End-of-Life Decisions: Think Ahead
Although it can often seem unpleasant to contemplate one’s end-of-life decisions in the short-term, I strong advise my clients to consider their end-of-life wishes during estate planning.
Recently, the December 2014 issue of Consumer Reports had an article that discussed the end-of-life journey of Paul Scheier, a retired dentist who was diagnosed with lung cancer. Mr. Scheier had shared his wishes with his daughters more than a decade before he had been diagnosed: no ventilators, no resuscitations, no pain. As a result of his discussions, planning, and hospice care, he was able to die as he wished, at home surrounded by his loved ones.
The article referred to a report from the Institute of Medicine that confirmed what I had already noticed in talks with clients: “the U.S. health care system is poorly designed to deal with end-of-life concerns, particularly when it comes to considering the wishes of terminal patients.”
As a result, the article encouraged its readers to do two major steps that I recommend to all of my estate-planning clients:
- Create an advance directive to physicians (known as a “living will”)
- Draft and sign a Medical Power of Attorney, which will appoint a health care agent to make medical decisions for you if you become incapacitated.
In a Consumer Reports survey, only about one in five adults had an advance directive or a Medical Power of Attorney. Less than half of the people 65 years or older had these documents.
As the author of the article states, “Having such a plan in place eases the burden on family members and improves the odds that your passing will be under circumstances of your own choosing.”
Just as important as having a living will and medical power of attorney is making sure these documents will accessible in times of emergency. Give copies to your health care agent named in your Medical Power of Attorney, your family, and your doctors to add to your medical record.
In addition, discuss your wishes with everyone in your family, not the health care agent named in your Medical Power of Attorney. Although disagreements among family members about treatment choices may not be common, it is best to get everyone on the “same page,” as they may have different opinions regarding your care if the living will is activated.