If you have a chronic illness, your personal planning will need to involve careful consideration of your condition. Many Americans experience ALS disease, Alzheimer's, Huntington's disease, Parkinson's disease, multiple sclerosis (MS) or other types of chronic diseases.

If you or a loved one has one of these conditions, it is important to communicate with your attorney and other advisors about your condition. There are specific planning options both during life and for your testamentary plan that should be considered.

ALS (Lou Gehrig's disease) is a disease that progressively affects a person's ability to control muscle movement. Symptoms include muscle twitching and cramping. Most ALS victims will eventually need a ventilator for breathing, but often will be quite clear-headed during their lifetime.

Alzheimer's is a disease with a progressive reduction in mental capacity. Mild Alzheimer's may be identified by memory lapse and forgetfulness. As Alzheimer's progresses, the individual begins to lose speech facility, forgets to follow normal personal cleanliness habits and loses control. Often, the Alzheimer's sufferer eventually loses the ability to recognize family members and other loved ones.

Huntington's disease is an inherited disorder. The person with Huntington's disease may have great difficulty with coordination and eventually will suffer from dementia and require full-time care.

Parkinson's disease is a disorder of the nervous system. It can lead to progressive deterioration of both the physical body and mental capabilities. Because there is great variation with the disease, some individuals with treatment are able to live reasonably long lives.

Multiple sclerosis (MS) is also a disorder of the nervous system. There is progressive damage to nerve fibers that leads to physical and mental disability. MS may be fairly moderate at first but tends to lead to attacks that can cause progressive deterioration. MS may range from fairly mild to quite severe and very debilitating.

These five and other chronic diseases are all unique and different. Some afflict the body and others reduce the capabilities of the mind. For example, Alzheimer's has greater impact on mental ability, while ALS victims are often suffering in body but may be quite clear in mind.

Your attorney and other advisors need to understand the conditions sufficiently well so that your documents and plans reflect your particular circumstance.

The principal documents for any chronic illness are a durable power of attorney for healthcare, a living will and a HIPAA release. In many states, the durable power of attorney for healthcare and living will are combined into one document described as an advance directive.

Durable Power of Attorney for Healthcare

If you have a chronic illness, particularly one that leads to loss of mental capacity, it is very important to have a designated person who can make medical decisions for you. In the event that you are unable to reason or communicate, your designated advisor must discuss your medical care with doctors and hospital staff.

A durable power of attorney for healthcare allows you to designate a trusted person to speak to the doctors on your behalf. This power in some states is a separate document. In others, it is the first portion of an advance directive. Many states refer to the person holding the durable power of attorney as your "healthcare proxy."

Regardless of the form of the document or the name of your agent, this person is qualified to make your medical decisions if required.

Whom Should You Appoint?

For a person with a chronic illness, this can be a challenging decision. You would like to select someone who understands your medical condition and your preferences about care. This could be a family member or friend.

Adult children are often selected, but may experience great emotional trauma in making an end-of-life decision. A friend may be a good choice if you do not have a child who feels willing or emotionally capable of making those decisions.

Generally, you will select a healthcare proxy agent and a successor. It is usually best not to select two persons as your proxy agent—they might disagree at a critical time while you are in need of an immediate decision.

Living Will

A person with chronic illness needs both a healthcare proxy agent and a living will. Your healthcare proxy agent can make decisions regarding your care, even if you are not near death. The function of the living will is to describe your preferences for care if you are potentially in your last weeks or days of life.

The advance of medical science has enabled doctors to keep people alive for extended periods of time, even if there is virtually no possibility of recovery. If you are in this circumstance, your living will provides guidance to your doctors.

For example, the living will can discuss whether or not heroic measures will be taken to sustain your life. If you have an irreversible condition with no chance of recovery, the living will also specifies whether nutrition and hydration will be maintained.

If you suffer from one of the chronic illnesses that affects mental capacity, it may be important for you to sign your living will before your mental health deteriorates. Many Alzheimer's patients and other individuals with great mental deterioration are no longer capable of signing a living will.

Health Insurance Portability and Accountability Act (HIPAA)

In 1996, Congress passed the Health Insurance Portability and Accountability Act. HIPAA was designed to protect your rights to medical information. Your doctor and other medical providers will frequently acquire extensive background information and treatment information for your chronic illness. Under the HIPAA rules, there are safeguards to protect your personal medical information. A doctor, medical center or other provider may not disclose this information, particularly to someone who will use it for marketing or similar purposes.

However, you may wish to have your medical information released to your professional advisors so they can make appropriate decisions for you. In order to receive this information, your healthcare proxy must have a formal release from you.

The HIPAA release, which will be in writing, should describe the type of health information that may be released to the person. It may provide a general list of medical centers or providers or could have an open-ended release for any hospital or medical provider and may include a termination date. After you sign your HIPAA release, you can always revoke that release and sign a new one.

Many states have specific forms for advance directives, living wills or durable powers of attorney for healthcare. You will want to be certain that you have signed the correct form for your state.

Can you tell me what I need to do to replace a variety of important documents? Our house burned down a few months ago and we lost everything including our home property deed, car titles, old tax returns, Social Security, Medicare and vaccination records, birth certificates, marriage license and passports.

I am very sorry for your loss, but you will be relieved to know that replacing important documents that are destroyed, lost or stolen is pretty easy once you know where to turn. Here are the replacement resources for each document you mentioned.

Birth certificates: If you were born in the United States, contact the vital records office in the state where you were born. See CDC.gov/nchs/w2w/index.htm for contact information. This office will give you specific instructions on what you need to do to order a certified copy. Usually, the cost is between $10 and $30 for a certified copy.

Car titles: Most states offer replacements through a local department of motor vehicles office. You will need to complete a replacement title application form and pay the application fee, which varies by state. You will also need to show ID and proof that you own the car, such as your vehicle registration or your license plate number and vehicle identification number (VIN). Contact your state department of motor vehicles to get an application.

Property deed: To access your house deed, contact your county clerk's office, where deeds are usually recorded. You may be charged a small fee to get a copy.

Marriage certificate: Contact the vital records office of the state you were married in to order a copy (see CDC.gov/nchs/w2w/index.htm). You will need to provide full names for you and your spouse, the date of your wedding and the city or town where the wedding was performed. Fees range from $10 to $30, and you may be required to prove you are authorized to receive a certified copy.

Social Security cards: In most states (except in Alabama, Minnesota, Nevada, New Hampshire, Oklahoma and West Virginia), you can request a replacement Social Security card online for free at SSA.gov/myaccount.

If you live in a state where the online service is not available, you will need to fill out form SS-5 (visit SSA.gov/forms/ss-5.pdf to print a copy) and take it in or mail it to your nearby Social Security office along with any evidentiary documents that are listed on this form. For more information or to locate the Social Security office that serves your area, call 800-772-1213 or see SSA.gov/locator.

Medicare cards: If you are enrolled in original Medicare, you can replace a lost or damaged Medicare card by calling Medicare at 800-633-4227 or by logging into your MyMedicare.gov account. If you get Medicare health or drug benefits from a Medicare Advantage Plan, such as an HMO, PPO or PDP, you will need to call your plan to get your card replaced.

Vaccination records: Your first step is to go back to your doctor's office or vaccination site and see if they have copies of the records you need. If you are visiting a site, bring an ID and try to recall any dates when you were vaccinated. If that is not feasible, contact your state health department immunization information system (visit CDC.gov/vaccines/programs/iis/contacts-locate-records.html) where you may be able to print out replacements.

Tax returns: To get copies of old tax returns, start with your tax preparer. Professionals usually keep copies of client returns on file for a few years. You can also get copies of federal returns directly from the Internal Revenue Service. You will need to fill out and mail in IRS form 4506. Call 800-829-3676 and ask them to mail you a copy or download the form at IRS.gov/pub/irs-pdf/f4506.pdf. The cost is $43 for each return requested. You may be able to request state tax returns, availability may vary.

Passports: You can apply for a replacement passport at a Passport Application Acceptance Facility. Many post offices, public libraries and local government offices serve as such facilities. You can search for the nearest authorized facility at Iafdb.travel.state.gov. The fee is $145.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Planning for retirement and senior care is very important. The activities of daily living for a senior person include eating, dressing, bathing and walking or moving. At some point, every senior will likely need assistance in one or more of these areas.

An important consideration will be the cost of providing that care. By retirement, it is helpful for you to own your home, be debt free, and have retirement income and savings. Retirement income will frequently include Social Security, your IRA or 401(k), a pension plan and investment earnings.

Typically, there are four different levels of care utilized by seniors. The first level includes "in-home care" which includes moderate assistance with certain living functions, such as meal delivery. In-home care often eventually progresses to "home healthcare," defined as assistance with the activities of daily living by a home healthcare aide or nurse. The next level is a more formal assisted living or independent living facility. In an assisted living facility, there are more staff and a higher level of assistance. Finally, the fourth level is skilled nursing care. This is 24-hour nursing care in a facility that is designed to provide a higher level of medical assistance.

Independent Home Care

Independent home care is popular for several reasons. First, it is the least expensive of the four levels of care. Independent home care, or "home care" typically provides a senior with assistance for one or more life functions that does not include healthcare.

With home care, seniors are able to live independently in their home. Seniors with home care might, for example, benefit from a program that delivers a daily meal to their home. If they are not able to maintain their driver's license, they might also participate in a ride-sharing program once or twice per week so they can go to the store to buy certain essentials.

There are a number of local charities that provide services to assist with home care and outreach services. In addition, friends and family can create a schedule to provide assistance to their senior loved one.

Finally, home care very often includes a home monitoring system that allows seniors to contact the monitoring service if they are injured. This service might also require seniors to check in at the same time every morning when an alert sounds so that the monitoring service can contact a relative who lives nearby if the senior does not respond.

Home Healthcare

The next level of care, home healthcare, involves a greater degree of assistance to seniors and includes healthcare services that are provided in the senior's home. Home healthcare will vary significantly depending on the level of services provided. However, it frequently will cost from $10,000 to $30,000 per year.

Home healthcare is preferred to assisted living or nursing home care because the person receiving care will be able to maintain his or her independence. While the cost is generally reasonable, there are many organizations and providers who can give you good quality care. A key decision for home healthcare is the person who will be the caregiver. Family is often the first option. If you have a child or other relative who is willing to provide assistance, you may be able to live quite comfortably in a family home or perhaps in an attached apartment.

The next level will frequently be a service provider such as a home healthcare aide. The aides visit on a regular basis and provide assistance. Many individuals are able to manage well by themselves as long as they have a home healthcare aide who makes regular visits.

A third level of home healthcare may involve visits by a practical nurse or registered nurse. The nurse may assist you with various types of care and check to see that you are using your medications or other types of therapy in a beneficial manner.

There are safeguards that should be carefully considered for home healthcare. The organizations that provide home healthcare are generally licensed by each state. You can check into their certification and also their reputation. It's also helpful to have a family member who is in regular contact with the senior person who is receiving home healthcare.

As you age and become more senior, it may be appropriate for you to stop driving and to depend on others for transportation. In addition, the family protector can watch to see that you do not make inappropriate expenditures or become vulnerable to any type of abuse.

Independent or Assisted Living

The next level of care is independent or assisted living which typically has a cost of $40,000 to $65,000 per year.

Many facilities provide both independent and assisted living. Independent living permits the individual to live in a residential facility, but to have a reasonably high level of control of his or her life. With independent living, the person will live in his or her own apartment or small residence and frequently retains a vehicle and the ability to drive. Independent living often offers a meals plan so that the resident can choose to eat in a common dining area.

Assisted living occurs in a more structured residence with a higher level of staff services. The assisted living facility will involve staff who regularly assist residents with the activities of daily living.

Long-term Care

Long-term care includes several levels of care. The two most common levels are skilled nursing and intermediate care. Skilled nursing will provide around-the-clock care from a licensed practical nurse or registered nurse. The cost of skilled nursing care may be $90,000 to $110,000 per year.

Intermediate care facilities also are intended to care for residents that have chronic illnesses or impairments of health. These facilities offer 24-hour staff care. However, they will not always have a registered nurse and may use vocational or practical nurse staff.

It is extremely important with long-term care to examine the facility. Is the facility owned and managed by a for-profit or a nonprofit? What is the affiliation of the organization?

A person may be in a skilled nursing home for several years. Because the costs are very significant, the financial strength of the organization is quite important. If the organization at some point in the future has a financial shortfall, it may find it necessary to reduce services. This could have great impact on the care of a senior person.

Other areas to consider are the facility and the services. What is the location of the facility? You should review the cleanliness of the rooms and the public areas and try to determine the general feelings of current residents toward the facility. Many care facilities offer a number of different types of services. Some of these are social or recreational while others are therapeutic and health related.

Finally, how are the levels of staffing and the food service for the facility? A good facility will have a caring and adequate staff and food service team for the number of residents.

Alzheimer's Care

Alzheimer's is a challenging disease because it leads progressively to very high care requirements. Because of the staff and facility requirements, Alzheimer's care can cost $100,000 or more per year.

There are three general levels of Alzheimer's. Early-stage Alzheimer's involves some short-term memory loss, difficulties with routine tasks and mood swings. Middle-stage Alzheimer's patients may start to show confusion about time and place, loss of memory and wandering. With late-stage Alzheimer's, there is a loss of cognitive function and eventual physical deterioration.

Home care is possible for early-stage Alzheimer's. A family member can provide the level of care needed. It is important that the caregiver understands the risks and takes protective actions to minimize the potential for the senior person to wander off and become lost.

The next level of care is an organized senior residence with a measure of independence. This will provide available 24-hour care, but still enables an early or middle-stage Alzheimer's patient to have some level of control of his or her activities.

Finally, for advanced stages of Alzheimer's, the senior person will need 24-hour residential care. Family members should examine the rooms, consider the staffing levels and review the policies regarding medication for those Alzheimer's patients.

How does Medicare cover in-home health care? My husband has a chronic health condition that makes it very difficult for him to leave the house, so I am wondering if he could qualify for Medicare home health care.

Medicare covers a wide variety of part-time or intermittent in-home health care services to beneficiaries in need, if they meet Medicare's criteria. Here is how it works:

In order for your husband to secure coverage for home health care, Medicare first requires that he be homebound. This means that it must be extremely difficult for him to leave home and that he needs help doing so either from another person or with the assistance of a medical device like a cane, wheelchair, walker or crutches.

He will need to have a face-to-face meeting with his doctor to get a home health certification confirming that he needs skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis.

His doctor can also request the services of an occupational therapist and a personal care aide to assist with activities of daily living such as bathing, dressing and using the bathroom. His doctor must renew and certify his home health plan every 60 days.

Your husband will also need to use a home health agency that is certified by Medicare. If he meets all of the requirements, Medicare should pay for his in-home health care.

Be aware that Medicare will not pay for personal care aide services (for bathing, dressing, using the bathroom, etc.), if he does not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either.

If your husband has original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting Medicare.gov/care-compare. If he has a Medicare Advantage plan, you should contact his plan directly and ask which home health agencies work with the plan and are within the plan's network of providers.

For more detailed information on how Medicare covers in-home health, see the "Medicare and Home Health Care" online booklet at Medicare.gov/Pubs/pdf/10969-Medicare-and-Home-Health-Care.pdf.

Other Options

If your husband does not qualify for Medicare home health care coverage, there are other coverage options depending on your situation. Here are several that may apply to you:

Insurance: If you have long-term care insurance, check to see if it covers in-home care. If you have a life insurance policy, see if it covers pay for care.

Medicaid: If your income is low, your husband may qualify for Medicaid, which offers different home and community-based services that can pay for in-home care. To investigate this, contact your local Medicaid office.

Also see if Programs of All-Inclusive Care for the Elderly (PACE) is available in your area at Benefits.va.gov/benefits/offices.asp. PACE provides in-home care, including help with activities of daily living, such as meals. PACE also provides dental and medical care, among other benefits.

Veterans Benefits: If your husband is a veteran, the Department of Veterans Affairs (VA) offers some benefits that can help. Two programs to inquire about are "Aid and Attendance or Housebound Allowances" and the "Veteran-Directed Care" program. Both programs provide monthly financial benefits to eligible veterans that can help pay for in-home care. To learn more, contact your regional VA benefit office (see Benefits.va.gov/benefits/offices.asp or call 800–827–1000).

To search for additional programs in your area that can help pay for your husband's home care, use your favorite search engine. You may want to search phrases such as, "paying for senior care", "find financial assistance for in-home care" and "eldercare financial assistance locator."

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

If at some point in life you have a serious illness, there are a number of planning options that should be considered.

With a serious illness, there are emotional, physical and mental challenges. The illness may be primarily physical, but the person will eventually start to suffer discouragement and even depression. His or her mental capabilities may also start to fail due to deterioration of the body.

Given these serious issues, it is important to consider the care of the person, care of his or her property, financial decisions, potential actions and securing assistance from advisors and family.

Care of the Person

There are several areas that are important in thinking through care of the person. You should check to make sure you have a current durable power of attorney for healthcare or advance directive. This document needs to be shared with the person who is designated as your healthcare proxy. A serious illness could lead to your hospitalization and a need for the healthcare proxy to make important medical decisions.

There also are potential physical changes for a home or a vehicle. If you have an illness but can operate a motorized wheelchair, it may be appropriate to modify or remodel your home to make it handicap accessible. Similarly, you may suffer from a major illness but are still capable of driving. However, it may be necessary to obtain or modify a vehicle so that you can still drive.

A primary concern for the ill person is, "Who will be my caregiver?" Initially, the seriously ill person may stay at home and a family member may be caregiver. However, he or she should have a plan in place in case it becomes necessary to move to assisted living, a nursing home or even a hospital.

Care of Your Property

If you have a serious illness, it will be important to have either a person who has a power of attorney to manage your property or a revocable living trust. With a revocable living trust, your property is transferred by deed or other document to the trustee. While you may be the initial trustee, your trust also lists a successor trustee to take over if you are no longer able to manage property. With a serious illness, you may wish to resign and have the successor trustee take over while you still have the ability to offer advice and counsel.

If you have a home with valuable art or other valuable collections, it will be important to prepare for management of your property. At any time in the future, you may need to move to nursing care or the hospital. Valuable property will need to be protected and preserved for your estate beneficiaries.

With a serious illness, it is a good time to review your will and all trusts. If you have a trust, you should make certain that the title and ownership of property is correct. The trust is effective only if property is legally transferred to the trustee. Similarly, some individuals hold property as joint tenants with right of survivorship with other family members. If this is the case and you pass away, the surviving family member will own the property outright. If that is your intention, this method is fine. However, you should check all titles to make sure that they are correct for the plan that you have created.

Financial Accounts

You may have bank accounts, securities accounts and other business accounts. Check to be certain that all of the accounts are listed on your financial records. If you have online access to the accounts, a trusted advisor should know all of the passwords. If you are in the hospital or nursing home, your advisor will need access to your accounts.

Potential Actions

You may have a current pattern of gifts to family or gifts to charity. If you wish to have your successor trustee or the person holding your power of attorney continue that gifting pattern, there will need to be a specific direction in your living trust or power of attorney to achieve that result.

In some states, there could be very significant income and estate taxes. Even though you have a serious illness, it may be worth considering changing your domicile to a state with a lower tax structure. This will require that you establish a new residence, change your driver's license and auto registration, file your income taxes and show that you are a permanent resident of the new state.

Advisors and Family

Particularly if you have a substantial estate and are quite ill, it is important to make sure that you have reliable and trustworthy advisors. Far too many elders who have substantial assets become weak and are victims of elder abuse. A group of trusted advisors and family members will protect you and your property.

Your advisors will discuss your vehicle use. There are several cases where seniors felt able to drive vehicles, but were progressively less capable. One individual in her 80s drove regularly to visit her daughter just one mile away. However, one day she made a wrong turn and became disoriented. A day and a half later, the highway patrol discovered the car idling at the side of the road several hundred miles away. Fortunately, she did not become lost during the winter or she very easily could have frozen to death before being discovered.

Advisors and family members will need to discuss with the seriously ill person the arrangements for transportation and the possibility of higher levels of care. This could mean moving from home into an assisted living facility or nursing home. These discussions are best undertaken while the seriously ill person is still able to think clearly and make good decisions.

Planning with a serious illness is a challenging process. Yet it is much better for the person and for the protection of the estate that the process is entered into openly and willingly by the individual and his or her advisors and family.

What types of financial or legal snags should I be aware of when considering remarriage? I am 62 years old and have been seeing a nice man for about a year. We have been talking about getting married, but I want to make sure I understand all the possible consequences beforehand.

Getting remarried later in life can bring about a host of financial and legal issues that are much more complicated than they are for younger couples just starting out. Here are some common problem areas you need to think about, and some tips that can help you solve them.

Estate plan: Getting remarried can have a big impact on your estate plan. Even if your will leaves everything to your kids, in most states, spouses are automatically entitled to a share of your estate – usually one-third to one-half. If you do not want to leave a third or more of your assets to your new partner, choose to have an attorney draft a prenuptial agreement where you both agree not to take anything from the other's estate. If you want to leave something to your spouse and ensure your heirs receive their inheritance, you may consider speaking with an attorney to set up a trust.

Medical and long-term care: As a married couple, you and your spouse will be responsible for each other's medical and long-term care bills. Remaining unmarried will not impact your eligibility for public benefits, such as Medicaid (which pays nursing home costs). If you choose to remarry and can afford it, consider getting a long-term care insurance policy to protect your assets. See AALTCI.org to help you find one.

Home: If you are planning on living in your house, you need to think about what will happen to the house when you pass away. For example, if you both decide to live in your home, but you want your kids to inherit the place, putting the house in both of your names is not a wise option. However, you may also not want your heirs to evict your husband once you die. One solution is for you to give him a life estate. This will allow your husband the right to live on your property during his lifetime. Once he dies, the house will pass to your heirs.

Social Security: Getting remarried can also affect your Social Security benefits if you are divorced, widowed or are receiving SSI. For instance, getting remarried makes you ineligible for divorced spouse's benefits. Getting remarried before age 60 (50 if you are disabled) will cause widows and widowers to lose their right to survivor's benefits from their former spouse. For more information, see SSA.gov.

Pension benefits: Be aware that if you are receiving a survivor's annuity from a public employee's pension, getting remarried may cause you to lose it. In addition, widows and widowers of military personnel killed in the line of duty may lose their benefits if they remarry before age 57. Survivors of federal civil servants that receive a pension will forfeit it if they remarry before age 55.

Alimony: If you are receiving alimony from an ex-spouse, it will almost certainly end if you remarry.

College aid: If you have any children in college receiving financial aid, getting married and adding a new spouse's income to the family could affect your children's financial aid.

To get help with these issues, consider hiring an estate planning attorney who can draw up a plan to protect both you and your partner's interests.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

As you approach end-of-life decisions, there are several steps that should be taken to make sure you receive the right type and level of care. To assist you in these decisions, most states now permit either an advance directive or a living will. Some seriously-ill persons also have a doctor sign a Physician Order for Life-Sustaining Treatment (POLST). These documents are designed to assist your family and doctors in making the decisions according to your preferences.

Senior Medical Planning

There are three important background areas that you should learn about before entering into senior medical care. These are the medical oath and principles of your care providers, the rules created by Congress to ensure your medical information is protected and the decisions by your state on the specific document that you use to convey your wishes.

Doctors will frequently follow a set of principles that were originally called the Hippocratic Oath. The first oath was written by Hippocrates, a Greek doctor who is considered the father of modern medicine.

A modern version of the Hippocratic Oath typically states, "To practice and prescribe to the best of my ability for the good of my patients." Following this principle, your doctor will attempt to restore you to good health.

Because of modern improvements in medicine, it is possible to prolong your life through the use of ventilators, intravenous feeding and other devices. While you certainly want your doctors and nurses to provide very good care, you may also need to offer some guidance on how extensively your family and doctors should use modern technology to prolong your life.

A second major area for you to understand is called HIPAA. The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996. It is designed to provide protection for you and to keep your health information private.

Under the HIPAA rules, you have the right to see your health records, but you must give written permission before your records are released to other individuals. The information provided by doctors or nurses about your care, medications or other personal information is protected. However, you will want to be certain that your designated healthcare proxy (the person who will assist in making healthcare decisions) has the right to review these records. You should sign a HIPAA release form in order to enable your advisors to give proper recommendations to your doctors and nurses.

Finally, you must understand the specific documents of your state. Some states use an advance directive in which you choose a combination of a durable power of attorney for healthcare and a living will. Other states have separate documents. It is very important that you use the appropriate document tailored for the laws of your state.

The Advance Directive

Your first key advisor is the person who will make your medical decisions if you are incapacitated. This individual is frequently called the healthcare proxy. He or she is your agent and holds your durable power of attorney for healthcare. Normally, you will select primary and secondary persons as your healthcare proxy agent.

You will want to list the persons, their addresses and phone numbers so they can be easily contacted. Your secondary healthcare proxy will assume the primary role if the first person is unable or unwilling to serve.

Part of your advance directive will also explain the level of authority that you have given. Your healthcare proxy usually does not have the authority to make decisions unless, in the view of your doctor, you are no longer able to make decisions yourself. However, many forms allow you to sign and empower that person immediately. The authority of your healthcare proxy may also extend after you pass away so that he or she can make appropriate decisions at that time.

Your healthcare proxy may be called upon to make significant decisions for your care. For example, it may be necessary to decide whether or not to use morphine or other types of pain medication. If the decision is to make use of morphine, then a second decision will be made on the use of a low dose or a high dose. With a lower dose of morphine or other types of pain medication, you may have greater clarity of mind but may be less comfortable. If you receive higher doses of medication, you may not be as clear-headed, even though you are at a higher comfort level. These decisions can only be made based on your condition at a given time, but they do directly impact the quality of your life in that circumstance.

A healthcare proxy may also be called upon to make very significant decisions about the hospital, nursing home or other care facility and the level of treatment. For example, some seniors have suffered broken hips or limbs at a time when their demise was near. A healthcare proxy will need to make decisions about the appropriate level of care or treatment under those circumstances.

A second section of an advance directive allows you to give counsel on the level of measures and technology that will be used to prolong your life. If you have an incurable or irreversible condition that will result in your death within a relatively short time, there are medical devices that can significantly prolong your life.

These are sometimes referred to as "heroic measures." If you desire all reasonable measures to be taken, you can generally request that care. If you do so, your life may be extended to the greatest extent possible under "generally accepted healthcare standards."

Your healthcare guidelines expressed in your advance directive will discuss your preferred level of nutrition and hydration. If you prefer to receive nutrition and hydration through intravenous methods, you may specifically request those options.

It is helpful for medical providers to have some level of direction for your pain management. If you prefer a higher level of pain management even though that gives you less clarity of thought, you may so indicate.

A third, fairly typical section of the advance directive covers donation of organs and designation of your primary doctor. If you would like to donate specific organs or designate specific purposes for the use of your body, you may identify the particular organs or discuss purposes. Common purposes include transplantation, therapy, research and education.

Advance directives and living wills may, under state law, be witnessed in a manner similar to the witnessing of your will. Some states require two witnesses or a notary to witness your advance directive. Check with your state law to make certain that you have complied with those requirements. A helpful website with state law requirements is caringinfo.org. It is maintained by the National Hospice and Palliative Care Organization and seeks to improve care at the end of life.

Physician Orders for Life-Sustaining Treatment (POLST)

A Physician Order for Life-Sustaining Treatment (POLST) is a medical order signed by your doctor or a medical staff person as authorized under your state law. While the name and provisions may be different in some states, the POLST option is generally available nationwide. If you have a serious illness or may pass away within one year, you may want to ask your doctor to sign this medical order.

The POLST typically covers cardiopulmonary resuscitation (CPR), medical interventions and nutrition. You may choose to have CPR or select "Do Not Resuscitate (DNR)." Your medical interventions may include full treatment to prolong your life, selective treatment that avoids burdensome procedures or comfort-focused treatment. Nutrition can be maintained long-term with feeding tubes, for a trial period or you may select no artificial means of nutrition.

All of these decisions should be made in consultation with your doctor. Both your doctor and you or your healthcare proxy must sign the POLST. Your POLST may reflect your values, religious beliefs and goals for care.

Even if you have a POLST signed by your healthcare provider, you still need an advance directive. The advance directive appoints your healthcare proxy (primary and secondary) and covers many medical circumstances not covered by the POLST. Everyone should sign an advance directive, while those who are seriously ill may benefit from a POLST.

Action Steps

After completing your living will or advance directive, you will sign and typically have witnesses for your original document. Prepare several copies of your advance directive. You will want to give a copy to your healthcare agent, your family, clergy, your doctors and other advisors who may be involved in assisting with your medical decisions.

At any time you may revoke the living will or advance directive. It generally is best to revoke the entire document and complete a new document. If you attempt to amend different parts of the advance directive, there is a risk that you may sign provisions that conflict or are inconsistent. If you are in need of urgent care or treatment, you do not want any conflicting provisions in your living will or advance directive.

Your living will or advance directive is a very important part of your personal planning. It is designed to help you receive the best possible care at the end of your life and still comply to the greatest extent with your personal healthcare preferences.

I am 58 years old and working on a plan for my retirement. I have read that I need to check my Social Security statement every year to validate its accuracy. How do I go about doing this?

Checking your official Social Security statement every year is a smart move to make sure your posted earnings are correct and ensure you get the benefits you are entitled to. Many Americans do not take this precaution. In fact, most U.S. workers have never created a digital "my Social Security account" to access their statement information. Here is what you should know.

Online Statements

In 2017, as a cost cutting measure, the Social Security Administration stopped mailing paper Social Security statements to everyone under age 60.

The only people who still get statements in the mail are those over age 60 who are not yet getting benefits and who have not set up an online account. Paper statements, however, are still available upon request to anyone who submits Form SSA-7004.

If you have not done so, you should create a "my Social Security account." This account will give you instant access to your personal Social Security statements. You can check your earning record and get estimates of your future retirement benefits at full retirement age, as well as at age 62 and age 70. Your statements will also let you know how much you would qualify for if you become disabled and how much your family members could receive in survivors benefits when you die.

How to Create an Account

To create a "my Social Security account," go to SSA.gov/myaccount. You will be asked to enter your Social Security number and birth date. You will also be prompted to answer a series of multiple-choice questions that might include inquiries about financial products you own and previous addresses to confirm your identity. Then you will receive a code either by email or text, which you will enter online to complete the process.

If you have a problem creating an online account, call 800-772-1213. After you establish an account, you will get an annual email reminder to log on and review your statement.

If you have a security freeze on your credit report to help ward off fraud, you must lift it temporarily to set up your online Social Security account. Specifically, you will need to thaw the freeze at Equifax, the company the Social Security Administration currently uses to help verify users' identities.

Creating an online account is also a good idea to prevent someone else from fraudulently creating one first and using it to steal benefit payments in the future. Given the number of security breaches in recent years, it is possible someone may be able to illegally obtain your sensitive personal information, like your Social Security number, and use it to set up an account in your name.

Once you get access to your statement, compare the earnings listed on your statement with your own tax records or W-2 statements. You must correct errors within 3 years, 3 months and 15 days following the year of the mistake. If you happen to spot a discrepancy within that timeframe, call 800-772-1213 to report the error. Some corrections can be made over the phone. You may need to schedule an appointment and visit your local branch with copies of your W-2 forms or tax returns to prove the mistake, or you can mail it in.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.