Planning for death and having conversations about end-of-life decisions make most people uncomfortable. The fact is we often start to contemplate these things only after a life-changing event or as we begin to feel the effects of age creeping up on us. According to a study conducted by the AARP Research Group in 2000, people are more likely to get estate planning documents as they get older, with significant increases in the percentages of folks with wills at age 55 and 65 and similar increases in those with durable powers of attorney and living trusts at age 70.
While this is not a shocking trend, it is a problem. If some catastrophe were to befall us without the proper documents in place, the repercussions would be tough, not only for ourselves but for our loved ones. The problem of putting this sort of thing off is significant enough that the NHDD website links to multiple games to help people start the discussion and work their way through the topic (“Hello” ; “Go Wish”).
While there’s an array of advanced care planning documents available, the most commonly used (and generally most useful) are the medical power of attorney and directive to physicians and family or surrogates (aka an “advanced directive” or “living will”).
A medical power of attorney is intended, should you become incapacitated, to let the person you’ve designated interact with people in the medical realm (e.g., hospital personnel and primary care physicians) and make decisions on your behalf. In the event of incapacitation, a medical power of attorney, in combination with a durable power of attorney, can potentially help stave off the necessity and associated costs of a guardianship.
On the other hand, an advanced directive specifies some of your wishes for hospital care. Usually it says one of two things. In the event that you’re incapacitated, on life support, and the doctors decide you’re going to pass away, an advanced directive either says you want them to: (1) withhold all treatment, make you comfortable, and let you pass away; or (2) continue treatment and do everything they can to keep you alive.
Some people don’t want an advanced directive because they think it shifts some of the decision-making authority to their doctors and away from their family. They trust their family to make the right decisions under the circumstances, and they don’t want to do anything to get in their way. Having said that, I’ve heard two or three compelling reasons for creating an advanced directive.
First, by publishing your wishes ahead of time, it may help to prevent infighting among family members. Second, no matter which course you choose, an advanced directive can help relieve family members of the guilt and uncertainty of deciding whether to take you off life support. Lastly, an advanced directive that elects to end life support can potentially save your family a tremendous amount of money by preventing them from keeping your body alive after the doctor has determined you will not recover.
So, NHDD’s a good reminder to create an advanced care plan or, if you already have one, to dust it off and make sure it’s up-to-date. It’s also an opportunity to let your loved ones know where these documents are, so they can access them if needed, and to ensure that your primary care physicians (and any hospital that you may be rushed to in an emergency) have a copy of your up-to-date documents.
Remember: Advanced care planning is a key component of your estate plan and, like the rest of your estate plan, it needs periodic review and updates. Frequently, attorneys will provide these documents when drafting your will or estate plan, so if you’re unsure whether you have them, you may want to look at your estate plan or consult your attorney first.