End of Life Planning

January 1, 2014

Since we are all mortal, we will all personally face end of life issues. It is essential to have appropriate documents in place that will address both financial and healthcare matters that ultimately arise. In a recent survey completed by Boomer Market Advisor, 50% of respondents did not have a Will (and this rather startling finding is consistent with numerous other survey findings). In another recent survey of Boomers, 60% of respondents did not have other equally important documents in place that aid in taking care of medical issues at end of life. These types of documents include the power of attorney for healthcare and living will.

Most people are not eager to think about the situation when they cannot direct their own medical care because of illness or advanced age. But as we continue to live longer, these types of situations become more common place. By doing a little advance planning—listing your treatment preferences and naming the person(s) you would like to make healthcare decisions on your behalf—you prevent decision-making from winding up in the hands of estranged family members or doctors, and provide direction to those to whom you have delegated these important decisions. There is plenty of anecdotal evidence showing that medical care of dying people can be unnecessarily prolonged, expensive, and emotionally burdensome. According to Wikipedia, “Aggressive medical intervention leaves nearly two million Americans confined to nursing homes, and over 1.4 million Americans remain medically frail so as to survive only through the use of feeding tubes. As many as 30,000 persons are kept alive in comatose and permanently vegetative states.”

In order to avoid such end of life decision dilemmas for family members, the living will was created. A living will is a document that details the type of care you want in the event that you become incapacitated. The living will describes certain life prolonging treatments that the signer wishes to receive (or not receive) in the event that he/she suffers from a terminal illness or is in a permanent vegetative state. A living will does not become effective unless the signer is incapacitated. The living will allows a person to choose whether he or she wants to die naturally, without death being artificially prolonged by various medical procedures.

“What” a person decides is not so important as “that” he or she decides. If we do not make our intentions known in writing, our doctors and families will be forced to make those decisions for us. For further details about a living will under Georgia law and a sample living will, enter the following Google search: Understanding the Georgia Living Will

The power of attorney for healthcare is another type of planning document that allows the signer to delegate to someone broad authority to make any necessary health care decisions on the signer’s behalf if the signer becomes incapacitated. Doctors and other health care providers can then take instructions from this person. For further details about a POA for healthcare under Georgia law and a sample form, enter the following Google search: Georgia Statutory Short Form Durable Power

Some states, including Georgia, have a form called an Advanced Medical Directive. This form combines both the living will and the power of attorney for healthcare into one form. This really simplifies matters since only one form is needed instead of two. For further details about the Advanced Medical directive under Georgia law and a sample form, enter the following Google search: Georgia Advanced Directive

There are a couple of other forms that relate to healthcare decisions that people may want to consider adding to their library of important documents. A Do Not Resuscitate (DNR) form is a legal document signed by the Doctor that respects the wishes of a patient not to undergo CPR or Advanced Cardiac Life Support (ACLS) if the heart were to stop beating or if the patient were to stop breathing. Advanced medical directives are not accepted by Emergency Medical Services, but they must honor a DNR. To obtain Georgia’s form, enter the following Google search: Georgia DNR form

A Physician Order for Life-Sustaining Treatment (POLST) is a form that states the kind of medical treatment a patient prefers toward the end of their life so that they have more control over their end-of-life care. For Georgia’s form, enter the following Google search:Georgia POLST form

For those people who would like to donate organs at death, a person may consent by simply signing their driver’s license. See www.organdonor.gov

As this article addresses end of life issues, there is one other written communication which people may consider leaving to their loved ones, and that is a letter in which they pass on their wisdom and life lessons to family and friends. This letter is typically called an “ethical will” or “legacy will.” This type of will is a document written to communicate values and wisdom, history, stories and love from one generation to another. An ethical or legacy will might accompany the probated will and articulate the values of the deceased and provide an opportunity to express how and why life choices were made by the writer. Such communication may have greater meaning to the recipient than any financial assets that they may receive.

In summary, there are three types of documents that people should complete in preparation for the end of their lives. The first type enables people to give their assets to their desired recipients (Wills and Trusts). The second type lets people express their healthcare wishes, even if they are incapacitated (Living Wills, POAs for healthcare, Advanced Medical Directives, DNRs, and POLSTs). The final type allows people to share their life lessons and experiences with loved ones long after they are gone.

Proper planning for end of life issues will be especially appreciated by family and friends. As no one knows when their life may unexpectedly end, it is never too early to do the proper planning, and here at The Fiduciary Group, we want to make sure you’re prepared.

“You’ve got to be very careful if you don’t know where you are going, because you might not get there.” -Yogi Berra

AUTHOR:

MALCOLM BUTLER, JD