Many people procrastinate estate planning. For some, the thought of these plans is uncomfortable. End-of-life planning can be one of the most uncomfortable areas within estate planning, but it is also one of the most important. One of the most important thing your plan can do for you is ensure that, when you are near the end of life and cannot make your own decisions, that the person making those decision for you is doing exactly what you'd want done.
There are many pieces that go into your estate planning puzzle. Most people, when they think about estate planning, they think about their will or living trust. In other words, they think about wealth distribution. Of course, there is much more that goes into truly complete estate planning. One of these other areas is end-of-life planning. It is an area that many people don't like to think about, much less talk about and plan for, but it is an absolutely vital area of your estate plan. For most people, their end-of-life planning wishes are put in writing in either their advance directive (a/k/a “living will”) or in their power of attorney for health care.
Inside these documents, the law gives you the opportunity to name someone, who will be known as your “surrogate” or “agent,” who is tasked with working with your healthcare providers and making your end-of-life decisions if you are in a position where you are unable to make those decisions for yourself.
Getting these documents in place is a vital part of ensuring that your end-of-life planning preferences are realized. This is, however, not the end of the process. A study recently released by the Yale University School of Medicine offers a clear representation of what else is involved, and how often people come up short. The study results showed a massive communication gap between those surveyed and their surrogates. According to a press release from the university, only around 20% of the surrogates could accurately state what the person's preferences for life-extending treatment actually were.
That is why communication is as important as having a plan written down on paper. In order to make sure that your healthcare surrogate actually makes the decision you wanted them to make - whether that decision is order the continuation of life-prolonging care, or that decision is to end the provision of that care or that decision is somewhere in between (such as providing only pain medication or only pain medication and nourishment) - you need to be sure that both of you are only the “same page.”
This means having an open and frank conversation about a very uncomfortable but very vital topic. Remember when you and your child had “the talk” when your child reached puberty? For some, this conversation (whether your surrogate is your child or someone else) may be no less awkward, but it is definitely no less important.
Having this talk accomplishes two major things. One, it helps iron out any potential communication gaps about your desires, which, as the Yale survey shows, occur far too frequently. Two, it allows you and your surrogate to ensure that you are both comfortable with that person acting on your behalf. If, for example, you've decided that you want, in certain situations, to have life-prolonging care stopped, you need to be sure that the person you're considering as your surrogate is prepared to do that job. She may have emotional or religious reasons why making such a decision would be difficult for her. Now is the time to get all this “on the table,” to make sure you choose wisely in selecting your surrogate (for the benefit of all of you.)