was going to say, oh, no, no, no.
But yeah, I think that's true because we keep that facade of being the provider, the protector, the one with the answers. And then we never really face that transition of life. Very seldom do I see that where people come in.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Emilia Bourland, OTR, ECHM, CFPS
Mm.
Rusty Fracassa
and have faced it. So, you know, at first I thought, well, that's kind of a funny question. But it's like, no, actually, no, that's probably a pretty perceptive question. And it happens often. Yeah, I would have said no initially, but no, I think you're right. I have three appointments today and now, and I've met two of them before. And I think that's a very legitimate question for both of those clients. Yeah, they're not totally honest. I don't want to say they're dishonest, which would be the opposite maybe of honest.
but they have just ignored what would be a legitimate conversation.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
I think sometimes it's hard, sometimes we're not honest with ourselves or we don't really know exactly what it is that we want. And so it's really difficult to have an open conversation if you don't know what you yourself wants or one of the people in the conversation doesn't really know that, which I mean, I think we've all been there sometimes, like I'm not really sure, I don't know.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Rusty Fracassa
That's what I thought of when you said other people being honest with you and I thought, no, I don't know if I want that.
Brandy Archie, OTD, OTR/L, CLIPP
Hahaha!
Rusty Fracassa
Something just kind of has to be in there.
Emilia Bourland, OTR, ECHM, CFPS
Well, honest doesn't mean rude.
Brandy Archie, OTD, OTR/L, CLIPP
I'm sorry.
Brandy Archie, OTD, OTR/L, CLIPP
Oh man, that's funny.
Emilia Bourland, OTR, ECHM, CFPS
So we do have, we kind of almost segwayed into, that was sort of a nice segway into real talk here already, but we did have a question for you kind of more specifically about estate planning that we wanted to get some insight for for our listeners. You know, obviously estate planning can be intimidating, it's complicated, that's why you need a lawyer, a really knowledgeable lawyer to work with and do it.
What are some of the mistakes or misconceptions that people either make or that they have about estate planning, you know, before they come to you?
Rusty Fracassa
Well, that's kind of funny because you already mentioned one of them about it being complicated because it very much is not complicated. I don't know why it has developed or evolved into something that people fear. Um, and they have that attitude because everybody does.
Brandy Archie, OTD, OTR/L, CLIPP
Hmm.
Emilia Bourland, OTR, ECHM, CFPS
Oh.
Rusty Fracassa
The reason to answer one of your questions, one of the mistakes people have when they walk in, one of the first questions I always ask is, well, what would make you want to come see a lawyer? And, you know, most people kind of avoid lawyers. And so, uh, Oh, I'd say nine out of 10 times. They say, well, I want to will because I don't want my kids to go through probate.
Well, when I was a 30 -year -old elder law attorney, it was a lot more difficult than it is now for me. Now that I'm older, people accept my statements much quicker. But what I mean by that is that assets that go through probate are assets that don't avoid probate.
And if you don't have a will, the law in every state already has given you a way for your assets to pass to people. The only reason you need a will is that if you want to change what the law says.
So most people believe a will avoids probate and that's very much the opposite. Yeah, when I said that when I was a young person, it's kind of funny how it was always kind of I had to convince them and now people are like, oh really? The reason why though, so that's number one misconception. The second misconception about being difficult and I just spoke for a hospice the other day training their people.
that it's kind of funny that everything's really in twos or threes. And what I mean by that, if you're, you know, I talk about primarily three things in every appointment, powers of attorney, which I think are very important. I talk about death because it's the only guarantee. And then I talk about asset protection, three things on power of attorney. You either do power of attorneys in advance before incapacity, or there's only one other option. And that's a guardianship.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Hmm?
Rusty Fracassa
through the probate court should you become incapacitated. On death, you have a choice. Your assets are either going to go through probate or they're not. If you're going to avoid probate, you've got two options. You either do a living trust or you put beneficiaries on them.
Joint titling is an option to avoid probate also, but I would recommend that only among, say, longtime married people. You never really want to put, a lot of people want to put a kid on a bank account and stuff, and you don't have to do that. That's what power of attorneys are for. But the reason why nobody will suggest joint ownership is because you're immediately exposing your assets to another person's problems.
and you don't have to. So see, everything's pretty straightforward to do a full estate plan. You talk about incapacity, death, and asset protection. If you talk about incapacity, you either do power of attorneys or you don't, and you know what you're facing. When you die, if you want to avoid probate, you do beneficiaries or you do a trust. And that's it.
Brandy Archie, OTD, OTR/L, CLIPP
So maybe it's not that it's complicated, it's that it's unfamiliar to people. Because you're saying basically that there's only like, there's only a couple bifurcations, only a couple pathways, right? But all of those pathways you said, I understand them because we've talked before and we've done this stuff. But the first time I heard it, it did feel overwhelming because I didn't know any of those words you just said.
Rusty Fracassa
It's a clerk.
Rusty Fracassa
Sorry. Sorry about that.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, I -
Brandy Archie, OTD, OTR/L, CLIPP
But yeah, it's not complicated. It's just that it might be unfamiliar because we haven't experienced or done it yet. And so I think that's a proof point.
Rusty Fracassa
I like that. I think I'm going to start using that phrase unfamiliar because I think that that's far more accurate.
Yeah, because it's not complicated. So that's why I'm confused because I'm using the wrong word. If I use the word unfamiliar, it'd be like, oh, it's kind of like if you started talking to me about occupational therapy, I would be we just year ago had our first medical and I've been married 40 years and we had the first time we had to go to a hospital or had any incident. So when people start talking, it's not that it's complicated. It's just I never had to think about this before.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Exactly. Exactly.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Rusty Fracassa
Yeah, I like that. Thank you.
Emilia Bourland, OTR, ECHM, CFPS
Are there things that people assume are or are not going to happen based on their estate plan that maybe isn't necessarily true? So like an example, and of course it could depend entirely on how the estate plan is written, I'm sure. But so for example, if people have a power of attorney over someone's finances, do you?
That's not the same as having a power of attorney over someone's like healthcare wishes, right?
Rusty Fracassa
Yeah, we like to do too.
separate ones. There are some attorneys, I don't see many of them, but enough to where they combine them. But oftentimes people have a perfect healthcare power of attorney. My wife is for my mother -in -law because we live right here. And my sister -in -law is the financial power of attorney, which is great because she's a CPA and she lives in Colorado. So it would be difficult if we had one power of attorney. And also, you know, the bank doesn't care.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
about things like you know nutrition, hydration, but likewise the hospital doesn't care about things like you know your right to access qualified assets. So two separate ones. Yeah.
Rusty Fracassa
Did that answer your question?
Emilia Bourland, OTR, ECHM, CFPS
I had a question. It did answer my question. I think that, again, it's that unfamiliarity that folks have with saying, okay, well, I've got a power of attorney. That should cover everything, right? But it's about having the right power of attorney for the particular powers that you need to have in different situations. That's what I'm hearing and understanding.
Rusty Fracassa
That's very perceptive of you. Now, the healthcare power of attorney...
I think that most healthcare workers, they don't get into that field without a compassionate heart and they just know that they have to have one and there's not a lot of scrutiny. There are the Terry Shivo and Nancy Cruzanne and some other cases, but those are very much the minority. Most times people are just looking for something out there.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
The other power of attorney, the one that deals with financial matters, which is typically legally referred to as a general power of attorney, that's different. That one is very heavily scrutinized. And you touched on something. I can't remember what you called it, but I recognize what you were saying because my phrase is, I say a good power of attorney.
because a lot of people think, oh, I have a power of attorney. I don't need one. Well, there's three things that I always, three quick qualities I look for for an initial evaluation. And I always like to tell people what I'm looking for because I don't ever want people to think, well, he's just saying I don't have a good one so that he can charge me money to have one.
But these are really honestly, it's like right here. That's not a factor here, but I want people to be able to determine on their own what is a good power of attorney from somebody that's got over 30 years experience of just dealing with them.
The first thing I always look at is size. And the reason I look at size is because most people that you're going to present that power of attorney to, they don't know really anything about the law and they don't know really what they're looking for. They're just kind of looking for what they think they've heard somebody told them. So like the lady at the desk at the bank, you know, maybe she's had some training from someone a few years ago. So she's looking for particular language.
or the person at the insurance company or the person at the utility company. Well, the difficulty is, is that nobody is required to accept a power of attorney. So if those words that they're looking for aren't there, they can just very easily reject it. So the likelihood of it, if you have a three page power of attorney, general power of attorney, then the likelihood of the words not being there that people are looking for is much greater than if you have say a 10 to 20 page power of attorney.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Rusty Fracassa
20 page power of attorney. I've seen them where they go over that, but to me that's also counterproductive because even I don't want to read those. Well, number one, I look at size. Number two, I look to make sure it's immediately effective.
Because it used to be back when I started practicing, you seldom saw those power of attorneys that were immediately effective. But one of the problems we always run into is that if Sammy's my power, or Brandy, sorry, I always want to say ask Sammy. If Brandy wants to.
Brandy Archie, OTD, OTR/L, CLIPP
Everybody does it. It's okay.
Rusty Fracassa
I did. If Brandy's my power of attorney and you know I've had an accident, a stroke, something's happened. Well she needs to access my bank account, she needs to deal with my insurance company. You know life is now, she had a full life before and now she's taken over my life. She needs to get moving. Well the problem is she needs to now contact my doctors and convince them to do some kind of letter.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
Well, contacting the doctors and getting a response for them takes time. To get them to cooperate may or may not occur. So now how long is that going to be before you get what you need to activate the power of attorney? Then you have to send those letters, one or two letters.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
you have to attach them to the power of attorney. So now the utility company, the banks, the insurance companies, they all have very private information of mine. And you know, honestly, Brandy, if I'm listing you as my power of attorney, I ought to trust you enough now.
that I can list you that you're not going to go out and do something wrong prematurely. So number one is size. Number two is immediately effective. And then number three, even though the power of attorney, everybody will say, oh, Brandy can do any and everything for me. Look, the power of attorney says Brandy can do anything I can do. Well, that's true, except for every state that I know of.
actually has a law that says, hey, that's true, except for these things. And in Missouri, there's 12 things, and I didn't count them for Kansas, but in Missouri, there's 12 things that the statute says you cannot do unless I specifically say you can do them.
And for the third step, asset protection, we need some of those things. Now, I don't really know that I care so much about giving Brandy the authority to authorize an autopsy. That's one of the 12. But to change beneficiary designations, to make gifts, to deal with trusts.
Emilia Bourland, OTR, ECHM, CFPS
For the record, I would let Brandy authorize my autopsy.
Brandy Archie, OTD, OTR/L, CLIPP
I appreciate the love of trust.
Rusty Fracassa
Oh.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, no problem. No problem.
Rusty Fracassa
Well, I'm usually more concerned about when a client's alive than when they're dead. But in any case, so when I always say that whenever I talk, I talk in twos or threes. And the three things there are when I'm going to glance at a power of attorney and just say, what's the likelihood that this is going to be something that I would not want to redo, I'll look at, you know, is it eight to 20 pages?
Is it immediately effective and does it contain the necessary language in there that we can later do some asset protection if we need to?
You know, the problem is you ask a lawyer and former pastor questions. And so the difficulty is not getting enough information. How do you stop them from talking? So just give me the book. You know,
Emilia Bourland, OTR, ECHM, CFPS
Now when -
Brandy Archie, OTD, OTR/L, CLIPP
I'm sorry.
Emilia Bourland, OTR, ECHM, CFPS
No, honestly, this is all really, really good. And the way you're presenting it is actually very easy to understand. I think I like the idea of talking about things in twos and threes because people have a tendency, the way our brains and our memories work, we remember things in clumps of twos and threes pretty well. So it's easy to say, oh, OK, so if I'm looking at this, maybe these are the three things that I'm looking for. If I'm speaking with my own attorney, these are the three things that I want to make sure that my attorney is bringing up.
you know, during the conversation. So I think that's a really helpful and manageable way to think about, you know, these unfamiliar kind of issues for folks. I do have a question though about, you know, finding, I think that the other part of having a power attorney or like in your advanced directive, you know, you've got to say who, you know, might be making decisions. I think the thing that's really hard for families is,
choosing who that person is going to be sometimes, that can be a really fraught kind of emotional decision and situation because you might know who you want to choose, but you might have fear based on the family dynamics of how that's going to go or work out or how everyone in the family might react to your choice. Do you help your clients? Do you help kind of like talk your clients through that situation or give them any advice? Not on
who necessarily they should choose, but how they should decide on what person they want.
Rusty Fracassa
You locked up, but I think you're asking me to counsel them on choosing those who... Are you talking about end of life decisions or healthcare decisions?
Emilia Bourland, OTR, ECHM, CFPS
Either. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, why did you separate those actually?
Rusty Fracassa
Well, they probably shouldn't be separated. Here's the issue in dealing with seniors. Usually what I find is the positions.
in a family, everybody has accepted their positions. I accept that my sister will be the caretaker. My sister has accepted that I will be the financial power of attorney and the executor and trustee for my father. Those are pretty well by the time you've lived 50 to 60 years.
They've pretty well set themselves in order. In fact, I'm working with a family right now. There's nine children. And there's mom and dad. They live apart in different cities for legitimate reasons. But everybody plays their part. And there's really no arguing about it.
I think what happened in my own case, I remember when the kids were young and we had people, we were needing to list people that were outside the immediate family. So we were thinking about like friends and family. And the concern there is that's very personal, but it's also putting quite a burden. Like when I was using Brandy as my example, Brandy's got a full life. And now suddenly for her, for me to ask her to take over my life,
That's a huge burden. You gotta have a real special friend for that.
Rusty Fracassa
Then your kids get to a particular age if you're dealing with kids. And the problem is with that is maybe you think they're too young, but you know, if they're over, well, if they're teenagers or above, they think they, you know, have enough competency in life to run things. So it's usually not too much of a dilemma to be honest. I think probably where I find the dilemma, and you guys are getting me to think about things I don't think about too often, but I find the dilemma.
is when you have a number of very solid kids in a very solid family. Unfortunately, that's not the common client, but when you have people, I had somebody yesterday and they had two daughters and they absolutely could not decide between them.
So in any case, because both of them are just stellar and their husbands were stellar. And so, but that's not the most common. I will tell you that on the end of life decisions on the living will or advanced directive, usually, of course, you're going to put the spouse if there is a spouse or there's a lot of times the majority of children is a very common factor.
Usually what happens is what I recommend that the person list and they usually do it on their own, but it is the last person that would pull the plug, so to speak. So for example, my wife is the first one listed. Cause I know that Brandy's talking to my wife saying, Hey, Renee, he's gone. He's not coming back. You know, it's okay to let him go. The hospital is.
other people she's gonna be the last person so that last person is probably the perfect person for nominating but you know what I've come to discover is that those advanced directives aren't really for me they're for my wife they're for Brandy because
Rusty Fracassa
I act as a power of attorney and trustee for a number of people. And so there's been people that I've had to remove life support from. And I remember Paul, it was about.
probably 25, 26 years ago, was the first person I did that for. If I'm acting as your power of attorney, that's a pretty good indication of how you've lived your life, because you have no friends or family. So this attorney is stepping in to do it for you. And so there I was with Paul and nobody's looking over my shoulder, absolutely no friends, no family at all, but.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
when the hospice worker is talking to me about removing life support, that's on a human being. And that was a big deal. And I realized at that point, oh, when he wrote that advance directive, that was not for him. That was for me. That kind of gave me comfort to do.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm.
Rusty Fracassa
what I thought was the right thing to do. And he thought I was the kind of person that he would trust my judgment. But that's what really took me over the edge in enabling me to make the right decision or a good decision was the peace of mind knowing that that's what he wanted when he got into this condition.
Brandy Archie, OTD, OTR/L, CLIPP
I think that's such an important point because like, that's who's dealing with it, right? It's the person who's sick or having a hard time, they're not dealing with it. That's why you have to deal with it, right? If we're dealing with the power of attorney. And if this is somebody you like or love and you want the best for them, and it's so much easier if they've already told you what that is. And that way, and there's also like less fighting involved.
with everybody else. And you know, I've been able to see this play out in other people's lives and watch how it impacts family dynamics and things. And if it's not clearly written out, then there's lots of room for opinions, if that makes sense. And when you clearly identify it, then all we have to do is say.
look, this is what mom wanted, this is what Auntie wanted, she wrote it down here. And then that's the end of it, it silences that. We might not like it, but that's not for us to choose because this is her life or his life. And then that can just squash that instead of it billowing up into like a big problem.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, it's such it's honestly it's like a great kindness for the people that you love that you're leaving behind when you pass away to make sure that you have that clearly communicated and frankly that the rest of your affairs are in order. I think that's something that my dad taught me, you know, relatively early in life after my grandfather passed away and my grandfather had gotten everything in order and my dad knew exactly what to do. So after.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
after my grandfather passed away and it made it so easy for him. And he always has like really clearly communicated that to me and my brothers and sister that like, this is something that you do for your family so that when they are already dealing with the grief of having lost you, there's not more complicated things that they have to talk about. I also think though like,
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
kind of going back to the idea of an advanced directive, I think it's really important to have discussions about things like quality of life and what quality of life means to you, because there are things that an advanced directive cannot capture. You know, life and end of life, like that can actually be really messy sometimes.
And it's not always clear cut on a page, right? So having a discussion with family about quality of life and those wishes along with the advance directive, I think is something that's important to do. Do you agree with that, Rusty? Or do you think that takes people down a labyrinth of pathways that just gets overcomplicated?
Rusty Fracassa
You cut out on part of that. Could you give me a quick?
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah. So I was basically just saying that, that, you know, in my own experience, things that are, you can't lay out every possible scenario on an advanced directive. It's just not possible because there are so many ways that things might go down kind of medically. So, you know, I always think that it's important to have conversations about quality of life and what kind of quality of life someone wants to have as well. And I was asking,
Does that, do you also advocate for those kinds of conversations or do you think that overcomplicates it for people?
Rusty Fracassa
Um, usually what happens is the person, the person or people that you're listening to be in this position are the ones that know you best or you trust their judgment the best. They've spent the most time with you. These questions or topics or.
somewhat like these have come up in life. And so I think they just kind of naturally know. And even if I might differ, if I'm laying there on the bed and I might differ a little bit from what say my wife is deciding my trust in her and my faith in her.
would if I was competent, which of course I wouldn't be probably at that time, but that I would trust in her. What I typically will say to people is don't pay as much attention to what I have written in the power of attorney or living will as you do the person you're nominating. Because no matter how great a power of attorney I write,
If you have the wrong person, they're going to do the wrong thing.
If I write a very poor power of attorney, but yet you've nominated the right people, they will end up doing the right thing. My job is to make that right person's job easier. So for example, in the financial power of attorney, I want to make sure that they're not going to have to go to the bank three times to get it accepted. And they're not going to have to argue with the insurance company. I want to make sure that if they go to the hospital that, you know, some
Brandy Archie, OTD, OTR/L, CLIPP
Hmm.
Rusty Fracassa
some nurse is not uncomfortable with the way this document looks. I just want my daughter, for example, if she's the one that's acting, I want her to be able to make a decision and concentrate on the situation and not concentrate on dealing with some bureaucracy at a bank or with a doctor.
So no, I usually pay far more attention to the person you're nominating than I do what the documents specifically say.
Rusty Fracassa
You're quiet. Did that throw you?
Emilia Bourland, OTR, ECHM, CFPS
No, I think Brandy and I just didn't want to step on each other there. No, I think, yeah, that's, I think that's a great takeaway and probably a good way, place to kind of wrap up the conversation here. Rusty, is there anything, any last parting words that you would want, any last parting words of wisdom that you would want to deliver to listeners of CareLab?
Rusty Fracassa
Thank you.
Brandy Archie, OTD, OTR/L, CLIPP
Great.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Rusty Fracassa
Actually, I always end any presentations or even when I'm talking to people with a story that whenever, like sometimes I'll be somewhere out and people will say, hey, I need to come and see you. What do I need to bring with me? And I'll say, you don't need to bring anything initially. All I need is the answer to two questions. So these two questions would be good for a listener if they're going to go speak with.
legal counsel and that is you need to know who's in charge when you can't be and who gets what.
who's in charge includes any successors. Because if my wife and I list each other first and we're in an accident, well, if she's incapacitated, the moment I start acting on her behalf, I have lost my first choice because she can't do it for me. So it's good to have a couple after that. So I always talk to people about thinking prior to our conversation, who is in charge when you can't be and who is to get what.
Emilia Bourland, OTR, ECHM, CFPS
Mm -hmm.
Rusty Fracassa
And then the second thing I always talk to people about is using the attorney that they work with. And there's kind of two things, two criteria that I pay attention to. Number one, I guess, because I've gotten older, it's an important one, is experience. That's the one nice thing about having worked really with just seniors is I've not just done the planning. I've been on the other side for.
an enormous number of clients. They've gone into the nursing home, they've become incapacitated, they've died, and we've seen their plans go full circle. So it's a lot of that. Why do you put, I get the questions, well, why do you put that in the document or why are you asking me that question? Well, it's because I've been on the other side enough to know that's gonna be important. So experienced attorney is number one. Well, I wouldn't say it's number one, but it's important.
Brandy Archie, OTD, OTR/L, CLIPP
Mm -hmm. Mm -hmm.
Rusty Fracassa
And the second one is somebody that you trust and is like -minded. Now, usually because I'm dealing with seniors, they usually have developed a great sense of discernment. You know, can't baloney older people too much and kind of like, you know, a three -year -old, they know the kind of person you are. Well, guess what? An 80 -year -old can tell pretty quickly also what kind of person you are.
And so I would say that, you know, if you're comfortable with a person, if you're being honest, Amelia, like you talked about, if somebody's honest and they're comfortable with the attorney and with that attorney clearly has experience in the area, then I'm sure that's going to be a very good choice.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Rusty Fracassa
So that's it, just who's in charge and who gets what and look for somebody who is experienced and that you're comfortable with.
Brandy Archie, OTD, OTR/L, CLIPP
Simple Nuggets to take with us. I appreciate you so much for coming on the podcast and sharing all your wisdom.
Rusty Fracassa
Well, thank you for the opportunity. Looking forward to your other podcasts.
Emilia Bourland, OTR, ECHM, CFPS
Yes, thank you so much, Rusty.
Emilia Bourland, OTR, ECHM, CFPS
Listen y 'all if you enjoyed this episode of the care lab podcast, please make sure that you are subscribing Make sure that you're sharing it with others who might also benefit from listening to the podcast or who might enjoy it And make sure that you are liking it as well And that will all help to make it so that next time we release an episode you will get notified right away So you can check it out?
Thank you all for being here. Thanks, Brandy. Thanks, Rusty. Thanks, listeners. And we'll see you next time on the Care Lab Podcast.
Brandy Archie, OTD, OTR/L, CLIPP
Next time, thanks.
Rusty Fracassa
Thank
Do us a favor and subscribe to the CareLab podcast on YouTube, Spotify or Apple Podcasts! It will help others find our conversations and grow the community and you’ll stay updated with the latest insights and expert advice on elder care.
